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Eyelid skin-cancer-update-website

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Eyelid skin-cancer-update-website

  1. 1. Eyelid Skin Cancer: Update Anne P. Rowland, M.D.
  2. 2. Skin Cancer As common as all other cancers combined  1.5 million new skin cancers this year*  Basal cell carcinomas (80%)  Squamous cell carcinomas (15%)  Melanomas (4%)  Sebaceous cell carcinoma (1%) *American Cancer Society Estimate
  3. 3. Classic Risk Factors  Elderly/Caucasian  Light complexion/Blue eyes  Actinic damage  Cigarette Smoking
  4. 4. Prolonged Sun Exposure John McCain s/p treatment for Melanoma
  5. 5. Skin Cancer  More than 90% of non-melanoma skin cancer is caused by sun exposure  Unprotected exposure  Outdoors, even in the fog  Tanning booths  Through car, home, or office windows  Only 33% of women and 10% of men wear daily sunblock  One bad burn in childhood doubles your lifetime risk for Melanoma
  6. 6. Skin Cancer Statistics United States  Incidence of has tripled since 1980  1 in 5 Americans will be diagnosed with skin cancer (1 in 3 Caucasians)  Men > Women 2 : 1 Early detection is crucial ! American Cancer Society Data
  7. 7. Deaths Due to Skin Cancer ** There were 9,480 deaths from melanoma in the U.S. in 2013
  8. 8. Skin Cancer: In The Youth  Dramatic Increase in People < 30:  Melanoma has tripled (76,690 new cases in 2013)  Squamous cell carcinoma doubled  Basal cell carcinoma have doubled
  9. 9. Watch Out: Skin Cancer Occurs in Non-Caucasians!  Melanoma Mortality   The overall 5-year melanoma survival rate for African Americans is only 77%, versus 91% for Caucasians More likely to be diagnosed later  % of patients receiving an initial diagnosis of advanced stage melanoma  Non-Hispanic blacks: 52%  Hispanics: 26%  Whites: 16%
  10. 10. Important Patient History  Have you had a prior skin cancer ?  If history of basal cell -> lesion at 5 years 50% have second  If history of squamous cell -> second lesion at 5 years  Think beyond the face:  Women: lower legs  Men: back 75% have
  11. 11. The History  Intermittent itching ?  Intermittent scaling or scabbing ?  Irritation when wearing glasses ?
  12. 12. Medial Canthal Region Common Beware of the “irritation due to eyeglass fit”!
  13. 13. American Cancer Association’s Warning Signs – ABCDE  Asymmetry   Border irregularity   Brown, tan, black mixed with red, white or blue Diameter   Uneven, scalloped or notched Color variations   Draw a line down the center > Pencil’s eraser Evolution  ANYTHING NEW
  14. 14. Cancer: Doesn’t always follow the rules!
  15. 15. American Cancer Association’s Warning Signs – ABCDE Evolution = ANYTHING NEW  Grows or shrinks (suddenly)  Irritation, redness  Scaling  Crusting, oozing or bleeding  Tenderness or pain  Itchy
  16. 16. Eyelid Specific Features Look for warning signs  Change in Pigmentation  Hyperpigmentation  Hypopigmentation  Change in Visible Vessels    Telangiectasis Vessel blanching Change in Lashes  Loss of lashes  Lashes in new locations
  17. 17. The Classic Teaching… Telangiectasias Lash Loss Ulceration or nodule
  18. 18. Eyelid Specific Features Look for warning signs  Chronic conjunctivitis  Eyelid malposition  Ectropion  Entropion  Ptosis
  19. 19. Sebaceous Cell Carcinoma The Worst Offender  Least common  50% misdiagnosed  Average age: 72 years old  Women: Men = 2:1  Ectropion/entropion 10%  Caruncle 5%  Chronic conjunctivitis, cyst or pannus
  20. 20. Sunblock  Apply on a daily basis  Multiple applications (every 2 hours!!) are necessary  Protect at all times, even when driving in your car
  21. 21. Sunblock  Chemical  Parasol (Avobenzone)  Physical  Zinc Oxide  Titanium Oxide  Advanced skin protection  UVA and UVB Windshield coating  Micronized zinc clothing  Micronized zinc topical (Colorscience, IS)
  22. 22. Micronized Zinc  Indications: Protection from sun damage  Result of 30 years of R&D  Easy-to-use retractable brush for:  Eyelids  Ears  Balding heads  Hands  Multiple applications  Applying over make-up
  23. 23. Micronized Zinc  Works best on skin that is moisturized  No greasy mess / No thick, white goop  Doesn't’t burn eyes – great for eyelids!  Men should pay particular attention to the tips of the ears – this area tends to be neglected and is prone to skin cancer.  FDA approved for infants > six months old  Good for post-op  Refillable powder
  24. 24. Thank you !

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