Skin Cancer
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Skin Cancer. Diagnoses and Treatments. Aims. NICE/IOG Use of the dermatoscope Pre malignant lesions BCC SCC Melanoma ‘quiz’. Reasons for referral. Diagnoses. Biopsies 2008. NICE guidance. Issued Feb 2006 Low risk BCCs, AKs primary care

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Skin Cancer

Diagnoses and Treatments


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Aims

  • NICE/IOG

  • Use of the dermatoscope

  • Pre malignant lesions

  • BCC

  • SCC

  • Melanoma

  • ‘quiz’





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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


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Skin surgery

  • Send all specimens for pathology

  • Accurate information on pathology form, eg site, clinical description

  • One specimen, one pot



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Types ofdermatoscope



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Management of pre- malignant non pigmented lesions

  • Diagnostic biopsy

  • Curettage

  • Efudix

  • PDT

  • excision


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SCC - prognosis

  • Lip

  • Ear

  • Immunocompromised pt

  • Higher recurrence rates


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Treatments for NMSC

  • Excision

  • Radiotherapy

  • Mohs surgery


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Mohs surgery

  • Microscpoically controlled

  • Margins examined

  • Precise removal of tumour

  • Used in cosmetically important areas

  • Tissue sparing


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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




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