TUMORS OF THE SKIN

Benign
Pracancer
Malignancy

Early Diagnossed good result easier than other

tumors at other places.
BENIGN :
• High degree of structure
differentiation
• Well differentiated cells
• Growth slow
• Expansile in nature
• Not metastases
MALIGNANT:
• Disorganized structure
• Abnormal structure
• Aberrant size & shape
• Abnormal Nucleous &
Cytoplasma Ratio
• Expansile growth
• Infiltrate, invasion & destruction
of adjecent tissue
• Metastases through lympatic or
blood vessels.
 MALIGNANCY TUMOR
ETIOLOGY :
1. Environment Factors
Carsinogenic : hidrokarbon, nikel, nitrogen, aromatic azodyes
Sun exposure (UV B)
Radiation
Environment (Job) : COAL TAR , X RAY
Viral infection : RNA (malignancy ), DNA (benign)
Chronic Ulcer: burn, vacination, lupus
Trauma

2. Genetic
 MALIGNANCY TUMOR

Basal Cell Carcinoma (BCC)

Squamous Cell Carcinoma (SCC)
Melanoma Malignum (MM)
 BCC :
Sun exposure
Inorganic arsenic, x-ray exps

• Does not metastasize , local invasion,

destruction, occasionally spread to visceral,
growth slow
• Arising from basal cell epidermis or
external root of hair follicle
• Common in white population
• Outdoor occupation
• Men > women : 30-40 years
Location: Face, Cheeks, Nasolabial folds,
Forehead, Eyelid margin)
CLINICAL FEATURES OF BCC
• Noduloulcerative • Superficial
• Pigmented • Fibroepitelial
• Morfea like • Nevoid basal cell syndrome linier

CHARACTERISTIC FEATURES
• Ulcerate “ rodent ulcer” • Waxy translucent
• Elevated border “pearly” papul
• Telangiectasic vessels • Center depressed
across the surface • Flesh colored to
erythematous hue
Nodul
*
Morfea
*
 SCC
• EPIDERMAL KERATINOCYTES
• MEN > WOMEN 3X : 40-70 YEARS
• WHITE PERSONS , SOLAR EXPOSURE : sailors
and farmers
• Genetic : fair skin, xeroderma pigmentosum, albinism
• De novo or post trauma

Clinical appearance:
• Invasive , destructive, metastasis
• Crust, ulcer, inflammation, slow but progressive
enlargement, induration
Usually arise from:
1. Giant condyloma accuminata
2. Oral cavity hyperplastic lesion
3. De novo

*
*
*
*nodul
*nodul
MELANOMA MALIGNUM
• Arising from melanocytic system of the skin
• Crust, ulcer, inflammation, slow but
progressive enlargement, induration
• Cause death
• Risk factors : blue eyes, blonde hair, family
history, sun sentivity
• Faster metastases than other skin tumors
blood vessels or lymphatic
• Young adult (35-55 years)
• Precursor cell (neural crest , nevus cell)
Etiology:
• Genetik, UV, trauma, hormon, viral infection
• Nevus pigmentosus (junctional)
• Giant pigmented nevus (25-40)
• Blue nevus

4 Types of melanoma malignum:

• Lentigo MM freckles
• Superfisial spreading M Nevus
• Nodular M De novo
• Acral lentiginous M nail, foot,palm
*
* Kanker menembus kedalam mulut, setiap kali
makan/minum , merembes keluar lobang
dilakukan operasi penutupan luka
 1 bulan sesudah terapi
Sebelum terapi elektrokauter dilanjutkan terapi
anti kanker

*
 RECOGNATION Nevus MM :

• A: Assymetry
• B: Border irregular : scalloped, notched, poorly circumscribed
border
• C: Color variegation: colourful : bluish, black, brown, red, gray
• D: Diameter : greater than 0.6cm
• Itching, burning, pain
• Raised, surface : scaling, ulceration, crusting, bleeding
• Satellite lesions
• A: Assymetry
• B: Border irregular : scalloped,
notched, poorly circumscribed
border
• C: Color variegation: colourful :
bluish, black, brown, red, gray
• D: Diameter : greater than
0.6cm
• Itching, burning, pain
• Raised, surface : scaling,
ulceration, crusting, bleeding
• Satellite lesions
*

• Kelainan ini dapat memicu

timbulnya kanker melanoma
malignum
TREATMENT skin cancer :
Excition, Laser, Electrocautery, Radioterapi

Depends on:
1. Economy
2. Technical
3. General condition of the patients
4. Devices
5. Tumor characteristics: location, diameter,
recurrent, metastases)
6. Cure rate

