Chapter 8: Skin Surgery Flashcards
1
Q
Incidence of different types of skin cancer:
A
- basal cell: 50%
- SCC: 25%
- Melanoma: 15%
2
Q
How do you diagnose different cancers?
A
- full-thickness incisional or punch biopsy at edge of lesion (including normal skin)
3
Q
Basal cell carcinoma description?
A
- waxy, raised lesion or non-healing ulcer
- prefers upper part of face (above line drawn across lips)
- doesn’t metastasize but signif local damage
Tx: local excision w negative margins (1mm) is curative
4
Q
Squamous cell carcinoma description?
A
- non-healing ulcer that has a preference for the lower lip and territories below a line draw across the lips
- can metastasize to lymph nodes
Tx: excision has WIDER margins (0.5-2 cm) compared to bcc. Node dissection is also done and radiation therapy is another option.
5
Q
Melanoma description?
A
1. pigmented lesion Asymmetric Borders irregular Color (different colors) w/i lesion Diameter (exceeds 0.5 cm) Evolution (changes--i.e. gets bigger, ulcerates, changes color or shape, bleeds)
6
Q
Prognosis of skin lesions by depth:
A
- less than 1 mm deep: good prognosis, only local excision
- deeper lesions: wider margins with excision (2-3cms)
- lesions deeper than 4mm have a very poor prognosis
- lesions between 1-4 cm–> do aggressive therapy including node dissection
7
Q
Places that malignant melanoma metastasizes?
A
Weird places;
- muscle of left ventricle
- wall of duodenum
- anywhere!
Conventional places; lymph nodes liver lung brain bone
8
Q
Natual history of malignant melanoma?
A
no predictable timeline!
months-decades bw diagnosis and metastasis
9
Q
What’s the preferred adjuvant systemic therapy for metastatic melanoma?
A
interferon