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Skin Malignancy (BCC (Viva (Mx (Superficial: curettage, Deep: surgical…

- - - - On face in sun-exposed areas
      - Pearly nodule c¯ rolled, telangiectactic edge
  - - - Commonest skin cancer
        secondary to sun exposure
        Slow growing locally destructive: “rodent ulcer”
        Do not metastasise
    - - Superficial: curettage
      - Deep: surgical excision ± radiotherapy
- - - - Ulcerated lesion c¯ everted edge
      - Actinic keratosis: irregular, crusty, warty lesions
      - Bowen’s: red/brown, scaly plaques
    - - Examine regional LNs
      - Examine rest of skin for other lesions
  - - - Actinic keratosis → Bowen’s → SCC
    - - Sun exposure
        Immunosuppression: e.g. ciclosporin
        Genetic: xerodermapigmentosum
        Chronic trauma: Marjolin’s ulcer
    - - Excisional biopsy
    - - Surgery ± radiotherapy
- - - - Regional LNs
      - Fundoscopy
      - Liver
        NB. Glass ye + ascites: ocular melanoma
  - - - Superficial spreading: 80%
      - Lentigo maligna melanoma: elderly
      - Acral lentiginous: Blacks, soles, palms
      - Nodular: younger, new lesion
      - Amelanotic: delayed Dx