Skin Cancer

Basal Cell Carcinoma (BCC)

N.B. Most common type of skin cancer.

This is a locally-invasive, slow-growing tumour of epidermal keratinocytes.

Risk factors:

• Fair skin

• Hx of frequent/severe sun burns

• Outdoor occupation or hobbies

• Personal/family hx of skin cancer

• Increasing age

Presentation:

• Small, shiny, skin-coloured nodule with a central depression

• Rolled edge

• Telangiectasia

• No pain or bleeding

• Typically on sun-exposed areas

Management - Surgical excision

Squamous Cell Carcinoma (SCC)

This is a locally-invasive, malignant tumour of epidermal keratinocytes.

Risk factors:

• Fair skin

• Hx of frequent/severe sun burns

• Outdoor occupation or hobbies

• Personal/family hx of skin cancer

• Increasing age

Presentation:

• Irregular, ill-defined red nodule with scale and ulceration

• Can be painful or bleeding

• Typically on sun-exposed areas

Management - Surgical excision

Melanoma

Presentation - ABCDE:

• Asymmetry

• Border irregularity

• Colour variation

• Diameter > 6mm

• Evolves over time

Always suspect if a mole has any of the ABCDE characteristics. If present, the patient should be 2 week wait referred to a dermatologist.

The main prognostic tool is the Breslow thickness, which measures the depth of the cancer.

N.B. Most (70%) start off with superficial spreading before spreading vertically in the later stages.

Management - Surgical excision