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 Carcinoma Treatment 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 But this is still controversial, and these recommendations change often

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 In addition to seborrheic keratoses mentioned earlier, I’m going to end with a few pictures of benign skin lesions that I see all the time, just so you are familiar with these growths -cherry angiomas are the small, red, round, fleshy papules that we all get starting around the age 30. Genetics determine how many we get, but sun exposure also likely plays a role. They are caused by a proliferation of a superficial blood vessel in our skin. They are benign and no treatment is necessary, but if a patient wants cosmetic treatment, they can be referred to a physician who has a vascular laser that destroys the blood vessells causing the lesion

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.