Skin Cancers Flashcards
What are the general risk factors for skin cancers?
Increasing age, sun bed use, sun exposure/Hx sunburn, family Hx, fair skin, outdoor occupation
Sqamous Cell Carcinoma - more common in men or women?
Men
What are the clinical features of SCC?
- Solitary papule/nodule often eroded in centre, crusty, pus-producing or bleeding
- Usually fleshy lesion
- usually on sun-exposed areas esp. LIPS
- May ulcerate
Differential diagnosis of SCC?
Keratocanthoma
Actinic keratosis
BCC
seborrhoeic wart
How do you diagnose SCC?
Do a skin biopsy - shave/punch/incisional and examined histologically.
If it has spread (unlikely) - do CT/MRI and lymph node biopsy
Management of SCC?
Surgical excision 4mm margin Curettage and cautery Pre-malignant: - cryotherapy - photodynamic therapy - topical imiquinod/5 fluorouracil cream
Which is more likely to spread? BCC or SCC?
SCC
What are the clinical features of BCC?
- “pearly nodule with raised, red edge with telangiectasia and central ulceration”
- Usually nodular
- May be erythematous, non-pigmented
- May be plaque-like
- Sometimes crusts-over
What is a rodent ulcer?
Basal-Cell carcinoma. Typically ulcerated centre and raised edge
Types of BCCs
Nodular
Superficial
Pigmented
Morphoiec
How do you diagnose BCC?
Skin biopsy - punch/shave/incisional. Examined histologically.
Differential diagnosis of BCC?
Nodular: molluscum contagiosum, keratocanthoma
Superficial: Psoriasis, actinic keratosis, SCC
Pigmented: Melanoma
Morphoeic: scar tissue, localised scleroderm
Management of BCC
Surgical excision: 5-4mm margin Curettage, cautery Cryotherapy Moh's micrographic surgery Topical imiquinod/5-fluorouracil cream
What is a melanoma?
Malignant tumour of melanocytes with potential for dermal invasion and metastatic spread
What are the risk factors for melanoma?
- Genetic markers
- Family Hx of dysplastic naevi/melanoma
- Moles (melanocytic naevi) >50, >5mm
- Skin type I & II
- Sunburns in childhood (10yrs)
- UV radiation
- Immunosuppression
