Transcript Non-Melanoma Skin Cancer: Basal & Squamous Cell

Non-Melanoma Skin Cancer:
Basal & Squamous Cell
Lisa Publicover
August 2005
Introduction
 Skin cancer can be conceptually divided into melanoma
and non-melanoma.
 The two forms of non-melanoma skin cancer are basal cell
carcinoma (BCC) and squamous cell carcinoma (SCC).
 Together, BCC and SCC comprise the majority of skin
cancers, however, melanoma is much more aggressive
and fatal.
 BCC is more common than SCC, accounting for ~70% of
non-melanoma carcinomas;
 However, of the two, SCC is more dangerous because of
its potential to metastasize1.
Risk Factors
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Sunlight (UVB particularly)
Male
Age
Celtic Descent
Fair Skin
Tendency to Sunburn
Outdoor Occupation
Exposure to Industrial Toxins
Cigarette Smoking
Immunosuppression
Sun exposure is the most significant factor in
the development of BCC and SCC and most
tumors develop on sun exposed areas of the
body.
Basal Cell Carcinoma
There are 4 variants of BCC defined by the
appearance of the lesion:
– Superficial BCC
– Nodular BCC (most common)
– Pigmented BCC
– Morphoeic /Sclerosing BCC
Clinical Characteristics:
Superficial BCC
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Plaque
Erythematous
Scaly
Fine Telangiectasias
at the margins
- Slowly enlarging
Clinical Characteristics:
Nodular BCC
 Pearly
 Telangiectasias on its
surface
 Nodular
 Small & Slow growing
 Depressed/Ulcerated
centre
Clinical Characteristics:
Pigmented BCC
- Same as Nodular BCC, but with Melanin
present
- Often misdiagnosed as melanoma
Clinical Characteristics:
Morphoeic/Sclerosing BCC
 Plaque
 Poorly defined
borders
 Flat or slightly
depressed
 Indurated
 White or Yellowish
Squamous Cell Carcinoma
 Clinical Characteristics:
– Nodule or Plaque
– Erythematous
– Indurated
– Eventual Ulceration
– Scaly or Crusty
– Possibly ill-defined borders
Clinical Pearl
Surface telangectasias are rare in
SCC, differentiating it from BCC
Treatment Options
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Excision
Electrodesiccation and curettage (ED&C)
Cryosurgery
Radiation therapy
Laser therapy
Mohs micrographic surgery (MMS)
Topical 5-fluorouracil
Topical immunomodulators
Treatment
 The most common treatment are ED&C for
low risk lesions and excision for more
aggressive lesions or those in high risk
areas.
 Excision is preferred for high risk lesions
because it offers greater histologic control.
The best treatment
for all types of skin
cancer is
prevention