SKIN CARCINOMA
• The skin CA is the most common malignancy.
• The causes of malignant skin tumors are:
Ultraviolet radiation
The most cause of skin CA is excessive
exposure to the ultraviolet rays of the sun.
Risk factors/ possible contributing
factors to skin cancer :
• Age: older people exposed to the sun –
damaged skin.
• Occupation e.g. people working outdoor.
• People with light complexions skin.
• Albinos.
• People living in the areas near equator.
• Excessive exposure to carcinogenic chemicals.
• Prolong exposure to soot (black powder arise
from smoke).
• Radioactive fall – out and radium.(exposed to
nuclear testing fallout ..)
• Repeated trauma to the skin.
• Prolonged exposure the skin to mineral
oils(white petroleum).
• Arsenic.(are used to preserve wood)
• Carcinogenic substances e.g. irritating metals.
• Scars from old burns e.g. people who have
had 2nd and 3rd degree burns.
• Long term immunosuppressive
therapy(tamoxifen, progestin).
• Genetic susceptibility.
• Congenital birth mark that large ( more than
20cm in size).
• Immuno suppressed patients who have an
increased risk to malignant skin tumor.
• HIV/AIDS
SKIN AREAS WHERE SKIN CA MOST
FREQUENTLY OCCURS
• Eyelids – especially the bottom lid.
• Nose – mostly on top of the nose, very seldom
in the shadow of the nose.
• Lip – lower lip more than upper lip.
• Scalp – higher incidence in men.
• Skin CA can, develop on any exposed areas
e.g. the dorsum of the hand or on the face.
GENERAL SIGNS AND SYMPTOMS OF SKIN CA
• A sore that will not heal.
• A nodule or wart.
• A scab (scales) that forms, fall off and
continually reforms.
The type of skin cancer
1. Basal cell carcinoma (BCC)
•
Arises from basal layers of the epidermis or
hair follicle.
2. Squamous cell carcinoma ( SCC)
• Arises from the epidermis.
3. Malignant melanoma
• Arises from neurocytic cells in the epidermis
metastasize.
BASAL CELL CARCINOMA (BCC)
• Arises from basal layers of the epidermis or
hair follicle.
• Most common type and rarely metastasizes.
• Are easily curable because of early diagnosis
and low progression.
• Have locally invasive and tend not to
metastasis.
Signs and symptoms
• Lesions begins as small nodules with a rolled,
pearly, translucent border with telangiectasia,
(are dilated superficial blood vessels )crusting
and occasionally ulceration.
• Appear most frequently on sun – exposed
skin, frequently on face, between hairline and
upper lip.
• If not treated may cause local destruction,
bleeding, and infection of adjacent tissue.
SQUAMOUS CELL CARCINOMA ( SCC)
• Are less common than BCC and have an
increased potential for metastasis.
• Arises from the epidermis.
Signs and symptoms
• Appear as a reddish rough, thickened, scaly
lesion with bleeding and soreness.
• May be preceded by leukoplakia (premalignant lesion of mucous membrane) of
the mouth, or tongue, actinic keratosis,
scarred or ulcerated lesions.
• Seen most common on lower lip, rims of ears,
head, neck, and back of the hands.
MALIGNANT MELANOMA
• Arises from neurocytic cells in the epidermis
metastasize.
• Are least common but have a higher risk of
metastasis.
• It is found in moles, warts, and birthmarks,
but it can occur anywhere e.g. in the nail bed,
mucous membranes, between the toes and
on the sole of the foot.
The characteristics of a malignant melanoma
• Changes in an existing mole are:
• Enlargement.
• Colour change.
• Satellite nodules.
• Infection (it looks like infection, but is actually a
malignant change).
• White are around the mole, which is an immune
reaction.
• Enlargement of glands.
• Metastasis, e.g. to the brain tissue.
Treatment.
• Surgery
• Radiotherapy
• Chemotherapy
• Immunotherapy
PATIENT EDUCATION WITH REGARD TO THE
PREVENTION OF SKIN CA.
• Avoid stress, stress is the contributory causes
of skin cancer.
• Avoid exposure to the sun between 10h00
and 14h00.
• Avoid long, continuous exposure to the sun
etc.
• Avoid long, continuous exposure to the sun
etc.
• Be careful of the reflection of the sun’ rays from
sand and water.
• Light, loosely woven clothes do not provide
adequate skin protection.
• The most damaging rays of the sun penetrate the
atmosphere even on cloudy day.
• Select a sun filter cream according to skin type.
• Apply the sun filter evenly and repeatedly.
• Examine the skin every month.
• Be on guard for signs and symptoms that might
possible suggest skin CA.
• If change is noted, it must not be ignored,
• If change is noted, it must not be ignored,
consult a doctor immediately.
• People who run a high risk of developing skin
CA because of the nature of their occupations
must take special precautions.
• Skin cancer is a very common form of cancer,
but it also has the greatest rate of recovery.