common mmalignant skin tumours, m elanoma, biopsy m ethods, surgical
DESCRIPTION
Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical. Therapy. Claire Temple MD MSc FRCSC Associate Professor, UW O Division of Plastic Surgery Hand and Upper Limb Centre. Skin Examination. Physical Examination. Overall skin type. Lesion description. - PowerPoint PPT PresentationTRANSCRIPT
Common MMalignant Skin
Tumours, M elanoma, Biopsy M ethods, Surgical Therapy
Claire Temple MD MSc FRCSC
Associate Professor, UW O
Division of Plastic Surgery
Hand and Upper Limb Centre
Skin Examination
Physical Examination
Overall skin type Lesion description
Fitzpatrick classification
I W hite II W hite III W hite IV Pale brown V Brown VI Dark brown/black
Always burns, never tans Always burns, little tan Slight burn, slow tan Slight burn, fast tan Rarely burns, dark tan Never burns, dark tan
Lesion description
Size in mm - two dimensions Color Surface characteristics –
scale(excess keratin) crust(dried serum) excoriated/erosion/ulcer
Lesion description
NOUN Macule/patch flat lesion<>1cmPapule/plaque raised lesion <>1cmNodule/tumour deep dermal lump <>1cmVesicle/bulla elevated fluid filled lesion<>1cm
If pigmented lesion, also describe:
A asymmetry B borders C color D diameter E elevation
Biopsy Techniques
Biopsy Techniques
Incisional Shave Punch
Incisional
ellipse
Excisional
Punch biopsy
Punch biopsy
Punch biopsy
Punch Biopsy
Incisional biopsy
Excisional Biopsy
Basal Cell Carcinoma
Etiology - MM ultifactorial
UVR (Sun, tanning beds) Ionizing radiation
Age >40 Fitzpatrick I, II phenotype Immunosuppression Old, unstable scars Genetic conditions Insecticides, hydrocarbons, arsenic
Basal Cell Carcinoma
Malignant tumour arising from basal cell layer of epidermis 90% of all skin cancers
40% of North Americans will develop a BCC 85% facial, 30% nose
Basal Cell Carcinoma
Nodular Form Telangiectatic papule
translucent
pearly rolled
border
Slow growing Rarely metastasizes
Variants
Nodular - 60%
Superficial
Pigmented Morpheaform or sclerosing
Nodular BCC
Rodent Ulcer
Sclerosing BCC
Somme Exammples to Practice
Pigmented Basal Cell Carcinoma
Superficial Basal Cell Carcinoma
Treatment
Prevention
Electrodessication/Curettage Surgical Excision with 4 mm margins
Mohs
Respect Basal Cell Carcinoma
Squamous Cell Carcinoma
Squamous Cell Cancer
Actinic Keratoses
SCC
Malignant lesion arising in epidermis Age >40 15% lifetime risk in Caucasians Risk of metastases 0.5-6% Thickened, ulcerated, erythematous lesion Examine nodal basins
SCC
Main treatment is surgical
6mm or wider margin
Radiation
May recur along nerves
May metastasize