MALIGNANT SKIN 2

SQUAMOUS CELL CARCINOMA (EPITHELIOMA)

These tumours can occur anywhere but usually occur on the exposed

parts  of the body (hand face).

 It also occurs in old burn scars, and sites of chronic irritation or irradiation.

 

CLINICAL FEATURES

The site of tumours formation starts as a hard nodule and develop

into an ulcer or cauliflower like growth.

Metastasis  occurs to the regional lymph nodes. These  are  hard

and soon get fixed to surrounding structure.

Histologic  examination  shows hyperchromatic  atypical  squamous

cells infiltrating the dermis forming "nests" or "pearls".

 

Treatment  is wide-excision with healthy margin or irradiation. 

The  involved lymph nodes need to be removed en block.

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SKIN TUMOURS MALIGNANT 1

6. MALIGNANT TUMOURS

6.1 Basal Cell Carcinoma (Rodent Ulcer  above left)

 

Clinical features:

Presents  as a hard pearly nodule on the face above the level  of

the  lips. It occurs most often in those above 40 years  of  age. 

The  nodule  shows small blood vessels and may  ulcerate  in  the

centre it grows slowly but does not metastasis.

 

On  histology shows a down growth of cells of the basal layer  of

the  epidermis.The nuclei of these cells show deep  staining  and

there may be extension of spread into the dermis.

 

TREATMENT

Can be with either with surgery (wide excision)or radiotherapy.

 

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SKN TUMOURS 2

4.4 BOWEN'S DISEASE

This is a slow enlarging red raised patch with irregular  outline

crusting is present.

   *  Histologic examination shows that the epidermis is

      thickened, cells are atypical and keratinisation is marked.

   *  Squamous cell carcinoma develops after many years.

   *  Treatment is wide excision.

 

5. TUMOURS OF THE DERMIS

5.1  The  tissue  of  the dermis can give  rise  to  LIPOMAS  and

NEUROFIBROMAS   the   latter  present  as  single   or   multiple

neurofibromas and can be inherited (von Recklinghausens Disease),

the epidermis moves free on these nodules and these nodules  move

free of the deep fascia and muscles. These are benign lesions and

rarely  undergo  malignant change.Malignant change  is  diagnosed

clinically on the basis of :

     a)  Rapid increase in size

     b)  Pain in the lesion

     c)  Fixity to skin or deeper structures

     d)  Metastasis

 

Treatment  of  any skin nodule should be  EXCISION  to  establish

histopathologic diagnosis

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SKIN TUMOURS 1

4. TUMOURS OF SKIN

4.1 Papilloma

Simple non-infective papillomas can occur at any site.

They  are usually pedunculated (Fig.) and the small  finger

like  processes on the surface can be seen with magnifying  lens. 

If  small they can be excised with an ellipse of skin to  include

the base.

 

4.2 KERATO-ACANTHOMA (Moluscum Sebaceum)

This  presents  as a rapidly increasing  hemisepherical  swelling

which soon ulcerates with crust formation (keratin),

It can also be cured by curreting Fig. .

 

4.3 CUTANEOUS NEUROFIBROMA

These  take origin from the sheath of nerves a nodule  can  occur

anywhere on the body and can be multiple.  They may be associated

with pigment of patches of skin.  One of these lesions should  be

removed and submitted for histology.

 

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