Cancer of the skin
Introduction
Skin cancers are usually classified into non melanoma and malignant melanoma.
Non-melanoma Skin Cancers
Basal cell carcinoma (BCC) and squamous cell (SCC) are the most common non melanoma skin cancers. SCC is more aggressive than BCC and has the potential to metastasis.
The main cause of these skin cancers is overexposure to Ultraviolet radiation. Risk factors include light-coloured skin (e.g albinism), previous burn and immunosuppression eg after transplant or HIV infection
Management
Surgery is the primary treatment. Wide local excision that achieves negative surgical margins is adequate. Skin grafting may be required after surgery.
Amputation sometimes is done for palliation.
Locally destructive methods such as curetting or cryotherapy may be employed
Radiotherapy
Indication: Positive margin, high grade disease or inoperable tumour.
Signs and Symptoms
Diagnostic criteria
The most common warning sign of skin cancer is a change in the appearance on exposed areas of the skin, such as a new growth or a sore that will not heal.
Occasionally, such changes may appear on an old burn area.
Investigation
• None if lesion is small
• Local x-ray if bone involvement is suspected
• CXR if undifferentiated tumour
• Biopsy – preferably excisional biopsy where possible for histology
Treatment
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Pharmacological
- Topical 5-fluorouracil for very superficial lesions or carcinoma in situ Systemic chemotherapy is given for palliation in advanced stage or as radio sensitizer.
Note:
Prevention or early detection is through frequent self–health check–up or screening exercise and prompt treatment of early skin lesions. For light skinned people–avoid UV light
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Non-pharmacological
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Prevention
Updated on,
5 Novemba 2020 10:07:42
References
1.STG