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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


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    Presentation Transcript
    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 ofdermatoscope

    10. Lesion ‘turned black’

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

    12. Diagnosis ?

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

    14. ~ 100 000 non melanoma skin cancers / year • 80% NMSC occur > 60 years of age • 95 % survival in NMSC overall • ~ 10 000 melanomas / year • Incidence doubling every 10 years

    15. SCC - prognosis • Lip • Ear • Immunocompromised pt • Higher recurrence rates

    16. Treatments for NMSC • Excision • Radiotherapy • Mohs surgery

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

    18. 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

    19. Advice on sun /UV exposure

    20. Types of melanoma