4. BASAL CELL PAPILLOMA
SOFT WARTY LESIONS,PIGMENTED AND HYPERKERATOTIC IN
BASAL LAYER
PAPILLARY WART
BENIGN SKIN TUMOURS HPV
FRECKLE
NORMAL NUMBER OF MELANOCYTES WITH INCREASE
PRODUCTION
5. LENTIGO
• SHARPLY CIRCOMSCRIBED PIGMENTED MACULES
• MAY AT TIMES ASSOCIATED WITH PEUTZ JEGHERS
SYNDROME
MOLES/NAEVUS
• MOLES/NAEVUS ARE LAYERED OR AGGREGATES OF
MELONICYTES IN EPIDERMIS
21. GIANT CONGINATAL PIGMENTED NAEVUS
GCPNSPRECURSORS FOR MM
MORE LIKELY WITH AXIAL LESIONS
RETROPERITONEAL OR INTRACRANIAL LESIONS
MULTIDICSIPILANARY MANAGEMENT
PERINATAL CURETTAGE,DERMAABRASION,LASER RESURFACING,
SURGICAL EXCISION WITH SKIN GRAFTS
DYSPLASTIC NAEVUS
IRREGULAR PROLIFERATIONS ATYPICAL MELANOCYTES
AT BASAL LAYER OF EPIDERMIS
25. ACTINIC SOLAR
KREATOSIS
20% S CC
CUTANEOUS HORN 10”% SCC
KERATOACHANTHOM
A
SCC
BOWENS DISEASE 3-11% SCC
EXTRA MAMMARY
PAGETS
GIANT CONGENITAL
PIMEMENTD NAEVUS
25% SCC
3-5% MM
26. BASAL CELL CARCINOMA
EPIDEMIOLOGY
• SLOW GROWING LOCALLY INVASIVE MALIGNANT TUMOUR
• PLURIPOTENT EPITHELIAL CELLS
• UVR IS STRONGEST PREDISPOSING FACTOR
• OTHERS MAY BEARSENICAL COMPOUNDS,COAL TAR,AROMATIC HYDROCARBONS
• 90%LESION ON FACE ABOVE ALINE FROM THE LOBE OF THE EAR TO THE CORNER OF
MOUTH
• WHITE SKIN 40-80 YRS M>F
PATHOGENESIS
• SLOW GROWING PROPOTIANTE TO DOSE OF CARCINOGEN
• RARLY METASTISE
• HARD TO CULTURE
MACROSCOPIC APPEARANCE
• NODULAR
• NODULOCYSTIC
• CYSTIC
MICROSCOPIOC APPEAREANCE
• OVOID CELLS IN NEST WITH SINGLE OUTER PALISADING LAYER
31. SQUAMOUS CELL CARCINOMA
EPIDEMIOLOGY
MALIGNANT TUMOUR OF KERATINISING CELLS OF EPIDERMIS OR ITS APPENDAGES
SECOND MOST COMMON TUMOUR
WHITE SKIN ELDERLY MEN WITH CUMULATIVE SUN EXPOSURE
ALSO ASSOCIATED CHRONIC INFLAMMATION(SINUS TRACTS , PREEXISTING SCARS
,OSTEOMYLETIS,BURNS,IMMUNOSUPPRESION,MARJOLINS )2% METASTASIS
20% RECURRENCE
MACROSCOPIC
• EVERTED EDGES WITH INFLAMMED SKIN
• SMOOTH NODULAR,VERROCOUS
• PAPILLOMATOUS
• ULCERATING
MICROSCOPIC
• IRREGULAR MASSES OF SQUAMOUS EPITHELIUM
• CELLULAR MORPHOLOGY,BRODERS GRADE ,DEPTH OF INVASIONPERINEURAL OR
VASCULAR INVASION
34. MANAGEMENT
• DEFINTE TREATMENT SURGICAL
LOUPE EXCISION(4MM CLEARANCE
MARGIN IF <2 AND 1CM MARGIN >2CM
LESIONS )
• IN TRANSIT METSTASIS
• LYMPHATIC METSTASIS
35. MALIGNANT MALENOMA
• EPIDEMIOLOGY
• MM IS CANCER MELNOCYTES
• MM ACCOUNTS FOR 5% OF SKIN
MALIGNANCY
• INCREASES UVR EXPOSURE
• 3%OF ALL MALIGNANCYS
• 75% OF ALL DEATHS
• 7%OCCULT METASTASIS
36. RISK FACTORS:
• XERODERMAPIGMENTOSUM
• PAST MEDICAL OR FAMILY HISTORY
• HIGH NUMBER OF NAEVI
• TENDENCY TO FRECKLE
• GCPN
• DYSPLASTIC NAEVUS
• IMMUNOCOMPROMISED
MACROSCOPIC APPEANRANCE
• SUPERFICIAL SPREADING MELANOMA75%
• NODULAR MELANOMA 15%
• LENTIGO MALIGNA MELANOMA5-10%
• ACRAL LENTIGIOUS MELANOMA2-8%
FEATURES IN NAEVI SUGGESTING MM
• CHANGE IN SIZE ,SHAPE COLOUR ,ITCHING,SATELLITE
LESIONS
• BLOOD SUPPLY
