In who is cancer of the skin seen?
Blond, blue-eyed, fair-skinned people who live in sunny places and are out in the sun all day
Which types of skin cancer are most common?
- Basal cell carcinoma 50%
- Squamous cell carcinoma 25%
- Melanoma 15%
How are skin carcinomas diagnosed?
Full thickness incisional or punch biopsy at the edge of the lesion, including healthy skin
How does Basal cell carcinoma show up?
- Raised, waxy lesion or nonhealing ulcer
- Common in upper part of the face (above the lips)
How is basal cell carcinoma managed?
It does not metastasize, but can kill by relentless local invasion (Rodent ulcer). Tx by excition with healthy margin of at least 1 mm. Other lesions may develop later
how does squamous cell carcinoma of the skin present?
- nonhealing ulcer, with preference for the are below the lips (inc. lower lip).
- It can metastasize to lymph nodes
How is squamous cell carcinoma of the skin managed?
Excision with margins of 0.5-2 cm + node dissection if involved.
-RT is another option
How does Melanoma present?
- Usually in pigmented lesion (ABCD)
- Asymmetric, Irregular Borders, Different Colors within lesion, Diamete exceeds 0.5 cm
When should melanoma be suspected?
-In any pigmented lesion that changes in any way
How is melanoma treated?
- bx should provide dx and depth of invasion
- Lesions 4mm deep have terrible prognosis
- Lesions btwn 1-4 mm should be treated aggressively including node resection.
What is metastatic malignant melanoma? How is it treated?
- Melanoma that comes from a deep, invasive primary melanoma, but that recurs and can metastasize anywhere (not only common places like nodes, liver, lung, etc).
- It has no predictable time table (metastasis and death can occur at any time and take months to years).
- Interferon is the main therapy
