NON-MELANOCYTIC SKIN CANCERS AND MELANOMA

Question 1

What is basal cell carcinoma?

Answer 1

• is commonest form of skin cancer and accounts for all thirds of all non-melanocytic skin cancers

a persistent non-healing lesion, scaly spot or pinkish-red growth

• Arises from the single layer of basal cells that line the basement membrane which separate the dermis from the epidermis

Question 2

Where are basal cell carcinomas commonly found?

Answer 2

face

Question 3

How are basal cell carcinomas categorised?

Answer 3

nodular, pigmented, superficial, mropheaform or sclerotic lesion

Question 4

What is Squamous cell carcinoma (SCC)?

Answer 4

• is a common form of skin cancer. It tends to be of greater concern as it is an invasive cancer and may metastasise via the lings and bloodstreams
• Usually presents as rough, thickened, scaly lesion
• Tumour of the keratinising cells of the epidermis
• Characterised as non-invasive (superficial) or invasive

Question 5

How do non-melatonic skin cancers often present and get diagnosed?

Answer 5

• Sinister looking lesions
• Non-healing ulcer
• Diagnosis of BCC and SCC requires a biopsy of the lesion (punch, shave, excision) and histopathological examination of the tissue
• Regional lymph nodes should be examined for suspected SCC metastases

Question 6

What is the treatment for non-melatonic skin cancers?

Answer 6

• Surgical excision – removed layer by layer until tissue margins are tumour free
• Frozen with liquid nitrogen
• Radiation therapy (advanced BCC or SCC metastases)

Question 7

What is malignant melanoma?

Answer 7

• a skin lesion commonly on the back and extremities
• Once a melanoma breaks through the basement membrane of the epidermis it has the potential to grow horizontally along the junction between the epidermis and dermis
• Can disseminate any organ but occurs most commonly in skin and subcutaneous tissue, lymph nodes, brain, bone, liver and the gastrointestinal tract

Question 8

How is a melanoma recognised?

Answer 8

ABCDE (asymmetry, border irregularity, colour variation, diameter greater than 6mm, and elevation of the lesion

Question 9

What is the medical treatment for melanoma?

Answer 9

• Intervention depends on the stage of the disease at diagnosis
• Excision for Stage 1 tumour or small lesion of less than 1mm with no ulceration
• Stage II (intermediate thickness) between 1 and 4 mm require a 2cm incision margin
• Stage III local incision and systemic chemotherapy and radiation
• Stage IV – if surgery is unlikely to be successful the patient is considered for palliation