skin conditions with normal skin anatomy and physiology.

This is a presentation of skin conditions involving the basic anatomy and physiology of the skin, then a discussion of abnormal skin disorders and cancers.

1. Skin conditions
Mr.tarigalsammani

3. Vascular
1. Hemangioma
a. capillary
(strawberry)
-compressible, vascular
lesion with sharp borders
-located mostly in the
face, scalp, and shoulder
-observe, 90% involute

4. neurofibromatosis
it is autosomaldominant disease
could be multiple (von
recklinhausens dis)
Or sporadic
Ass with
1.Skin tags
2.Café au laitspots
3.Acusticneuroma
4.5%may develop
neurofibrosarcoma
5.phaeochromcytoma

5. Dermoidcyst
Congenital:atline of fusion of
front nasal and maxillary
processes
•Location: outer & inner ends
of the eye brow or at the root
of the nose
•There is a possibility of
communication with the intra
cranium
Acquired: occurs after
trauma due to implantation of
skin
Treatment:surgry

6. Sebaceous cyst
Commonest site :scalp ,
scrotum, neck ,shoulder , back
and loop of ear
Complications:
1.Infection
2.Ulceration cocks peculiar
tumor calcification
3.Keratin horn formation
4.Malignant change is very rare
•Treatment : surgical excision

8. lipoma

9. Dermoidcyst

10. -skin cancer

11. Basal cell carcinoma
Affects fairskinnedadults who have had a lot of
sun exposure or repeated episodes of sunburn
BCCs usually arise in normal-looking skin
BCCs grow slowly over months or years
Metastasis exceedingly rare but BCCs can
cause destructive changes in surrounding
tissues

12. BASAL CELL CARCINOM

13. Nodular BCC
Most common type on face
Small, shiny, skin-coloured swelling
Telangiectasia cross the edge
May have central ulcer or scab so edges appear
rolled
Often bleed spontaneously, then heal over
Rodent ulcer is an open sore
Facial BCC should be referred to plastic surgeon

14. Nodular basal cell carcinoma

15. Superficial BCC
Often multiple
Upper trunk or shoulders commonest site
but can appear anywhere
Pink or red scaly patch with raised edge
on close examination
Slowly growing over months or years
Bleed or ulcerate easily

16. Superficial basal cell carcinoma

17. Why BCCs need treatment

18. BCC-treatment:
Shave,curettage,cautery
Excision biopsy, may need grafting or flap.
Moh’smicrographic excision
Photodynamic therapy
Cryotherapy
Radiotherapy

19. Squamous cell carcinoma
SCC is a common type of skin cancer
It develops in the epidermis from
squamous cells which produce keratin
Usual presentation is a slowly –growing
scaly or crusted lump
Can present as a non-healing sore or ulcer
“punched out” in appearance
Sometimes growth is rapid over a matter
of weeks

20. Squamous cell carcinoma

21. Squamous cell carcinoma

22. Squamous cell carcinoma

23. Squamous cell carcinoma,or is it?

24. Squamous cell carcinoma-causes:
UV radiation-damages DNA in skin
Genetic predisposition to develop SCCs
Smoking-especially SCC lip
Thermal burns
Chronic leg ulcers
HPV infection implicated in genital SCCs

25. Squamous cell carcinoma-
treatment
Histological diagnosis confirmation.
Surgery, possibly with skin graft.
Radiotherapy may be needed.

26. Malignant melanoma
Melanocytes are found in the basal layers
of the epithelium
Non-cancerous growth of melanocytes
results in moles or freckles
Cancerous growth of melanocytes results
in malignant melanoma

27. MELANOMA

28. Malignant melanoma-risk factors:
Sun exposure, particularly during
childhood
Fair skin which burns easily
Blistering sunburn, especially when young
Previous melanoma
Family history of melanoma
Previous non-melanoma skin cancer
Large numbers of moles/ dysplastic moles

29. Common sites for melanoma:
In men commonest site is the back
In women commonest site is the leg
Can occur on mucous membranes, eg lips
or genitals
Can occur under the nail
Can occur in eye, brain or mouth
BEWARE AMELANOTIC MELANOMA

30. Glasgow 7 point checklist:
MAJOR FEATURES:
Change in size
Irregular shape
Irregular colour
MINOR FEATURES:
Diameter > 7mm
Inflammation
Oozing
Change in sensation

31. . Malignant melanoma
-arises from dysplastic
melanocytes
Types
i. superficial spreading
-most common (70%)
-flat with areas of regression

32. ii. nodular –15-20%
-dark, slightly raised
-growth more vertical than
radial
Has the worst prognosis.
iii. lentigomalignant 5-10%
-best prognosis
-occurs in areas of high solar
degeneration
Iv .Acral

33. The ABCDE of melanoma
A Asymmetry
B Border irregularity
C Colour variation
D Diameter over 6mm
E Evolving (enlarging or changing)

34. Malignant melanoma

35. Growth of melanomas
Horizontal growth within
epidermis=melanoma in situ
Vertical growth through basement
membrane into dermis=invasive
melanoma
Once melanoma penetrates dermis,it
spreads via lymphatic and blood stream
= metastatic melanoma

36. Malignant melanoma

37. Histological classification:
Breslowthickness:
This is the thickness of the melanoma in mm
Clark’s level:
This describes which layer of skin has been
breached.

39. Treatment of melanoma
Surgical excision by with 2-3 mm margin
Wider excision if histology confirms melanoma
Thicker melanomas> 1mm-wider excision +/-
sentinel node biopsy
Widespread melanoma-surgery/chemotherapy

40. Prognosis of melanoma
Breslow thickness< 1mm, almost 100%
5 year survival
Breslow thickness > 4mm, only 50%
5 year survival
Remember, melanoma is a major cause of
death from malignancy in young people

41. Malignant melanoma

42. Malignant melanoma

43. Malignant melanoma

44. Malignant melanoma

45. Advanced melanoma

46. At-risk groups:
Fair-skinned individuals
Children and babies
Outdoor workers
Immunosuppressed
People with personal/FH of skin cancer
People with > 50 moles
People who overexpose skin by
sunbathing/use of sunbeds