This document summarizes different types of skin cancer and their characteristics. It discusses the three main types: non-melanoma skin cancers like basal cell carcinoma and squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common type, usually appearing as nodular lesions on sun-exposed areas. Squamous cell carcinoma is also common and can metastasize. Melanoma subtypes include superficial spreading, nodular, lentigo maligna, and acral lentiginous. Prevention strategies focus on reducing sun exposure and applying sunscreen. Surgical excision is a common treatment, along with Mohs surgery, radiation, and medical therapies.

1. Skin Cancer
Group A 4th year
Surgery Department
Chiangrai Prachanukroh Hospital

3. Physiologic Function
• Squamous epithelial cells
(keratinocytes)
• Melanocytes
• Dendritic cells & Langerhans cells
• Neural end organs
• Adnexal components

4. 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

5. 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

6. 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

7. Basal Cell Carcinoma
• Nodulocystic Subtype
– Found on 70% of BCC
– pearly papules often containing prominent,
dilated subepidermal blood vessels
– Rodent Ulcer
(Rat Tooth)

8. 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

9. Superficial subtype
Pigmented Subtype
Morpheaform subtype

11. Treatment
• Surgical
– Excision (Margin 2 – 4 mm)
– Moh’s surgery
• Destructive
– Electrodessication/curretage
– Cryosurgery
– Laser phototherapy
• Medical
– Radiotherapy

12. 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

13. Squarmous Cell Carcinama
• Dysorganized Keratin
• Keratin Horns on fleshy tumorous base
• Surface tends to ulcerate

14. Squarmous Cell Carcinama
• Tumor Thickness
• Local of Lesion (Metastasize Early)
– burn scars (Marjolin's ulcer)
– areas of chronic osteomyelitis
– areas of previous injury

16. 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

17. 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

18. 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

19. 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

24. Additional Skin Malignancies
• Merkel Cell Carcinoma
• Kaposi's Sarcoma
• Extramammary Paget's Disease
• Angiosarcoma
• Dermatofibrosarcoma Protuberans
• Fibrosarcoma
• Liposarcoma

25. Tumors of Skin Migrants
• Mycosis Fungoides (Cutaneous T-Cell
Lymphomas)
• Mastocytosis

26. 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

27. Preventions
• “Slip! Slop! Slap! Wrap!”
– Slip on a Shirt
– Slop on SPF 15+ Sunscreen
– Slap on Hat
– Wrap on Sunglasses

28. Reference