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Skin cancer

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Skin cancer

  1. 1. Skin cancer
  2. 2. Incidence  Main types of skin cancer – malignant melanoma of the skin – non-melanoma skin cancer (NMSC).  It has been estimated that the lifetime risk of developing malignant melanoma is 1 in 91 for men and 1 in 77 for women in the UK. These were calculated in February 2009 using incidence and mortality data for 2001-2005.
  3. 3. Incidence  Malignant melanomas are the least common but most serious type of skin cancer, with more than 10,400 new cases diagnosed in 2006.  In 2006 over 81,600 non-melanoma skin cancers (NMSC) were registered in the UK ( registration is known to be incomplete). One study estimated that at least 100,000 cases of NMSC are diagnosed each year.
  4. 4. Aetiology  UV radiation  Skin type  Predisposition  Marjolins
  5. 5. Incidence  Malignant melanoma – Unlike most malignancies, malignant melanoma is more common in women than men with a M:F ratio of 4:5. In 2006 it was the sixth most common cancer in females and the eighth in males: for both sexes combined it was the sixth most common cancer. – The distribution of cases on the body also varies by sex over a third of male cases arise on the trunk of the body, particularly the back, while the most common site for females is on the legs. – Malignant melanoma is rare in children, while in adults the incidence rates rise steadily with age.
  6. 6. Malignant melanoma
  7. 7. Malignant melanoma  Increasing incidence
  8. 8. Malignant melanoma  Melanoma types – Superficial spreading  Sub group arising within lentigo maligna – Nodular – Acral lentiginous – Amelanotic
  9. 9. Malignant melanoma  Features to elicit concern – Change – see right – Itch – Bleeding
  10. 10. Malignant melanoma  Lentigo maligna – Elderly patient – Gradually increasing pigmentation – Beware dark areas
  11. 11. Malignant melanoma  Nodular melanoma – Rapid change – Ulceration – Urgent
  12. 12. Malignant melanoma  Acral lentiginous – Refer early – Do not observe  Subungal – Beware unclear history of trauma
  13. 13. Incidence  Non Melanoma Skin cancer – The majority of NMSCs are either basal cell carcinomas (BCCs), also known as rodent ulcers, or squamous cell carcinomas (SCCs). Both forms are highly treatable and survival rates for NMSCs are over 95%. – Whilst BCCs rarely metastasise, SCC can, and in 2006 there were 577 deaths in the UK from NMSC. Around 80% of NMSCs occur in people aged 60 years and over and they constitute a substantial public health problem due to the very large number of cases each year.
  14. 14. Pre-malignant  Pre-malignant – Actinic keratosis  25% progress to scc – Bowens disease  If progress to SCC can be aggressive  Assoc with internal malig 7% – Keratoacanthoma  Rapid growth  Central depression
  15. 15. Squamous Cell  Two main types – Verrucous – Nodular
  16. 16. Basal cell  Types – Nodular – Superficial – Sclerosing – Pigmented
  17. 17. Basal cell  Rarely metastasizes  Danger sites – Inner canthus – Alar base – External auditory meatus
  18. 18. Treatment  All melanoma skin cancers should be referred to a specialist who works within a multidisciplinary team set up to deal with the full spectrum of this condition  Complex or high risk non melanoma skin cancers should be referred in a similar fashion

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