Non-melanoma skin cancers Flashcards
which is the most common malignant skin ca
basal cell carcinoma (rodent ulcer)
BCC arise from
hair follicals
what layer of skin affected in BCC
epidermis
BCC is the most common ca in Europe!
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RF for BCC
genetics
UV radiation
skin types I and II (skin that always burns and never/only sometimes tans)
immunosuppression
commonest site of BCC
head and neck (sun exposed)
BCC lesions look lie…
usually small, translucent/pearly with raised areas with telangiectasia
classic BCC has indurated edge and ulcerated centre
when to refer
low risk BCCs -> managed in primary care
high risk -> 2ndry care
what is low risk BCC
> 24, NOT on head and neck, <1cm, clearly defined, not a recurrent/persistent BCC, in a place that is easy to excise (e.g. not over major nerve or where good cosmetic result is important)
rx of BCC and SCC
1st line = excision
other options incl: curettage and cautery, cyrotherapy, topical rx (imiquimod cream), photodynamic therapy, radiotherapy, Mohs’ micrographic surgery (
2nd most common skin cancer?
SCC
which metastasises out of BCC and SCC
SCC
RF for SCC
UV light fair skin arsenic and chromium, soot, tar HPV ionising radiation exposure immunodeficiency
scc lesion looks like
- non healing growth
- sun exposed area
- small red nodule enlarges and centre becomes necrotic and sloughs, developing into ulcer
- slow growing
- bleeding may occur
ix of ? skin ca
usually diagnose by visual inspection
-excise for rx and then send for histology to confirm dx
in advanced stages, may need CT or lymph node biopsy
staging for SCC
TNM
staging for BCC
not needed apart from examining for lymph node involvmenet
BCC vs SCC referral
BCC mostly managed in primary care but can be referred on routine referral pathway if necessary
SCC refer 2ww
prevention
avoid sun, use sunscreen
