1. Skin Cancer
Diagnoses and Treatments

2. Aims NICE/IOG Use of the dermatoscope Pre malignant lesions BCC SCC
Melanoma
‘quiz’

3. Reasons for referral

4. Diagnoses

5. Biopsies 2008

6. NICE guidance Issued Feb 2006 Low risk BCCs, AKs primary care
High risk BCCs, SCC, melanoma, ? diagnosis refer
BCCs should not be referred via 2 week wait
Guidelines are being revised.
GPSI with interest in skin cancer
NB accreditation

7. Skin surgery Send all specimens for pathology
Accurate information on pathology form, eg site, clinical description
One specimen, one pot

8. Let there be light !

9. Types of dermatoscope

10. Lesion ‘turned black’

13. Distinguish vascular lesions from pigmented ones
Distinguish melanocytic lesions from seb warts
Adjunct to diagnosis
If in doubt refer

14. Diagnosis ?

15. Management of pre- malignant non pigmented lesions
Diagnostic biopsy
Curettage
Efudix
PDT
excision

17. ~ 100 000 non melanoma skin cancers / year
80% NMSC occur > 60 years of age
95 % survival in NMSC overall
~ melanomas / year
Incidence doubling every 10 years

18. SCC - prognosis
Lip
Ear
Immunocompromised pt
Higher recurrence rates

20. Treatments for NMSC
Excision
Radiotherapy
Mohs surgery

21. Mohs surgery Microscpoically controlled Margins examined
Precise removal of tumour
Used in cosmetically important areas
Tissue sparing

30. Malignant melanoma Commonest cancer in 15 -34 age group
Commoner than cervical cancer in women
Average 20 years loss of life for each death
Positive correlation with affluence

32. Advice on sun /UV exposure

33. Types of melanoma