Skin lesions
Actinic Keratoses (solar keratosis)bound damagesnskin frequent exposure to sun
Arms, back of hands, lower legs, scalp - skin pink or red or brown Rough, dry - raised, hard, crusty 1-2 cm diameter 20% turn into form of skin cancer - Squamous Cell Carcinoma Treat - freeze liquid Nitro, surgical removal, photodynamic Therapy, laser Treat - topical,cream - 5-Flucorouracil, imiquimodmor ingenol mebutate - selectively destroy cells Treat -mDICLOFENAC CREAM - mildn& small lesions
Cancerous skin lesions
Classification - Melanoma (4 main types) or Non-Melanoma -excessive UV exposure 11,000 in U.K. Malignant Most common cancer in people aged 15 to 34 Change size, shape, colour of mole indicator - treatvearlynstage can grow,quickly If not spread to lymph nodes no further treatment - chemo/radiotherapy If spread likely - further treat Immunotherapy Interferon or IL-2 - Biologicsl therapynMonoclonal Antibodies (IPILIMUMAB) can stop,spread
Lentigo maligna melanoma (cancerous)
Develops from pre-cancerous condition called Lentigo Maligna or Hutchinsons Freckle - stain on skin
Merkel Cell Carcinoma non-melanoma (Trabecular Cancer)
Rare &naggressive -,Forms when merkel cells (found in Epidermis) grow,out of control Single lump fast growing painless firm dome-shaped or raised red or,violet Grows fast & spreads early stage to nearby lymph nodes - then lymph nodes/skin in distant part of body lung brain bones or other organs Treat surgery with chemo or radio
cutaneous T-cell lymphoma (CTCL) - non-melanoma
Rare - affects people 40-60 yrs - more common in men Cause - T-cells growing uncontrolledmway -mdevelops,slowly Early stage - looks like eczema/psoriasis itchy, red rash-likempatches - may be skin tumours or swollen lymph nodes Advanced stage - large areas skin affected - swollem]n, red, scaly, itchy, may be painful Early treatment - topical steroid or chemo cream (efudix) - PUVA - radio Advanced treatment - systemic, chemo, retinoids, biological
Acral Melanoma (cancerous)
Rarest Type - hand palms, soles, under nails Common back/brown skinned people - thought not to be related to sun exposure
Benign skin lesions
Skin growths. - abnormal,pigmentstion present at birth or later in life sun exposure Freckles/Moles - sun exposure - UV radiation -,can lesd tomskin csncer
Nodular melanoma (cancerous)
aggressive tumor with no radial growth phase - chest, back, head, neck
Angiosarcoma non-melanoma
Malignant vascular tumor arising from endothelial cells lining blood vessels - men/women - any age/race Cutaneous Angiosarcoma - majority - scalp / face Subcutaneous Angiosarcoma - underneath skin surface Most are high grades- aggressive fast growing Skin infection - bruise - lesion doesn't heal - soft lump felt/seen Treat surgery with chemo ormradio Due to aggressive nature -mpatinet soften diagnosed after spread -,poor diagnosis
Non-Melanoma Skin Cancer
Most common - 100,000 U.K. New cases per annum Develop in epidermis 2 most common - BASAL CELL CARCINOMA & SQUAMOUS CELL CARCINOMA Rare - CUTANEOUS T-CELL LYMPHOMA - KAPOSI'S SARCOMA. - ANGIOSARCOMA. - MERCKEL CELL CARCINOMA
Superficial spreading melanoma (MC) (cancerous)
Most common - men chest/back women legs. Cells spread out across skin surface
squamous cell carcinoma - 20% non-melanoma skin cancer
Originates cells lining top of Epidermis (squamous cells) Appears firm red lump or flat scaly crusted scab lesion that doesn't heal Slow,growing spread if left untreated Face, lips, hands arms. Legs, ears - less common mouth genital/anus Treat - localised or minor surgery - topical 5-fluroouracil,chemo cream - altermaitvemtomsurgery If spread - chemo/radio therapy
basal cell carcinoma - 75% non-melanoma skin cases
malignant tumor of the basal cell layer of the epidermis - red/pink lump - pearly white or waxy looking visible blood vessels or flat flesh coloured or brown patches Grow slowly 10-15cm size - areas lots of sun exposure -,face, legs, painless - may itch or bleed Dos not metastasise - treatvearly can cure completely - aggressive deeper layers of skin/tissue Treat - superficial - topical IMIQUIMOD (interferon) immunotherapy cream -,alternative to,surgery Treat - locally invasive - chemo/radio - shrink tumour Treat - large, shallow - cream contains 5-Aminolaevulinic Acid (ALA) - absorbed then exposed to light - cells with ALA destroyed
Kaposi's sarcoma
malignant tumor of the blood vessels associated with AIDS or elderly men African, Jewish, Italian ancestry - rare Cause - virus - human heroes virus 8n(HHV8) - affects cells lining blood & lymph vessels causes abnormal,growth - not a truce cancer - known as reactive hyperplasia Transmitted bodynfluid Not all with HHV8 get Kaposis Sarcoma - weakens immune system (HIV or immunosuppressant meds) may assist development Treat - dependent on cause - antiviral or switching immunosuppressant can help,with HIV - radio shrink tumour chemo treat internal tumour