BCC & SCC (562-574) Flashcards
What are the characteristic features of a keratoacanthoma?; ADD PIC
Dome shaped nodule. Keratin plug. Rapidly grows for 4 months and then regresses within 1 year
What are the characteristic features of a BCC?;
Rolled pearly edges.Telangiectasia. Typically small and slow-growing with central ulceration. Unlikely to metastasis or have lymph node involvement.
What are the types of BCC?;
Nodular (pink pearly nodule with telangiectasia) superfical (erythematous scaly plaque), Morphoeic (sclerosing plaque with poorly defined borer), Basosquamous (mixed BCC and SCC),
What is commonest type of BCC?;
Nodular (50-70%)
Name some risk factors for BCC;
Long term UV exposure- repeated sun burn, sun beds, lack of skin crame. Genetic- fair skin (Fitzpatrick type 1 skin), family history, Gorlin syndrome. Other- immunosuppression (e.g. transplant patient have a 10 times risk of skin cancer)
What are characteristic features of an SCC?;
Highly variable. Can appear nodular, indurated or keratinisied with associated ulceration or bleeding. Margins everted (unlike BCC).Exophytic (grows outwards beyond surface). Potential to metastasis via lymphatic system then most commonly to lungs or liver.
How would you manage a 1x1cm sized BCC over the following regions in a 77 year old male (with no previous hx of BCCs and no significant PMH)?
A) Over the vertex of the scalp.
B) Over the alar region of the nose.
C) Over the temple.
D) 2mm inferior to the lower eye lid.
A) excise up to periosteum. Close with skin graft or local flap.
B) Excise. Close with naso-labial flap.
C) Excise. Close with local flap.
D) Excise. Closure dependant on procedure choice (Usually MOHS procedure done [margin controlled excision]).
What surgical margins would you consider for a biopsy-proven BCC?;
3-5mm margin.
What are the managemnt options for a cutaneous SCC over the head and neck region?;
Surgical excision +/- lymph node removal (requires imaging). MOHS surgery if anatomically difficult area.
What surgical margins would you consider for a biopsy-proven SCC?;
6-10mm
What characterist features of a venous lef ulcer?;
Shallow ulcer. Sloping edges. Granular wound. Highly exudating wound. Hemosidin staining. Lipodermatosclerosis. Usually in gaiter area (inverted champagne bottle leg)
What is Marjolin’s ulcer?;
Malignant transformation of long standing ulcer or scar to squamous cell carcinoma.
What are the characteristic features of an arterial leg ulcer?;
Punched out appearance. Pale or necrotic wound tissue. Pale skin, shiny. Absence of hair. Atrophy of muscle. Often between toes over phalangeal heads r tips of toes or lateral malleolous (bony points). [Make sure to do ABPI]
