SUN DAMAGE and SKIN CANCER

ACTINIC KERATOSIS

ACTINIC or SOLAR KERATOSES

Treatment o Surgery Cryosurgery Curettage o Topical 5-fluorouracil Diclofenac sodium Tretinoin o Nothing and Observe

SCC-Risk Factors
Fair Skin Pipe Smoker (lip) Chronic UV exposure - PUVA Tar, arsenic Immunosuppression (renal transpalant) - HPV infection X irradiation Longstanding scars/ulcers Genetic - defective DNA repair - albino

SCC PADA KULIT

SCC PADA BIBIR PEROKOK

BCC
Clinical types Nodulo-cystic

 Superficial Pigmented Morphoeic

BCC
Risk Factors fair skinned patients chronic sun exposure X-irradiation chronic arsenic genetic predisposition

BCC
Treatment Options - excision MOHS surgery - curettage and cautery - radiotherapy

- Cryosurgery - Topical 5 fluorouracil Imiquimod

MALIGNANT MELANOMA
1985 ABCD rule Asymmetry Border irregularity Color variegation Diameter of > 6 mm

RISK FACTORS FOR MELANOMA

>50 melanocytic naevi Atypical melanocytic naevi Family history of melanoma Mutations in CDKN2A and CDK4 genes Personal history of melanoma Risk greatest in first 2 years Fair skin Blond / red hair, blue eyes, freckles Intermittent sun exposure and sunburn in childhood Tanning beds

TYPES OF MELANOMA
Superfical spreading the commonest in the UK Nodular Acral Rare in UK Common in Asian and Afro-Caribbean Lentigo maligna melanoma Arises in lentigo maligna

PROGNOSIS
93% 5-year survival 67% 5-year survival 38% 5-year survival < 1.5 mm thick 1.5-3.49 mm thick > 3 mm thick

TREATMENT
Breslow thickness - In situ - 1 mm - 1 2 mm - 2 4 mm Excision margin 0.5 - 1 cm 1 cm 2 cm 2 cm

TERIMAKASIH