BCC vs SCC

Question 1

What are some risk factors in the development of SCC?

Answer 1

• excessive exposure to sunlight
• actinic keratoses and Bowen’s disease
• immunosuppression e.g. following renal transplant
• smoking
• long-standing leg ulcers (Marjolin’s ulcer)

Question 2

What is Bowen’s disease?

Answer 2

A type of intraepidermal SCC. (SCC in situ) it doesn’t invade the deeper layers of skin and thus is like a precusor to SCC.

It is more common in females.

Question 3

What is this?

Answer 3

Bowen’s disease

Question 4

What is this?

Answer 4

Squamous cell carinoma

Question 5

What is this?

Answer 5

Squamous cell carinoma

Question 6

What is this?

Answer 6

Bowen’s disease

Question 7

What is this?

Answer 7

A keratoacanthoma.

Question 8

What is a keratoacanthoma?

Answer 8

• A benign epithelial tumour.
• Looks like a smooth dome shaped papule and rapidly grows to become a crater centrally filled with keratin.
• Treatment - spontaneous regression within 3 months is common. But it can be difficult to exclude SCC so urgent referral for excision is treatment of choice.

Question 9

What is this?

Answer 9

Squamous cell carcinoma

Question 10

What is this?

Answer 10

BCC

Question 11

What is this?

Answer 11

Nodular BCC

Question 12

What is more likely to metastasize SCC or BCC?

Answer 12

Both rarely metastasize BUT

4% of SCC will metastasize whilst BCC rarely ever.

Question 13

What is the management option for a BCC?

Answer 13

1. surgical removal
2. curettage
3. cryotherapy
4. topical cream: imiquimod, fluorouracil
5. radiotherapy

GPs can do it but the crieteria for doing it is so vast, better to refer.

Question 14

What are the 4 main types of BCC?

Answer 14

1. Cystic/Nodular BCC
2. Superficial BCC
3. Pigmented BCC
4. Morphoeic BCC

Question 15

What is this

Answer 15

Nodular/Cystic BCC

Question 16

What is the most common type of BCC on the face?

Answer 16

Nodular/Cystic BCC

Question 17

What is this a picture of?

Answer 17

A pigmented BCC

Brown, blue or greyish lesion

Question 18

What is this a picture of?

Answer 18

Morphoeic BCC

Question 19

What is this a picture of?

Answer 19

A superficial BCC

Tends to occur in younger patients

Question 20

What is this a picture of?

Answer 20

A nodular/ cystic BCC

They may have a central ulcer so its edges appear rolled

Question 21

What is this a picture of?

Answer 21

Nodular/cystic BCC

Small, shiny, skin coloured or pinkish lump

Question 22

What is the treatment for this?

Answer 22

This is a keratocanthoma.

Treatment - spontaneous regression within 3 months is common. But it can be difficult to exclude SCC so urgent referral for excision is treatment of choice.

Question 23

What is this?

Answer 23

Keratocanthoma