WEEK TEN Flashcards
Causes of skin cancer?
Complexion Age Mole count Relatives Genetics Damaging effects of UV radiation Breakdown of Immune Protection
relative risks for skin cancer?
Naevi (Moles) >100: 7 times the risk for melanoma
History of solar keratosis: 4 times the risk
Pale skin with poor tanning ability: 3 times the risk
Living in Australia: 0.3 times the risk
One 1st degree relative with melanoma: 2.2 times the risk
History of sunburn: 1.9 times the risk
Non-occupational intermittent sun exposure 1:7 times the risk
Freckling skin: 1.5 times the risk
Caucasian race: overall increased risk
Define melonoma?
Melanoma is a malignant cancer that starts from the pigment cells (melanocytes) of the skin
Define basal cell carinoma?
A slow-growing neoplasm that is locally invasive but rarely metastasizes. It is derived frombasal cells, the deepest layer of epithelial cells of the epidermis or hair follicles
Define Squamous cell carcinoma?
“A carcinoma that arises from squamous epithelium and is the most common form of skin cancer
Treatment for skin cancers?
Surgery
Simple Excision
Re-excision (wide local excision)
Therapeutic lymph node dissection
Moh’s surgery
Amputation
psychosocial issues?
Pain Discomfort Distress Family fears of relapse Health information needs are unmet Need more psychological support Understanding life expectancy
Palliative care in melonoma?
Improved symptom control Overall satisfaction with care Reduction of patient and family anxiety Reduction of time in hospital Assistance in clarifying the goals of care
Define majorlins ulcers?
Marjolin’s ulcers are malignant tumours arising in chronic wounds. Strictly defined, they include carcinomas that transform from the chronic open wounds of pressure sores or burn scars. They behave aggressively and have a propensity for local recurrence and lymph node metastases
Majorlins ulcer screening
Personal screening by individuals
GP visit/ mole scanning
Dermoscopy
Digital monitoring – photographed 3 monthly
Overall screening should be done 6 monthly
Genetic Testing - Family history CDKN2A mutations 10%
Punch biopsy
Broad Shave biopsy
Deep Shave biopsy
Incisional biopsy
PET scans/ MRI or fine needle aspiration
Majorlins ulcer managment?
Wide excision of lesion
Split skin Graft
Amputation of extremity
Management of odour, pain & wound dressings
Documentation Discharge or home advice following a split skin graft
negative pressure dressings?
125 mm Hg: alternating pressure of 5 minutes of suction followed by 2 minutes off suction.
Optimises blood flow in the wound bed
Decreases local tissue swelling
Removes excessive fluid that can slow cell growth and proliferation in the wound bed
Decreases numbers ofbacteria
Wounds for negative pressure dressings?
Acute surgical Traumatic wounds Subacute Dehisced wounds Pressure ulcers Chronic and open wounds
Contraindications for negative pressure dressings?
Fistulas
Necrotic tissue
Osteomyelitis
Wounds due to skin cancer
Note: silver-containing dressings should not be used if the patient is sensitive to these.
potential complications of negative pressure dressings?
Pressure necrosis Damage to surrounding tissues Granulation extends into the foam dressing Pain Contact dermatitis Fistula formation Skin cancer in the wound bed
