Skin Cancer

basal cell carcinoma,

 Most prevalent, rarely causes death
 Appears on sun exposed hands, face, neck, scalp
 Small waxy nodule
 May appear shiny, flat, gray, yellow
 Rarely metastasizes
 Reoccurrence common

squamous cell carcinoma

 Arises from epidermis, sun damaged skin
 Less aggressive than melanoma, can cause death
 May metastasize by blood or lymph
 Rough, thickened, scaly tumor
 May be asymptomatic or bleed
 Border is wide, more infiltrated, more inflammatory

melanoma.
 Cancerous neoplasm present in dermis and epidermis
 Manifests as a change in nevus or a new growth on the skin
 Color is dark, red, blue colored or a mix, irregular shape
 Itching, rapid growth, ulceration, bleeding
 Treatment: surgical excision, chemotherapy

Risk Factors
 Fair skin
 A history of sunburn
 Excessive ultraviolet (UV) light exposure
 Living closer to the equator or at a higher elevation
 Having many moles or unusual moles
 A family history of melanoma
 Weakened immune system

also Kaposi sarcoma, Merkel cell carcinoma and Sebaceous gland carcinoma
 A malignancy of endothelial cells that line the blood vessels: dark reddish-purple lesions of the skin, oral
cavity, GI tract, and lungs

Risk factors
 Classic KS: older men Mediterranean or Jewish chronic, benign
  Endemic (African) KS: Eastern half of Africa, men, resembles classic
 Iatrogenic/organ transplant-associated KS: organ transplant clients and immunosuppressants
 AIDs related or epidemic: occurs with AIDs, aggressive

Merkel cell carcinoma

 A very rare disease in which malignant (cancer) cells form in the skin.
 Causes a firm, shiny nodules that occur on or just beneath the skin and in hair follicles.
 Most often found on the head, neck and trunk.
 Sun exposure and having a weak immune system can affect the risk of Merkel cell carcinoma.
 Merkel cell carcinoma usually appears as a single painless lump on sun-exposed skin

Sebaceous gland carcinoma

 This uncommon and aggressive cancer originates in the oil glands in the skin. Sebaceous gland carcinomas
— which usually appear as hard, painless nodules — can develop anywhere, but most occur on the eyelid,
where they're frequently mistaken for other eyelid problems.

Mohs surgery
 Used with basal and squamous cell carcinoma
Tissue is sectioned horizontally in layers and each layer is examined for presence of residual cancer; the
process is continued until the samples are free of cancer
 COMPLICATIONS: Skin abscess and cellulitis

 Treatment options
o Mohs micrographic surgery removes the tumor layer by layer. The first layer excised
includes all evident tumor and a small margin of normal-appearing tissue. The specimen is
frozen and analyzed by section to determine if all the tumor has been removed. If not, additional
layers of tissue are shaved and examined until all tissue margins are tumor-free.
 The cell membranes are altered in cancer cells, which affect fluid movement in and out of the cell. The
cell membrane of malignant cells also contains proteins called tumor-associated antigens. Typically,
nuclei of cancer cells are large and irregularly shaped (pleomorphism), though they are not always
mobile. Fragility of chromosomes is commonly found when cancer cells are analyzed.
 Squamous cells: Thin, flat cells that form the top layer of the epidermis. Cancer that forms in squamous
cells is called squamous cell carcinoma of the skin.
 Basal cells: Round cells under the squamous cells. Cancer that forms in basal cells is called basal cell
carcinoma.
 Melanocytes: Found in the lower part of the epidermis, these cells make melanin, the pigment that gives
skin its natural color. When skin is exposed to the sun, melanocytes make more pigment and cause the
skin to tan, or darken. Cancer that forms in melanocytes is called melanoma.