Dermatology - Skin Cancers for Medical Students

Summary

In this educational video, Jade, a medical student, discusses common skin cancers: basal cell carcinomas (BCC), squamous cell carcinomas (SCC), and malignant melanomas. She explains the characteristics, risk factors, and appearances of these tumors, using dermatological terms to describe them. Jade also covers various treatment options, including surgical excision, cryotherapy, photodynamic therapy, and radiotherapy, emphasizing the importance of early detection and management for better prognosis.

Takeaways

• 🌞 Basal cell carcinomas (BCC) are slow-growing, invasive malignant tumors of epidermal keratinocytes, often caused by UV exposure.
• 🌚 BCCs can present as nodular, superficial, cystic, morphic, carrot otic, or pigmented, with nodular being the most common.
• 🏥 Treatment for BCC includes cryotherapy, topical treatments, surgical excision, and Mohs micrographic surgery.
• 📈 Squamous cell carcinomas (SCC) are fast-growing, invasive tumors that can metastasize, sharing similar risk factors with BCC.
• 🔍 Suspicious SCC lesions should be surgically excised and examined histologically to confirm diagnosis.
• 🏥 Management of SCC involves surgical excision, possibly plastic surgery referral, radiotherapy, and chemotherapy for metastatic disease.
• 🖤 Malignant melanomas are invasive malignant tumors of melanocytes, with superficial spreading being the most common type.
• 🔎 Key features of suspicious melanomas include asymmetry, border irregularity, color irregularity, diameter over 7mm, and evolution of the lesion.
• 🩺 Suspicious melanoma lesions require excision biopsy for diagnosis, with imaging and sentinel node biopsy considered for metastasis.
• 🏥 Malignant melanomas are treated with wide local excision, possibly involving regional lymph node removal, and radiotherapy or chemotherapy if surgery is inappropriate.
• ⚠️ Early detection and treatment are crucial for all skin cancers to prevent metastasis and improve prognosis.

Q & A

What is a basal cell carcinoma (BCC)?

A basal cell carcinoma is a slow-growing invasive malignant tumor of epidermal keratinocytes. It originates from the cells that produce keratin, which forms the protective barrier of the skin.

What are the different types of BCC mentioned in the script?

The script mentions several types of BCC: nodular, superficial, cystic, morphic, carrot otic, and pigmented. The most common type is nodular.

What are the risk factors for developing basal cell carcinomas?

Risk factors for developing BCC include UV exposure, history of frequent or severe sunburn in childhood, skin type 1, increasing age, male gender, immunosuppression, family history of skin cancers, and personal history of skin cancer.

How would you describe the appearance of a nodular BCC?

A nodular BCC is described as a round pearly pink papule or nodule with notable telangiectasia, a well-defined border, central depression, and rolled edges. It may also appear dry and flaky.

What is the difference between a papule and a nodule in dermatological terms?

In dermatology, a papule is a small, solid elevation less than 0.5 centimeters in diameter, while a nodule is a larger solid elevation greater than 0.5 centimeters in diameter.

What is telangiectasia and how does it relate to BCC?

Telangiectasia refers to dilated red blood vessels visible on the skin. In BCC, telangiectasia can be observed as dilated red blood vessels on the skin lesion.

How is a basal cell carcinoma typically managed?

Basal cell carcinomas are typically managed by surgical excision with histology, which includes a margin of normal skin around the tumor. Other options include cryotherapy, topical photodynamic therapy, and topical treatments like Emiquon Maude cream.

What is a squamous cell carcinoma (SCC)?

A squamous cell carcinoma is a fast-growing invasive malignant tumor of epidermal keratinocytes that can metastasize. It is associated with risk factors similar to BCC, such as excess UV exposure and immunosuppression.

What are the signs that distinguish a malignant melanoma from other skin conditions?

Malignant melanomas are distinguished by the presence of an asymmetrical, irregularly bordered, colored irregularly pigmented lesion with a diameter of over seven millimeters. Symptoms such as bleeding or itching can also raise suspicion.

How is a malignant melanoma diagnosed and treated?

A malignant melanoma is diagnosed through excision biopsy for histological confirmation. It is treated with wide local excision, possibly including the removal of regional lymph nodes based on clinical findings and sentinel node biopsy results. Radiotherapy and chemotherapy may also be necessary in certain cases.

What does the 'ABCD' rule refer to in the context of melanoma detection?

The 'ABCD' rule is a mnemonic used to identify suspicious moles or pigmented lesions that may indicate melanoma. It stands for Asymmetry, Border irregularity, Color irregularity, and Diameter over 6 millimeters.