Post treatment evaluation : every 3 months for 2

years, 6 months for 3 years, then 6 months for
every year
 PRA CANCER
1. Obligative
• Keratosis Aktinik: hiperkeratosis, UV,
multiple
• Keratosis Kimia: arsen, insectisida, tonikum
: corn like
• P bowen: viral infection, well dermacated
erytematous lesion, scally, crust
• Eritroplasia: penis, velvelet
• P. paget: mamary/extra,1/3adenokarsinoma
• Leukoplakia: smoker’s patch
• Lentigo maligna
*
*Paget’s
2. Facultative
• Infection and chronic ulcer
• Liken Planus
• Liken sklerosus et atrofikus
• Giant kondiloma
• Lupus
• Scar
*Ulcus chronic SCC
*
*
*

07/03/11
TUMOR JINAK
• Keratosis seboroik
• Dermatofibroma
• Skin tags
• Xantelasma
• Milium
• N. Pigmentosus
• Kista atheroma
• Moluskum kontagiosum
• N. Sebaseus jadason
• Hiperplasia sebasea
• Neurofibromatosis
• Haemangioma
 *
Orang tua di atas 50 tahun
Asimptomatik
Sering mengenai wajah,
leher, dada, punggung, dan
perut (tubuh bagian atas)
Papul coklat / hitam, batas
tegas, permukaan tebal seperti
lilin / hiperkeraik, diameter
millimeter – 3 cm
Menempel (stuck on) pada
kulit dan dapat mengelupas
berulang kali
07/03/11
*

07/03/11
*
*Tumor jinak vaskular

*Kongenital , biasanya
muncul pada masa neonatal /
2 minggu kelahiran

*Makula eritem atau nodul

merah kebiruan, batas
irregular
*Komplikasi : pendarahan
*Dapat remisi spontan
07/03/11
*

07/03/11
*

07/03/11
*

POST PIERCING

07/03/11
 *

*Umumnya kongenital,
dapat pada semua usia

*Bisa terdapat pada bagian

tubuh manapun

*Papul coklat / hitam,

batas tegas, permukaan
mengkilap dan berambut

07/03/11
*

*Tumor kelenjar ekrin

*Banyak pada dekade 2 dan 3

*Wanita > Pria

*Terdapat pada kelopak mata

bagian bawah

*Papul datar multipel, milier -

lentikuler, batas tegas,
berwarna putih pucat
07/03/11
 *
*Sering pada dewasa muda dan *Terjadi karena sumbatan pada muara
pertengahan kelenjar sebasea

*Muncul di daerah yang memiliki *Tumor kistik lunak, berfluktuasi,

kelenjar sebasea (wajah, leher, bulat atau lonjong, titik kebiruan di
dada punggung, kulit kepala) puncak lesi (puncta)

*Tumor kistik tegang, konsistensi

kenyal, ukuran lentikular –
nummular, tidak fluktuatif , tidak
nyeri warna kulit normal,
puncaknya terdapat titik berwarna
hitam yang nyeri jika pecah

07/03/11
*
07/03/11
07/03/11
 *

*Herediter, diperkirakan autosomal

dominan
*Mulai saat pubertas / dewasa
muda
*Pria > wanita

*Lokasi pada skrotum, paha, lengan

atas belakang

*Nodul multipel lentikular –

nummular, konfluen, warna
kekuningan, teraba keras
07/03/11
07/03/11
*
*Tumor jinak subkutan
yang berisi jaringan
lemak

*Tumor soliter /
multipel dengan
konsistensi lunak, dapat
digerakkan dan tidak
nyeri
07/03/11
*
*GENETIK

*LOKASI : LEHER

*PAPUL MULTIPLE

*ONSET : 30AN

*HAMIL : BERTAMBAH

07/03/11
*
07/03/11
 *
*Biasa pada usia pertengahan

*Sering dihubungkan dengan

hiperkolestrolemia

*Banyak terdapat pada kelopak mata

* Papul / plak lunak memanjang

berwarna kuning-oranye

07/03/11
 *
*Tumor jinak yang berisi
jaringan saraf

*Predileksi pada badan,

tangan, kaki

*Banyak pada usia 20 – 30

tahun

*Papul / nodul multipel

dengan konsistensi lunak,
tumbuh lambat, kadang terasa
nyeri

*Genetik
07/03/11
07/03/11
*
*Tumor jinak kelenjar getah
bening

*Kongenital, biasanya muncul

dalam 2 tahun pertama
kehidupan, infeksi mempercepat
pertumbuhannya

*Benjolan berwarna coklat-

kekuningan

*Tidak dapat remisi spontan

07/03/11
* Fail in DNA repair by
UVRion skin Cancer
* Photosensitive easy
sunburn, freckles,
thick, hyperkeratotic,
atrophic,
telangiectation
* Autosomal resecive
* 20% neurologic
complication

*
*