Skin Lesions, C63 P469-471 Flashcards
What are the most common
skin cancers?
P469
- Basal cell carcinoma (75%)
- Squamous cell carcinoma (20%)
- Melanoma (4%)
What is the most common
fatal skin cancer?
P469
Melanoma
What is malignant
melanoma?
A redundancy! All melanomas are
considered malignant!
SQUAMOUS CELL CARCINOMA
What is it?
P469
Carcinoma arising from epidermal cells
SQUAMOUS CELL CARCINOMA
What are the most common
sites?
P469
Head, neck, and hands
SQUAMOUS CELL CARCINOMA
What are the risk factors?
P469
Sun exposure, pale skin, chronic
inflammatory process, immunosuppression,
xeroderma pigmentosum, arsenic
SQUAMOUS CELL CARCINOMA
What is a precursor skin
lesion?
P469
Actinic keratosis
SQUAMOUS CELL CARCINOMA
What are the signs/symptoms?
P469
Raised, slightly pigmented skin lesion;
ulceration/exudate; chronic scab; itching
SQUAMOUS CELL CARCINOMA
How is the diagnosis made?
P469
Small lesion—excisional biopsy
Large lesions—incisional biopsy
SQUAMOUS CELL CARCINOMA
What is the treatment?
P469
Small lesion ( < 1 cm): Excise with 0.5-cm
margin
Large lesion ( >1 cm): Resect with 1- to
2-cm margins of normal tissue (large
lesions may require skin graft/flap)
SQUAMOUS CELL CARCINOMA
What is the dreaded sign of
metastasis?
P469
Palpable lymph nodes (remove involved
lymph nodes)
SQUAMOUS CELL CARCINOMA
What is Marjolin’s ulcer?
P469
Squamous cell carcinoma that arises in an
area of chronic inflammation (e.g., chronic
fistula, burn wound, osteomyelitis)
SQUAMOUS CELL CARCINOMA
What is the prognosis?
P470
Excellent if totally excised (95% cure rate);
most patients with positive lymph node
metastasis eventually die from metastatic
disease
SQUAMOUS CELL CARCINOMA
What is the treatment for
solitary metastasis?
P470
Surgical resection
BASAL CELL CARCINOMA
BASAL CELL CARCINOMA
What is it?
P470
Carcinoma arising in the germinating
basal cell layer of epithelial cells
BASAL CELL CARCINOMA
What are the risk factors?
P470
Sun exposure, fair skin, radiation, chronic
dermatitis, xeroderma pigmentosum
BASAL CELL CARCINOMA
What are the most common
sites?
P470
Head, neck, and hands
BASAL CELL CARCINOMA
What are the signs/symptoms?
P470
Slow-growing skin mass (chronic, scaly);
scab; ulceration, with or without pigmentation,
often described as “pearl-like”
BASAL CELL CARCINOMA
How is the diagnosis made?
P470
Excisional or incisional biopsy
BASAL CELL CARCINOMA
What is the treatment?
P470
Resection with 5-mm margins (2-mm
margin in cosmetically sensitive areas)
BASAL CELL CARCINOMA
What is the risk of
metastasis?
P470
Very low (recur locally)
MISCELLANEOUS SKIN LESIONS
What is an Epidermal
Inclusion Cyst?
P470
EIC = Benign subcutaneous cyst filled
with epidermal cells (should be removed
surgically) filled with waxy material; no
clinical difference from a sebaceous cyst
MISCELLANEOUS SKIN LESIONS
What is a sebaceous cyst?
P470
Benign subcutaneous cyst filled with sebum (waxy, paste-like substance) from a blocked sweat gland (should be removed with a small area of skin that includes the blocked gland); may become infected; much less common than EIC
MISCELLANEOUS SKIN LESIONS
What is actinic keratosis?
P471
Premalignant skin lesion from sun
exposure; seen as a scaly skin lesion
(surgical removal eliminates the 20% risk
of cancer transformation)
MISCELLANEOUS SKIN LESIONS
What is seborrheic
keratosis?
P471
Benign pigmented lesion in the elderly;
observe or treat by excision (especially
if there is any question of melanoma),
curettage, or topical agents
MISCELLANEOUS SKIN LESIONS How to remember actinic keratosis vs. seborrheic keratosis malignant potential? P471
Actinic Keratosis = AK = Asset Kicker
premalignant
Seborrheic Keratosis = SK = Soft
Kicker = benign
MISCELLANEOUS SKIN LESIONS
What is Bowen’s disease of
the skin?
P471
Squamous carcinoma in situ (should be
removed or destroyed, thereby removing
the problem)
MISCELLANEOUS SKIN LESIONS
What is “Mohs” surgery?
P471
Mohs technique or surgery: repeats thin excision until margins are clear by microscopic review (named after Dr. Mohs)—used to minimize collateral skin excision (e.g., on the face)
