Lecture on Skin Cancer

Introduction

• Presenter: Brittany, Nurse Practitioner with SMMP Reviews
• Topic: Skin cancer, the most common type of cancer
• Importance: Likely to appear on exams, critical for patient care
• Focus Areas:
  • Risk factors
  • Precursors to skin cancer
  • Types of skin cancers
  • Management and education to decrease risk

Risk Factors for Skin Cancer

• Universal susceptibility: Anyone can get skin cancer
• Higher risk characteristics:
  • Light skin
  • Skin that burns easily
  • Freckles or redness
  • Blonde or red hair
  • Large number of moles
  • Family history
  • Increased age
  • Frequent sun exposure

Prevention Strategies

• Non-modifiable risks: Family history, light skin, age
• Modifiable factors:
  • Limit sun exposure
  • Use sunscreen
  • Wear protective clothing (hats, sunglasses, long sleeves)
  • Avoid indoor tanning (high UV exposure)

Precursors to Skin Cancer

• Actinic Keratosis:
  • Pre-cancerous lesion
  • Characteristics: Flaky, scaly, rough, yellow/pink in color
  • Symptoms: Itching or burning
  • Management: Removal via dermatologist (cryotherapy or 5-FU)

Types of Skin Cancer

Squamous Cell Carcinoma

• Common areas: Sun-exposed skin (scalp, shoulders, back, hands, ears, lips)
• Characteristics: Rough edges, scaly/flaky, nodular or ulcerated center

Basal Cell Carcinoma

• Most common type
• Characteristics: Waxy, pearly, raised, visible blood vessels (telangiectasia)
• Mnemonic for Basal Cell: "B"s – Bump, Blood vessels, Big

Malignant Melanoma

• Most deadly type
• Can occur anywhere, including uncommon sites (under fingernails)
• Patient education: Regular skin self-exams using ABCDE mnemonic

ABCDE Mnemonic for Melanoma

• Asymmetry: Uneven shape
• Borders: Irregular or jagged
• Color: Darker, mixed colors, uneven distribution
• Diameter: Greater than 6 mm
• Evolving: Changes over time

Management of Suspected Skin Cancer

• Early detection critical to improve outcomes
• Strategies:
  • Removal of pre-cancerous lesions (e.g., actinic keratosis)
  • Referral to dermatology for biopsy and removal of suspicious lesions

Practice Questions

1. Scenario: Flaky, scaly pink spot, itchy, sun-exposed location.
   • Diagnosis: Actinic keratosis
2. Scenario: Dark line under fingernail, no injury reported.
   • Diagnosis: Malignant melanoma
   • Also consider splinter hemorrhages in other contexts (e.g., infective endocarditis)

Conclusion

• Importance of education, prevention, and early detection
• Emphasis on patient exams and recognizing warning signs
• Subscription reminder for more educational content

Remember: Taking preventive measures and early action can significantly impact patient outcomes in skin cancer.