Skin Cancer Sarah Boyce Sawyer MD Dermatology Laser
Skin Cancer Sarah Boyce Sawyer, MD Dermatology & Laser of Alabama
Skin Cancer l Melanoma l Squamous cell carcinoma l Basal cell carcinoma
Statistics 1, 000 CA 52(1): 10, 2002. BCC 350, 000 SCC 55, 000 1, 285, 000 MM All other
Lifetime Risk of Developing Melanoma 1: 71 1: 100 1: 150 1: 250 1: 600 1: 1, 500 1935 1960 1985 Rigel DS, et al. NYU Melanoma Cooperative Group, 2001. 1993 2001
Melanoma Facts (2002) l 6/7 skin cancer deaths. l More common than any other nonskin cancer in women 25 -29 years old. l Lifetime risk was 1/71 in the year 2001. l 1 person dies of melanoma every hour. l 6 th and 7 th most common cancer in men and women respectively.
Types of Melanoma l l l 1) 2) 3) 4) 5) Superficial spreading-70% Nodular-15% Acral lentiginous-8% Lentigo maligna-5% Other-2%
Acral Lentiginous Melanoma
Nodular Melanoma
Melanoma
Melanoma
Melanoma
Melanoma
Melanoma
Therapy for Melanoma l l l Excision +/- LND Sentinel lymphoscintigraphy No effective adjuvant therapy – – – Interferon alpha-2 b Radiation Chemotherapy
Dysplastic Nevi
Dysplastic Nevi
Non-melanoma skin cancer l Squamous cell carcinoma Basal cell carcinoma l Lifetime risk: 1 in 3 in Caucasians l
Squamous cell carcinoma l l Erythematous to skin-colored, hyperkeratotic, scaly papule/plaque +/- overlying crust or eschar, underlying induration, and ulceration. Differentiation – – – Well Moderate Poor
Squamous cell carcinoma l Higher risk for metastasis – – – Lower lip (16%) Osteomyelitic ulcer (31%), an area of prior radiation (20%), or burn scar (18%) “Modified” skin, e. g. , the glans penis, the vulva, or the oral mucosa The host is immunocompromised Diameter > 2. 0 cm
Squamous cell carcinoma
Squamous cell carcinoma
Squamous cell carcinoma
Basal Cell Carcinoma l l Most common skin cancer diagnosed Rarely metastatic (invades locally) Can be pearly papule or scaling macule/plaque From basal layer of epidermis
Types of basal cell carcinoma Nodulo-ulcerative or nodular l Superficial multifocal l Morpheaform or sclerosing l Pigmented l Fibroepithelioma l
Noduloulcerative l Translucent, waxy papule/plaque with “rollededge” border +/- central ulceration and telangiectasia
Noduloulcerative basal cell carcinoma
Noduloulcerative basal cell carcinoma
Superficial multifocal type l Ill-defined, erythematous, scaling papule/plaque with minimal underlying induration
Superficial multifocal type
Superficial multifocal type
Morpheaform or sclerosing type l Ill-defined, depressed, firm skin-colored to yellowish papule/plaque with rare ulceration
Morpheaform or sclerosing type
Pigmented basal cell carcinoma l Similar to nodular basal cell carcinoma but has pigment l Melanoma in differential diagnosis
Pigmented basal cell carcinoma
Fibroepithelioma • Fibroepithelioma – Pedunculated, skin-colored to erythematous papules 1 o on the trunk
Fibroepithelioma
Treatment l Shave ED & C l Excision l Mohs micrographic surgery
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