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Skin neoplasm

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  • 1. DR IMRANA TANVIRCOMMON SKIN NEOPLASM
  • 2.  Skin neoplasms, are skin growths with differing causes and varying degrees of malignancy. Malignant skin cancer is named after the type of skin cell it arises from. Skin cancer generally develops in the epidermis.
  • 3. CLASSIFICATIONThere are three main types of skin cancer: Basal cell carcinoma (BCC), Squamous cell carcinoma(SCC) Malignant melanoma
  • 4. BASAL-CELL CARCINOMA The most common type of skin cancer. It rarely metastasizes or kills. Because it can cause significant destruction and disfigurement by invading surrounding tissues it is consider as malignant.
  • 5. CLASSIFICATION Nodular basal-cell carcinoma (Classic basal-cell carcinoma) Cystic basal-cell carcinoma Cicatricial basal-cell carcinoma Infiltrative basal-cell carcinoma Micronodular basal-cell carcinoma Superficial basal-cell carcinoma Pigmented basal-cell carcinoma Rodent ulcer Fibroepithelioma of Pinkus Polypoid basal-cell carcinoma Pore-like basal-cell carcinoma Aberrant basal-cell carcinoma
  • 6. SIGNS AND SYMPTOMSPresent as A shiny, pearly nodule. A red patch like eczema. A skin thickening or scar tissue.
  • 7. DISTRIBUTION Two thirds of basal-cell carcinomas occur on sun-exposed areas of the body. One-third occur on areas of the body that are not exposed to sunlight, emphasizing the genetic susceptibility of basal-cell cancer patients.
  • 8. BASAL CELL CA
  • 9. DIAGNOSIS Skin biopsy. Common method is a shave biopsy under local anesthesia.
  • 10. PATHOPHYSIOLOGY Basal cell Ca develop in the basal cell layer of the skin. Sun light exposure leads to the formation of thymine dimers, a form of DNA damage. DNA repair removes most UV-induced damage, not all crosslinks are excised. Cumulative DNA damage leads to mutations. Apart from the mutagenesis, sunlight depresses the local immune system, decreasing immune surveillance for new tumor cells. Basal-cell carcinoma also develops as a result of Basal-Cell Nevus Syndrome.
  • 11. HISTOLOGY OF BASAL CELL CA
  • 12. PREVENTION Sun screens with at least SPF 30. Use of a chemotherapeutic agent such as 5- Fluorouracil can prevent development of skin cancer. It is usually recommended to individuals with extensive sun damage, history of multiple skin cancers, or precancerous growths
  • 13. TREATMENT Standard surgical excision Chemotherapy Immunotherapy Radiation Photodynamic therapy Cryosurgery Electrodesiccation and curettage
  • 14. PROGNOSIS Prognosis is excellent if the appropriate method of treatment is used in early primary basal-cell cancers. Recurrent cancers are harder to cure, with any methods of treatment.
  • 15. SQUAMOUS-CELL CARCINOMAA histologically distinct form of cancer. It arises from the uncontrolled multiplication of malignant cells deriving from epithelium, or showing particular cytological or tissue architectural characteristics of squamous cell differentiation, such as the presence of keratin.
  • 16. THE INTERNATIONAL CLASSIFICATION OFDISEASES FOR ONCOLOGY Papillary carcinoma Verrucous squamous cell carcinoma Papillary squamous cell carcinoma Squamous cell carcinoma Large cell keratinizing squamous cell carcinoma Large cell keratinizing squamous cell carcinoma Small cell keratinizing squamous cell carcinoma Spindle cell squamous cell carcinoma Adenoid/pseudoglandular squamous cell carcinoma Intraepidermal squamous cell carcinoma Lymphoepithelial carcinoma Basaloid squamous cell carcinoma Clear-cell squamous cell carcinoma Keratoacanthoma Signet-ring-cell squamous-cell carcinoma
  • 17. SIGNS AND SYMPTOMS The lesion caused by SCC is often asymptomatic Ulcer or reddish skin plaque that is slow growing Intermittent bleeding from the tumor Usually the tumor presents as an ulcerated lesion with hard, raised edges The tumor may be in the form of a hard plaque or a papule. The tumor commonly presents on sun-exposed areas (e.g. back of the hand, scalp, lip, and superior surface of pinna Evidence of chronic skin photodamage, such as multiple actinic keratoses. Unlike basal cell carcinoma (BCC), squamous cell carcinoma (SCC) has a substantial risk of metastasis. Risk of metastasis is higher in SCC arising in scars, on the lower lips or mucosa, and occurring in immunosuppressed patients. About one-third of lingual and mucosal tumors metastasize before diagnosis (these are often related to tobacco and alcohol use)
  • 18. SQUAMOUS CELL CA
  • 19. CAUSES Human papilloma virus has been associated with SqCC of the oropharynx, lung, fingers, and anogenital region. Sunlight exposure and immunosuppression are risk factor for SCC of the skin. Bladder cancer associated with Schistosomiasis is often squamous cell carcinoma.
  • 20. DIAGNOSIS Diagnosis is via a biopsy.
  • 21. HISTOLOGY OF SCC
  • 22. PREVENTION Appropriate clothing. Avoidance of intense sun exposure Avoidance of sunscreen may prevent skin cancer.
  • 23. MANAGEMENT Surgical excision with a free margin of healthy tissue is a frequent treatment modality. Radiotherapy, given as external beam radiotherapy or as brachytherapy (internal radiotherapy), can also be used to treat squamous cell carcinomas. A few selected cases are treated with topical medication.
  • 24. MELANOMA A malignant tumor of melanocytes. Melanoma is less common than other skin cancers.
  • 25. SIGNS AND SYMPTOMS Asymmetry Borders (irregular) Color (variegated), and Diameter (greater than 6 mm) Evolving over time
  • 26. MALIGNANT MELANOMA
  • 27. CAUSE All cancers are caused by damage to the DNA inside cells. This damage can be inherited in the form of genetic mutations. In most cases, damage builds up over a persons lifetime and is caused by factors in their environment UV radiation
  • 28. DIAGNOSIS Visual diagnosis of melanomas is still the most common method employed by health professionals. Biopsy of the suspicious mole.
  • 29. HISTOLOGY OF MALIGNANT MELANOMA
  • 30. CLASSIFICATION Lentigo maligna Lentigo maligna melanoma Superficial spreading melanoma Acral lentiginous melanoma Mucosal melanoma Nodular melanoma Polypoid melanoma Desmoplastic melanoma Amelanotic melanoma Soft-tissue melanoma
  • 31. PREVENTION Minimizing exposure to sources of ultraviolet radiation
  • 32. TREATMENT Wider excision of the scar or tumor. Depending on the stage, a sentinel lymph node biopsy is done. Adjuvant treatment Chemotherapy and immunotherapy
  • 33. PROGNOSISFeatures that affect prognosis are: Tumor thickness in millimeters (Breslows depth) Depth related to skin structures (Clark level), Type of melanoma Presence of ulceration, presence of lymphatic/ perineural invasion, Presence of tumor-infiltrating lymphocytes Location of lesion, Presence of satellite lesions. Presence of regional or distant metastasis.

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