Basal cell carcinoma
- Commonest skin malignancy
- Occurs on sun exposed skin
- Commonest site face above line from angle of mouth to ear
- Predisposing factors:
- Xeroderma pigmentosa
- Radiotherapy
- BCC are locally invasive
- They rarely metastasise
Clinical types
- Nodular or Noduloulcerative
- Cystic
- Pigmented
- Sclerosing
- Cicatrical
- Superficial
Treatment
- Local excision with 0.5 cm margins
- May require full thickness graft
- Radiotherapy
- Mohs Surgery
- Cure rate > 95%
Squamous cell carcinoma
- Second commonest cutaneous malignancy
- Commonest site - face & hands
- Arises from keratinising cell layer
Predisposing factors
- Solar keratoses
- Bowen's Disease
- Viral warts
- Chronic ulceration or sinuses ( = Marjolin's ulcers)
- Appear as keratotic nodule with ulcerated centre
Differential diagnosis
- Keratoacanthoma
- Basal cell carcinoma
- Amelanotic melanomas
- Skin adnexal tumours
Treatment
- Wide local excision and possible elective lymph node dissection
Bibliography
Alam M, Rotner D. Cutaneous squamous cell carcinoma.
N Engl J Med 2001; 344: 975-983.
Campbell F A, Gupta G. The management of non-melanoma skin
cancer. Hosp Med 2005; 66: 288-293.
Holt P J A, Motley R J. The treatment of basal cell carcinoma. Curr
Pract Surg 1994; 6: 98 - 101.
Ruben A I, Chen E H, Ratner D. Basal-cell carcinoma.
N Engl J Med 2005; 353: 2262-2269.
Telfer N R, Colver G B, Bowers P W. Guidelines for the management of
basal cell carcinoma. Br J Dermatol 1999; 141: 415-423. |
