MEDI7305 Lecture Notes - Lecture 2: Wart, Palliative Care, Radiation Therapy
M1b - Skin Lesions in Rural Setting
Non-melanoma skin cancer (NMSC)
Epidemiology 2 out of 3 Australians will develop NMSC, whereby BCC is 2x more common than SCC
Sun exposure
NMSC is preventable via sun protection starting from childhood
UVB (280-315nm) is more carcinogenic via p53 mutations
UVA (315-400nm) is less carcinogenic via ROS
BCC is linked to intense intermittent UV exposure, also immunosuppression, ionising
radiation, arsenic, scars, Gorlin syndrome etc
SCC is linked to chronic UV exposure, also immunosuppression, tobacco, arsenic, scars,
chronic ulcers
BCC 4 main clinical subtypes
Nodular Shiny, translucent/ pearly, telangiectatic papule or nodule
Superficial Bright pink, shiny, well-defined erythematous macular lesion
Morphoeic Scar-like appearance
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Pigmented Variably pigmented
SCC Subtypes
SCC Scaling lesion with erythematous base + induration, thickness
or tenderness
Dermoscopy is not particularly helpful
Bowen's disease Sharply defined, erythematous, round-oval scaling
hyperkeratotic plaque in non-light exposed skin areas
Dermoscopy is helpful
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
2 out of 3 australians will develop nmsc, whereby bcc is 2x more common than scc. Nmsc is preventable via sun protection starting from childhood. Uvb (280-315nm) is more carcinogenic via p53 mutations. Bcc is linked to intense intermittent uv exposure, also immunosuppression, ionising radiation, arsenic, scars, gorlin syndrome etc. Scc is linked to chronic uv exposure, also immunosuppression, tobacco, arsenic, scars, chronic ulcers. Scaling lesion with erythematous base + induration, thickness or tenderness. Sharply defined, erythematous, round-oval scaling hyperkeratotic plaque in non-light exposed skin areas. Fast-growing then resolving (~12wk period) symmetrical cup- shaped lesions with central keratin-filled crater, sharply circumscribed, usually on sun-damaged skin. Complex excision with flap repair or skin graft. Useful - maximal preservation of health tissue required and/or aggressive/ poorly differentiated +/- unclear clinical margins. Indication - sks, kas, bowen"s, well-defined primary bccs, seborrhoeic keratoses, pyogenic granulomas, viral warts, skin tags. Photodynamic therapy granulomas nose or near eyes) wavelength light o.
