Skin Cancer
Group A 4th year
Surgery Department
Chiangrai Prachanukroh Hospital
Physiologic Function
• Squamous epithelial cells
(keratinocytes)
• Melanocytes
• Dendritic cells & Langerhans cells
• Neur...
Malignant Tumors of the Skin
• frequently subject to epidermal tumors
• arising from cells of the dermis or adnexal
struct...
Type of Skin Cancer
• Non – Melanomas
– Basal Cell Carcinoma
– Squarmous cell Carcinoma
• Melanomas
• Others
– Merkel Cell...
Basal Cell Carcinoma
• most common type of skin cancer
• slow growing, and Locally invasive
• Most commonly develop on sun...
Basal Cell Carcinoma
• Nodulocystic Subtype
– Found on 70% of BCC
– pearly papules often containing prominent,
dilated sub...
Basal Cell Carcinoma
• Superficial subtype
– commonly occur on the trunk
– Flat red, scaling lesion (Bowenoid Lesion)
• Pi...
Superficial subtype
Pigmented Subtype
Morpheaform subtype
Treatment
• Surgical
– Excision (Margin 2 – 4 mm)
– Moh’s surgery
• Destructive
– Electrodessication/curretage
– Cryosurge...
Squarmous Cell Carcinama
• Seccond most common
of skin cancer
• Arise from Epidermal
Keratinocytes
• More invasiveness and...
Squarmous Cell Carcinama
• Dysorganized Keratin
• Keratin Horns on fleshy tumorous base
• Surface tends to ulcerate
Squarmous Cell Carcinama
• Tumor Thickness
• Local of Lesion (Metastasize Early)
– burn scars (Marjolin's ulcer)
– areas o...
Treatment
• Surgical
– Excision (Margin 1 mm)
• lymph node (LN) dissection remains topic of debate
– Moh’s surgery
• Destr...
Malignant Melanoma
• Pathogenesis of melanoma is complex and
remains poorly understood to date
• Over 90% found on skin
ab...
Malignant Melanoma
– A (Asymmetry) one portion of the mole does
not match the other
• Radial : Grows horizontally; not ass...
Malignant Melanoma
• The four types of melanoma
– superficial spreading (most common type)
• Found in anywhere except hand...
Additional Skin Malignancies
• Merkel Cell Carcinoma
• Kaposi's Sarcoma
• Extramammary Paget's Disease
• Angiosarcoma
• De...
Tumors of Skin Migrants
• Mycosis Fungoides (Cutaneous T-Cell
Lymphomas)
• Mastocytosis
Syndromic Skin Malignancies
• Basal Cell Nevus (Gorlin's syndrome )
• Nevus Sebaceus of Jadassohn
• Epidermodysplasia verr...
Preventions
• “Slip! Slop! Slap! Wrap!”
