SKIN CANCER

 

Non melanoma skin cancers may be of two distinct types: Basal cell Carcinoma (BCC) and Squamous cell carcinoma (SCC). It is important to be able to identify the early signs that characterise these conditions. 

 

BASAL CELL CARCINOMA

 

 

 

 

 

 

 

 

 

 

What is a Basal cell carcinoma? 

 

The BCC is the commonest skin tumour occurring in man.  It develops on sun-exposed areas of the body eg. face, chest, shoulders, upper back and the arms.  It is seen exclusively in light skinned individuals. BCCs tend to have a very indolent clinical course. They are usually not dangerous as they do not commonly spread to distant parts of the body. 

 

What are the clinical appearances of a BCC?

 

A BCC may present in five different ways:

 

An open sore that bleeds, oozes or crusts and remains open for three or more weeks. A persistent non-healing sore is a very common early sign of a BCC.

 

A reddish patch or irritated area, frequently occurring on the chest, shoulders, arms or legs. Sometimes, the patch crusts. It may also itch or hurt.

 

A shiny bump or nodule that is pearly or translucent and is often pink, red or white. The bump may also be tan, brown or black especially in dark-haired individuals and may be confused with a mole.

 

A scar-like area that is usually white, yellow and waxy and has poorly defined borders. The skin itself appears shiny and taut. This warning sign may indicate the presence of an aggressive tumour

 

A pink growth with a slightly rolled and elevated border with a crusted indentation in the centre. As the growth slowly enlarges, tiny blood vessels may develop on the surface.

 

How do you confirm the presence of a BCC?

 

A small biopsy is done of the suspected lesion is done under local anaesthetic.

This small piece of tissue is then sent to the laboratory for analysis to confirm the diagnosis.

 

What are the treatment options for a BCC?

 

The treatment options for a BCC depends on the size, site, extent, clinical and histological subtype of BCC and the age of the patient. The options include the following:

 

Surgical excision

Moh’s Micrographic surgery- minimal marginal surgery

Cryosurgery

Curettage and electrocautery

Interferon injections- 1,5mu 3 x week for 3 weeks

Topical Aldara(Imiquimod) 3 x week for 6 weeks- for superficial BCC.

Photodynamic therapy (632nm red light) for superficial BCC.

 

SQUAMOUS CELL CARCINOMA

 

 

 

 

 

 

 

 

 

What is a squamous cell carcinoma (SCC)?

 

A SCC is a type of skin cancer, which commonly occurs in sun exposed areas, at sites of chronic sun damage. The skin usually presents with wrinkling, pigmentary change and alteration in elasticity. It occurs more commonly in older patients. The common precursor lesions are SOLAR KERATOSES. These are small gritty lesions which are seen on the face, scalp, V of the neck and dorsal aspect of the forearms. It is important to treat these lesions to prevent progression to a SCC. 

 

What are the clinical appearances of a SCC?

 

A SCC may present in the following ways:

 

A wart like growth that crusts and occasionally bleeds.

A persistent scaly red patch with irregular borders that sometimes crusts or bleeds.

An open sore that bleeds and crusts and persists for weeks.

An elevated growth with a central depression that occasionally bleeds. A growth of this type may rapidly increase in size.

What are the treatment options for a SCC?

 

The treatment options for a SCC depends on the size, site, extent, clinical and histological subtype of SCC and the age of the patient. The options include the following:

 

Surgical excision

Cryosurgery

Curettage and electrocautery

Topical Aldara(Imiquimod) 3 x week for 6 weeks- for superficial SCC (Bowens disease).

Photodynamic therapy (632nm red light) for superficial SCC (Bowens disease).