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Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical PowerPoint Presentation
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Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical

Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical

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Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical

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  1. Common MMalignant Skin Tumours, M elanoma, Biopsy M ethods, Surgical Therapy Claire Temple MD MSc FRCSC Associate Professor, UW O Division of Plastic Surgery Hand and Upper Limb Centre

  2. Skin Examination

  3. Physical Examination  Overall skin type  Lesion description

  4. Fitzpatrick classification  I W hite  II W hite  III W hite Always burns, never tans Always burns, little tan Slight burn, slow tan  IV Pale brown  V Brown Slight burn, fast tan Rarely burns, dark tan Never burns, dark tan  VI Dark brown/black

  5. Lesion description  Size in mm - two dimensions  Color  Surface characteristics –  scale(excess keratin)  crust(dried serum)  excoriated/erosion/ulcer

  6. Lesion description  NOUN Macule/patch flat lesion<>1cm Papule/plaque raised lesion <>1cm Nodule/tumour deep dermal lump <>1cm Vesicle/bulla elevated fluid filled lesion <>1cm

  7. If pigmented lesion, also describe:  A asymmetry  B borders  C color  D diameter  E elevation

  8. Biopsy Techniques

  9. Biopsy Techniques  Incisional  Shave  Punch  Incisional ellipse  Excisional

  10. Punch biopsy

  11. Punch biopsy

  12. Punch biopsy

  13. Punch Biopsy

  14. Incisional biopsy

  15. Excisional Biopsy

  16. Basal Cell Carcinoma

  17. Etiology - MM ultifactorial  UVR (Sun, tanning beds)  Ionizing radiation  Age >40  Fitzpatrick I, II phenotype  Immunosuppression  Old, unstable scars  Genetic conditions  Insecticides, hydrocarbons, arsenic

  18. Basal Cell Carcinoma  Malignant tumour arising from basal cell layer of epidermis  90% of all skin cancers  40% of North Americans will develop a BCC  85% facial, 30% nose

  19. Basal Cell Carcinoma  Nodular Form  Telangiectatic papule  translucent  pearly rolled border  Slow growing  Rarely metastasizes

  20. Variants  Nodular - 60%  Superficial  Pigmented  Morpheaform or sclerosing

  21. Nodular BCC

  22. Rodent Ulcer

  23. Sclerosing BCC

  24. Somme Exammples to Practice

  25. Pigmented Basal Cell Carcinoma

  26. Superficial Basal Cell Carcinoma

  27. Treatment  Prevention  Electrodessication/Curettage  Surgical Excision with 4 mm margins Mohs

  28. Respect Basal Cell Carcinoma

  29. Squamous Cell Carcinoma

  30. Squamous Cell Cancer

  31. Actinic Keratoses

  32. SCC  Malignant lesion arising in epidermis  Age >40  15% lifetime risk in Caucasians  Risk of metastases 0.5-6%  Thickened, ulcerated, erythematous lesion  Examine nodal basins

  33. SCC  Main treatment is surgical  6mm or wider margin  Radiation  May recur along nerves  May metastasize