2. Basal Cell Carcinoma

3. Basal Cell Carcinoma

4. 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

5. 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

6. Melanoma

7. Melanoma

8. ABCDE’s of Melanoma

9. 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

10. 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

12. 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

13. Solar Lentigo

14. Benign Nevus

15. Dermatofibroma

16. 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.