Skin Cancers Flashcards
Types of Skin Cancer
- Basal cell carcinoma
- Squamous cell carcinoma
- Malignant melanoma
Malignant Melanoma: What is it?
- tumors arising from malignant transformation of melanocytes (pigment-producing cells)
- leading cause of death due to skin disease
- incidence has doubled over past 30 years
- tumor thickness is the single most important prognostic factor
- lymph node involvement and metastases decrease survival
Malignant Melanoma: Assessment
- use the ABCDE mnemonic
- be suspicious of any moles that look different than the others
- look on the hands, soles of feet, and nails of dark-skinned individuals
Malignant Melanoma: ABCDE
A - asymmetry of lesion
B - borders, irregular
C - color (blue/black or variegated)
D - diameter greater than 6 mm
E - elevation above skin level
** Refer immediately if suspected!!!
Malignant Melanoma: Diagnostic Tests
- clinical exam
- biopsy
Malignant Melanoma: Prevention
- sunscreen with at least 45 SPF
- wide brimmed hats
- long sleeves when in the sun
- avoid tanning bed use
- avoid sun exposure at peak hours (10-4)
- instruct to do a full body exam once per month and notify HCP of any changes
Malignant Melanoma: Treatment
- complete excision of the melanoma
- refer for sentinel lymph node biopsy, complete excision, and chemotherapy
- F/U every 3-6 months after treatment complete for skin reassessment
Squamous Cell Carcinoma: What is it?
- epithelial tumors arising from the keratinocytes of the epidermis
- may arise from actinic keratosis
Squamous Cell Carcinoma: Risk Factors
- fair skinned organ transplant patients
- smokers
- Same risk factors as other skin cancers
Squamous Cell Carcinoma: Assessment
- indistinct margins
- surface is firm, scaly, irregular
- may bleed easily
- may appear as a nonhealing ulcer or warty nodule
Squamous Cell Carcinoma: Prevention
- nicotinamide 500 mg PO BID can decrease the rate of development by 30% in high risk groups
- sunscreen with at least 45 SPF
- wide brimmed hats
- long sleeves when in the sun
- avoid tanning bed use
- avoid sun exposure at peak hours (10-4)
- instruct to do a full body exam once per month and notify HCP of any changes
Squamous Cell Carcinoma: Diagnostic Tests
- clinical exam
- biopsy
Squamous Cell Carcinoma: Treatment
- Preferred treatment for invasive SCC is excision or Mohs micrographic surgery
- SCC in situ can be treated with imiquimod
OR - 5-fluorouracil
OR - curettage and electrodessication
*** REFER
Squamous Cell Carcinoma: Follow-Ups
Complete skin assessment is needed every 3 months with careful examination of lymph nodes for a year, then twice yearly afterward
Basal Cell Carcinoma: What is it?
- tumors arising from the basal cell layer of the skin and skin appendages
- most common form of skin cancer
- metastasis is rare
- slow growing
- commonly found on the face, head, and neck