– Slip on a Shirt
– Slop on SPF 15+ Sunscreen
– Slap on Hat
– Wrap on Sunglasses
Reference
Skin cancer
Skin cancer
Skin cancer
Skin cancer
Skin cancer
Skin cancer
Skin cancer
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Skin cancer

  1. 1. Skin Cancer Group A 4th year Surgery Department Chiangrai Prachanukroh Hospital
  2. 2. Physiologic Function • Squamous epithelial cells (keratinocytes) • Melanocytes • Dendritic cells & Langerhans cells • Neural end organs • Adnexal components
  3. 3. Malignant Tumors of the Skin • frequently subject to epidermal tumors • arising from cells of the dermis or adnexal structures are relatively uncommon • UV radiation, albino individuals of dark skinned races is associated with an increased development of skin cancer
  4. 4. Type of Skin Cancer • Non – Melanomas – Basal Cell Carcinoma – Squarmous cell Carcinoma • Melanomas • Others – Merkel Cell Carcinoma – Kaposi's Sarcoma – Extramammary Paget's Disease – Angiosarcoma – Dermatofibrosarcoma Protuberans – Fibrosarcoma – Liposarcoma
  5. 5. Basal Cell Carcinoma • most common type of skin cancer • slow growing, and Locally invasive • Most commonly develop on sun-exposed areas (e.g., nose, lip) • Mutations : PTCH, p53. • several subtypes
  6. 6. Basal Cell Carcinoma • Nodulocystic Subtype – Found on 70% of BCC – pearly papules often containing prominent, dilated subepidermal blood vessels – Rodent Ulcer (Rat Tooth)
  7. 7. Basal Cell Carcinoma • Superficial subtype – commonly occur on the trunk – Flat red, scaling lesion (Bowenoid Lesion) • Pigmented subtype – tan to black in color must DDx with early Malignant Melanomas • Others : morpheaform, micronodular, infiltrative
  8. 8. Superficial subtype Pigmented Subtype Morpheaform subtype
  9. 9. Treatment • Surgical – Excision (Margin 2 – 4 mm) – Moh’s surgery • Destructive – Electrodessication/curretage – Cryosurgery – Laser phototherapy • Medical – Radiotherapy
  10. 10. Squarmous Cell Carcinama • Seccond most common of skin cancer • Arise from Epidermal Keratinocytes • More invasiveness and tendency to metastasize than BCC • Sun-exposed sites in older people
  11. 11. Squarmous Cell Carcinama • Dysorganized Keratin • Keratin Horns on fleshy tumorous base • Surface tends to ulcerate
  12. 12. Squarmous Cell Carcinama • Tumor Thickness • Local of Lesion (Metastasize Early) – burn scars (Marjolin's ulcer) – areas of chronic osteomyelitis – areas of previous injury
  13. 13. Treatment • Surgical – Excision (Margin 1 mm) • lymph node (LN) dissection remains topic of debate – Moh’s surgery • Destructive – Electrodessication/curretage – Cryosurgery – Laser phototherapy • Medical – Radiotherapy
  14. 14. Malignant Melanoma • Pathogenesis of melanoma is complex and remains poorly understood to date • Over 90% found on skin about 10% anogenital mucosal surfaces, esophagus, meninges, and the eye • 5 to 10% of Melanomas are Nonpigmented • The most consistent clinical signs are changes in the color, size, or shape of a pigmented lesion needs biopsy
  15. 15. Malignant Melanoma – A (Asymmetry) one portion of the mole does not match the other • Radial : Grows horizontally; not associated with metastases. • Vertical : Grows downward into the dermis; is associated with metastases. – B (Border & Bleeding) edges are irregular, notched, or blurred – C (Color) different shades of black or brown, patchy colors – D (Diameter) spot is 6 millimeters across, or growing larger
  16. 16. Malignant Melanoma • The four types of melanoma – superficial spreading (most common type) • Found in anywhere except hand and feet • prolonged radial growth phase – Nodular (most aggressive type) • vertical growth phase – lentigo maligna • the best prognosis • indolent lesion on the face of older men – acral lentiginous • Unrelated to sun exposure (soles,palms, subungal) • Hutchinson's sign
  17. 17. Additional Skin Malignancies • Merkel Cell Carcinoma • Kaposi's Sarcoma • Extramammary Paget's Disease • Angiosarcoma • Dermatofibrosarcoma Protuberans • Fibrosarcoma • Liposarcoma
  18. 18. Tumors of Skin Migrants • Mycosis Fungoides (Cutaneous T-Cell Lymphomas) • Mastocytosis
  19. 19. Syndromic Skin Malignancies • Basal Cell Nevus (Gorlin's syndrome ) • Nevus Sebaceus of Jadassohn • Epidermodysplasia verruciformis • Epidermolysis Bullosus and Lupus Erythematosus • Xeroderma pigmentosum • Familial dysplastic nevus syndrome
  20. 20. Preventions • “Slip! Slop! Slap! Wrap!” – Slip on a Shirt – Slop on SPF 15+ Sunscreen – Slap on Hat – Wrap on Sunglasses
  21. 21. Reference
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