Skin Lesions Flashcards
What are the most common skin cancers?
- Basal cell carcinoma (75%)
- Squamous cell carcinoma (20%)
- Melanoma (4%)
What is the most common fatal skin cancer?
Melanoma
What is malignant melanoma?
A redundancy!
What is squamous cell carcinoma?
Carcinoma arising from epidermal cells
What are the most common sites for squamous cell carcinoma?
Head, neck, and hands
What are the risk factors for squamous cell carcinoma?
Sun exposure, pale skin, chronic inflammatory process, immunosuppression, xeroderma pigmentosum, arsenic
What is a precursor skin lesion for squamous cell carcinoma?
Actinic keratosis
What are the signs and symptoms of squamous cell carcinoma?
Raise, slightly pigmented skin lesion; ulceration or exudate; chronic scab; itching
How is the diagnosis of squamous cell carcinoma made?
Small lesion: excisional biopsy
Large lesion: incisional biopsy
What is the treatment for squamous cell carcinoma?
Small lesion ( 1 cm): Resect with 1-2-cm margins of normal tissue (may require skin graft or flap)
What is the dreaded sign of squamous cell carcinoma metastasis?
Palpable lymph nodes (remove involved lymph nodes)
What is Marjolin’s ulcer?
Squamous cell carcinoma that arises in an area of chronic inflammation (e.g. chronic fistula, burn wound, osteomyelitis)
What is the prognosis for squamous cell carcinoma?
Excellent if totally excised (95% cure rate)
What is the treatment for solitary metastasis of squamous cell carcinoma?
Surgical resection
What is basal cell carcinoma?
Carcinoma arising in the germinating basal cell layer of epithelial cells
What are the risk factors for basal cell carcinoma?
Sun exposure, pale skin, radiation, chronic dermatitis, xeroderma pigmentosum
What are the most common sites for basal cell carcinoma?
Head, neck, and hands
What are the signs and symptoms of basal cell carcinoma?
Slow-growing skin mass (chronic, scaly); scab; ulceration +/- pigmentation, pearl-like
How is the diagnosis of basal cell carcinoma made?
Excisional or incisional biopsy
What is the treatment for basal cell carcinoma?
Resection with 5-mm margins (2-mm in cosmetically sensitive areas)
What is the risk of metastasis of basal cell carcinoma?
Very low (recur locally)
What is an epidermal inclusion cyst?
Benign subcutaneous cyst filled with epidermal cells (should be removed surgically) filled with waxy material.
No clinical difference from a sebaceous cyst.
What is actinic keratosis?
Premalignant skin lesion from sun exposure.
Seen as a scaly skin lesion.
What is seborrheic keratosis?
Benign pigmented lesion in the elderly.
Observe or treat by excision (especially if there is any question of melanoma), curettage, or topical agents
What is Bowen’s disease of the skin?
Squamous carcinoma in situ (should be removed or destroyed, thereby removing problem)
What is Mohs surgery?
Repeats thin excision until margins are clear by microscopic review.
Used to minimize collateral skin excision.
