skin cancer sarah boyce sawyer, md dermatology & laser of alabama
TRANSCRIPT
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Skin Cancer
Sarah Boyce Sawyer, MDDermatology & Laser of Alabama
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Skin Cancer
Melanoma
Squamous cell carcinoma
Basal cell carcinoma
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Statistics
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
BCCBCC SCC MM All other
1,000,000 350,000 55,000 1,285,000
CA 52(1):10, 2002.
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Lifetime Risk of Developing Melanoma
Rigel DS, et al. NYU Melanoma Cooperative Group, 2001.
19351935 19601960 19801980 19851985 19931993 20012001
1:1,5001:1,500
1:6001:600
1:2501:250
1:1501:150
1:1001:100
1:711:71
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Melanoma Facts (2002)
6/7 skin cancer deaths. More common than any other nonskin
cancer in women 25-29 years old. Lifetime risk was 1/71 in the year 2001. 1 person dies of melanoma every hour. 6th and 7th most common cancer in men
and women respectively.
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Types of Melanoma
1) Superficial spreading-70% 2) Nodular-15% 3) Acral lentiginous-8% 4) Lentigo maligna-5% 5) Other-2%
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Acral Lentiginous Melanoma
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Nodular Melanoma
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Melanoma
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Melanoma
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Melanoma
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Melanoma
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Melanoma
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Therapy for Melanoma
Excision +/- LND Sentinel lymphoscintigraphy No effective adjuvant therapy
– Interferon alpha-2b– Radiation– Chemotherapy
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Dysplastic Nevi
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Dysplastic Nevi
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Non-melanoma skin cancer
Squamous cell carcinoma Basal cell carcinoma
Lifetime risk: 1 in 3 in Caucasians
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Squamous cell carcinoma
Erythematous to skin-colored, hyperkeratotic, scaly papule/plaque +/- overlying crust or eschar, underlying induration, and ulceration.
Differentiation– Well– Moderate– Poor
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Squamous cell carcinoma
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
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Squamous cell carcinoma
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Squamous cell carcinoma
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Squamous cell carcinoma
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Basal Cell Carcinoma
Most common skin cancer diagnosed Rarely metastatic (invades locally) Can be pearly papule or scaling
macule/plaque From basal layer of epidermis
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Types of basal cell carcinoma
Nodulo-ulcerative or nodularSuperficial multifocalMorpheaform or sclerosingPigmentedFibroepithelioma
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Noduloulcerative
Translucent, waxy papule/plaque with “rolled-edge” border +/- central ulceration and telangiectasia
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Noduloulcerative basal cell carcinoma
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Noduloulcerative basal cell carcinoma
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Superficial multifocal type
Ill-defined, erythematous, scaling papule/plaque with minimal underlying induration
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Superficial multifocal type
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Superficial multifocal type
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Morpheaform or sclerosing type
Ill-defined, depressed, firm skin-colored to yellowish papule/plaque with rare ulceration
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Morpheaform or sclerosing type
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Pigmented basal cell carcinoma
Similar to nodular basal cell carcinoma but has pigment
Melanoma in differential diagnosis
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Pigmented basal cell carcinoma
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Fibroepithelioma
• Fibroepithelioma– Pedunculated, skin-colored to
erythematous papules 1o on the trunk
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Fibroepithelioma
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Treatment
Shave ED & C
Excision
Mohs micrographic surgery