BCC, SCC and Melanoma

Question 1

What is the presentation of a BCC?

Answer 1

sun exposed areas
pearly, rolled edge with telangiectasia
may later ulcerate to form a crater

Question 2

What is the management of a BCC?

Answer 2

surgical removal
curettage
cryotherapy
topical imiquimod or fluorouracil 
radiotherapy

Question 3

What are the risk factors for SCC?

Answer 3

excessive sunlight exposure
actinic keratoses or Bowen's disease
immunosuppression
smoking
long standing leg ulcers (Marjolin's ulcer)

SCC is a hyperkeratotic lesion w/ crusting and ulceration

Question 4

What is the treatment for SCC?

Answer 4

surgical excision within 4mm if margins are <20mm

if tumour >20mm, margins should be 6mm

Question 5

What factors indicate a good prognosis for SCC?

Answer 5

Well differentiated
<20mm diameter
<2mm deep
No associated diseases

Question 6

Outline the ABCDE of melanoma

Answer 6

Asymmetrical
Border is irregular, ragged or blurred
Colour: multiple colours seen
Diameter: >0.25 inches 
Evolving: changing in size, shape, colour

Question 7

What is the single most important factor in determining the prognosis of patients with a melanoma?

Answer 7

Breslow depth

The invasion depth of a tumour

Question 8

What is the major criteria for the diagnosis of a melanoma

Answer 8

Change in size
Change in shape
Change in colour

Question 9

What are the investigations of a melanoma?

Answer 9

1) dermatoscopy, skin biopsy

2) sentinel lymph node biopsy, LDH, CXR

Question 10

What is Bowen’s disease?

What is the treatment of Bowen’s disease?

Answer 10

also known as intraepidermal squamous cell carcinoma
occurs in elderly people in sun exposed areas
red, scaly patch

topical fluorouracil or imiquimod
cryotherapy
excision