Non-Melanoma Skin Cancers and Benign Skin Tumours Flashcards
How common is non-melonoma skin cancer?
the commonest cancer in UK
What are examples of non-melanoma skin cancer?
basal cell carcinoma (BCC)
squamous cell carcinoma (SCC)
What are the precursors of SCC?
Actinic keratosis Intraepidermal carcinoma
What are the risk factors for developing non-melanoma skin cancer?
Long term UV light exposure
Fair skin type
Increasing age
Immunosuppression
Genetic - goblins syndrome (BCCs), xeroderma pigmentosum
Sites of chronic inflammation, wounds, scars
Human papillomavirus (SCC)
How common is BCC?
80% of all non melanoma skin cancers
How does BCC present?
slow growing, locally invasive usually asymptomatic most common location is head and neck but may also be present on non sun-exposed areas
How serious is a BCC?
very low metastatic potential but locally invasive
What are the BCC subtypes?
Nodular Superficial Morpheic/Sclerosing Pigmented
What are the signs seen that suggest a BCC?
well defined erythematous papulonodules or plaques ulcerating crust telangectasia pearly white rolled edge may bleed, become fibrotic and scar
What are the factors that lead to increased risk of recurrence in basal cell carcinoma?
Increasing tumour size Tumour site - lesions on central face are at higher risk of recurrence
Poorly defined clinical margins
Histological subtype
Histological features of aggression (perineurial and perivascular invasion)
Previous treatment failure - recurrent lesions are at higher risk of further recurrence
What are the treatment options for BCC?
Simple excision
Mohs’ micrographic surgery
Surgical, histological margins not examined (destructive methods) - curettage and cautery, cryotherapy
What are the non-surgical treatment options for BCC?
Radiotherapy
Imiquimod (Aldara)
Photodynamic therapy
How common are SCC?
20% of all skin cancer
Do SCC metastise?
can metastasise
What are the survival rates of SCC?
overall 5 year survival - 75-90% for metastatic disease - 25%
What are the factors that increase metastatic potential in SCC?
Site - ear, lip
Size >2cm
Depth - thicker>thinner
Aetiology - non sun exposure sites, areas of chronic inflammation
Differentiation - poorly>moderately>well differentiated Immunosuppression
Mucosal SCC > cutaneousSCC
Perineural invasion
How can SCC appear?
skin coloured nodule with central keratin
fleshy nodule with eroded surfacenon healing ulcer
What are the treatment options for SCC?
Simple excision
Mohs’ micrographic surgery
Radiotherapy
What is actinic keratosis?
also known as solar keratosis very common dysplastic lesions with small risk of progression to SCC
What is the treatment for actinic keratosis?
cryotherapy 5-fluorouracil cream (efudix) curettage and cautery photodynamic therapy diclofenac gel (solareze) imiquimod
What is an intraepidermal carcinoma (IEC)?
bowen’s disease
intraepithelial carcinoma
squamous cell carcinoma in-situ
full thickness epidermal dysplasia
What are the treatment options for IEC?
5-fluoouracil cream (efudix) cryotherapy curettage and cautery excision photodynamic therapy imiquimod
What is a cutaneous horn?
compacted keratin may have AK/IEC/SCC at the base can be benign
How should a cutaneous horn be treated?
excise lesion - histology
