Professional Documents
Culture Documents
Slow growing
AETIOLOGY AND
EPIDEMIOLOGY
Type 1 skin
DIFFERENTIAL DIAGNOSIS
Cyst
Bowens disease
Infected spot
Tinea
Sebaceous hyperplasia
Eczema/psoriasis
Naevus
Malignant melanoma
Molluscum contagiosum
Seborrhoeic keratosis
Wart
MANAGEMENT
Photodynamic therapy
Radiation therapy
FOLLOW UP POLICY
Overall recurrence rate for BCC is around
5%
Thus patients are followed up for 2 years
at least 6 monthly
However risk of second primary 5 years
after excision 36% patients develop a
second primary and 20% develop multiple
new BCCs
2.SQUAMOUS
CELLCARCINOMA
Less common than
BCC but more
aggressive
The incidence is rising
Most important
aetiological agent is
UV radiation total
life time exposure
AETIOLOGY
Sunlight exposure
Therapeutic radiation
Immunosuppression
Viral infection
Premalignant lesions
Genetic syndromes
CLINICAL FEATURES
May be seen at any body
site
Disorganised keratin
Keratin horn on a fleshy
tumourous base
Surface tends to ulcerate
METASTASES
SCC may spread in several ways:
Local invasion
Along tissue plains, between muscles, over
periosteum
Along nerves and blood vessels
Distant mets
DIFFERENTIAL DIAGNOSIS
Solar keratosis
Bowens disease
Viral warts
Cutaneous horn
Keratoacanthoma
Basal cell carcinoma
Leg ulcers
MANAGEMENT
Intention to cure primary lesion and prevent recurrences
No one treatment has been shown to be effective in all
patients
Thus treatment should be tailored to the individual as
much as possible
Ideally multidisciplinary oncology team clinical
oncologist, dermatologist, pathologist, appropriate surgeon
TREATMENT METHODS
Cryotherapy
Laser
Photodynamic therapy
Retinoids
Radiation therapy
FOLLOW UP POLICIES
75% SCCs recur within 2 years
95% recurrences are within 5 years
Most clinicians follow up for at least 4 years
3 monthly for first year then every 6 months
Close examination of the scar site and draining lymph
node areas is recommended