Basal Cell Carcinoma

Basal Cell Carcinoma

Basal Cell Carcinoma• Malignancy of the basal keratinocytes of the epidermis• Caused by ultraviolet radiation; more common in fair

skinned individuals• Most common skin cancer• Very rarely metastasizes. Locally grows• Several different types with different appearances• Most common on the head and neck followed by the

trunk then the extremities• Diagnosis: skin biopsy• Nonhealing scars should undergo biopsy to exclude

carcinoma

Basal Cell CarcinomaTreatment

• Excision with 0.5 cm margins• Curettage and electrodessication• Mohs’ micrographic surgery• Radiation• Cryosurgery• 5-Flurouracil or imiquimod cream for

superficial basal cell carcinomas

Melanoma

Melanoma

ABCDE’s of Melanoma

Malignant Melanoma• Malignancy of the pigment-forming cells or melanocytes

within the epidermis• Exact cause is unknown but sunlight, heredity, and a large

number of moles are risk factors• Incidence of melanoma is increasing faster than any other

cancer in the USA• Melanomas tend to metastasize to lymph nodes, lungs, and

brain• Several different types depending on location, growth

pattern, metastatic potential, but overall, most common location is back for men and lower legs for women

• Diagnosis: excisional biopsy

Malignant Melanoma Course and Treatment

• Thin melanoma is curable with wide excision• Margin recommendations: – 0.5 cm for melanoma-in-situ – 1 cm for tumors <2 mm in thickness– 2 cm for tumors >2 mm in thickness

• Prognosis is best predicted by depth of invasion into the skin

• If invades >1 mm, sentinal lymph node biopsy is recommended

• If have a deep tumor, positive lymph nodes, or metastasis is noted on PET scan, chemotherapy, immunotherapy, and radiation can be discussed

Cherry Angioma

Solar Lentigo

Benign Nevus

Dermatofibroma

References

• Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology. 3rd edition. Saunders Elsevier, PA; 2012.

• James WD, Berger TG, Elston DM. Andrews’ Diseases of the Skin: Clinical Dermatology. 11th edition. Saunders Elsevier, PA; 2011.

• Lebwohn MG, Heymann WR, Berth-Jones J. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th edition. Saunders Elsevier, PA; 2014.

• Marks JG, Miller JJ. Lookingbill and Marks’ Principles of Dermatology. 4th edition. Saunders Elsevier, PA; 2006.