A Simple Guide to Skin Polyp

A Simple Guide to Skin Polyp
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What is a Skin Polyp?
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Skin Polyp is a benign tumor with soft round body rising on a stalk from the skin surface.

They are often called skin tags.


Who is affected by Skin Polyp?
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Skin polyp usually occur in middle age.

Skin Polyp is more common in women than in men.

Polyps can also be found all over the body especially areas where the skin forms creases, such as the neck, armpits and groin.

Some may found on the eyelids.


What is the Cause of Skin Polyp?
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Skin Polyp is a well encapsulated round swelling rising from the skin on a stalk called the peduncle.

The cause of formation of skin polyps is unknown but may be related to:

1.Age

2.Obesity

3.hereditary


What are the Symptoms and signs of Skin Polyp?
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Symptoms :

1.slow growing round soft tissue swelling on a stalk rising from the skin

2.mutiple swellings may also be present.

3.Usually painless

Signs:

1.swelling is well demarcated and rounded

2.there is a stalk or peduncle attached to it.


How do you make the Diagnosis of skin Polyp?
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1.round well encapsulated swelling

2.soft on palpation

3.there ia a stalk attached to the swelling from the skin

4.Microscopic examination shows the presence of a fibrovascular core together with fat cells and nerve cells covered by skin.


What are the complications of skin Polyp?
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The skin polyp can be irritated by shaving, clothing or jewellery.

There can be :

1. bleeding

2. infection especially in diabetes

What is the treatment of skin Polyp?
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The only treatment is removal of the skin Polyp.

This can be done by :

1.Excision with a scalpel

2.Cauterization: with cautery instrument

3.Cryosurgery (freezing with liquid nitrogen)

4.Ligation with a sterile thread: by cutting off blood supply to the polyp

Small Polyps may left alone if they are slow growing and does not impinge on the nearby organs.

What is the prognosis of skin Polyp?
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The prognosis is usually excellent.

Recurrence at the same spot is rare but do occur due to regrowth of the blood vessel supplying the Polyp.

A Simple Guide to Squamous Cell Carcinoma(skin)

A Simple Guide to Squamous Cell Carcinoma(skin)
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What is Squamous Cell Carcinoma?
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Squamous Cell Carcinoma is a progressive neoplastic tumor of the epithelial cells of thee skin which are found mainly in the late middle age and consists of a solitary skin lesion.

Who is affected by Squamous Cell Carcinoma?
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Squamous Cell Carcinoma is more common in :

1.People with fair skin than in those with darker skin.

2.People who spend time outdoors under the sun than those staying indoors.

3.People with skin condition called xeroderma pigmentosa

4.People with autoimmune disease such as systemic lupus erythematosus

5.People with family history of Squamous Cell Carcinoma


What is the Cause of Squamous Cell Carcinoma?
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A.Sun exposure:

Exposure to the sun is one of the most common causes of Squamous Cell Carcinoma.

Risk factors are:

1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

B.Familial:

1.skin condition called xeroderma pigmentosa (autosomal recessive)

2.family history of Squamous Cell Carcinoma


What are the Symptoms and signs of Squamous Cell Carcinoma?
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Squamous Cell Carcinoma presents usually as:

1.single firm lesion

2.raised

3.red

4.indurated

5.scaling

6.ulceration may occur

7.rarely bleeding

8.found in sun exposed areas of body

9.regional lymph nodes may be enlarged


How do you make the Diagnosis of Squamous Cell Carcinoma?
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Biopsy show malignant epithelial cells with varying degrees of infiltration


What are the complications of Squamous Cell Carcinoma?
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Squamous Cell Carcinoma can spread to the organs and other parts of the body


What is the treatment of Squamous Cell Carcinoma?
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Treatment is simple surgical removal of the skin lesion .

Sometimes the regional lymph nodes are also removed.

If the spread is further, chemotherapy and radiotherapy may be necessary.


What is the prognosis of Squamous Cell Carcinoma?
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The prognosis is good if detected early and there is complete removal of the cancer.

If there is spread to the organs, prognosis is variable depending on the degree of metastases.


What are the preventive measures for Squamous cell carcinoma?
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1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats).

Use sunscreens.

2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.

3.Patients with family history of skin cancer should be reviewed yearly

4.Recently a melanocyte-stimulating hormone called melanotan has been found to provide photo-protection against squamous cell carcinoma of the skin.

A Simple Guide to Basal cell carcinoma

A Simple Guide to Basal cell carcinoma
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What is Basal cell carcinoma?
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Basal cell carcinoma is a localized malignant tumor of the basal cells of the skin which seldom spread beyond its location.

It is the most common skin cancer.

It usually occurs in fair skinned people above the age of 50.

It is never life threatening.

Who is affected by Basal cell carcinoma?
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Basal cell carcinoma is more common in :

1.People with fair skin than in those with darker skin.

2.People who spend time outdoors under the sun than those staying indoors.

3.People with a family history of Basal cell carcinoma.

What is the Cause of Basal cell carcinoma?
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A. Familial:

Familial cases of Basal cell carcinoma with

1.autosomal dominant genes(basal cell nevus) and

2.xeroderma pigmentosum(autosomal recessive)

are more common especially in fair skin people.

B.Sun exposure:

Exposure to the sun is one of the most common causes of Basal cell carcinoma.

The majority of basal cell carcinomas occur on sun-exposed areas of the body.

Risk factors are:

1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

C:Environmental causes:

1.Arsenic exposure in certain occupations(preparation of arsenic products)

2.Exposure to X-ray radiation especially radiotherapy

What are the types of Basal cell carcinoma?
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1.Nodular: flesh-colored papule with capillaries which can become ulcerated ( called rodent ulcer )

2.Cystic: less common with a central cystic cavity.

3.Pigmented: pigmented nodular form

4.Sclerosing: looks like a keloid

5.Superficial: a red scaly flat lesion.

What are the Symptoms and signs of Basal cell carcinoma?
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Basal cell carcinoma can present as:

1.firm nodule which grows within the skin and below it

2.Color may be like normal skin, dark brown or black.

3.Border is characteristic rolled up edge

4. red, flat, scaling areas similar to a patch of eczema.

How do you make the Diagnosis of Basal cell carcinoma?
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1.Skin biopsy under local anesthesia

2.small lesions can be totally removed

3.larger ones are biopsied first and surgically removed if there is confirmed malignancy.


What are the complications of Basal cell carcinoma?
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1.local growth and destruction of neighboring tissues (e.g. nose).

2.Growth into vital structures resulting in the loss of extension or function

3.rarely metastases or cause death.

What is the treatment of Basal cell carcinoma?
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Surgery:

Most basal cell carcinomas are removed by surgical excision with margins of 4-6mm.


Chemotherapy:

local therapy with 5-fluorouracil(a chemotherapy agent) with 70-90% success rate

Radiation:

Radiation therapy may be used in older patients not suitable for surgery.

Cryosurgery:

Cryosurgery can be done for basal cell cancer that invades cartilage.

Mohs surgery:

Mohs micrographic surgery is an outpatient procedure in which the cancer nodule is surgically excised and then immediately examined under a microscope. The base and edges are microscopically examined to confirm no evidence of malignancy before repair is done.

Immunotherapy:

Immunotherapy research indicates that treatment with Euphorbia peplus, a common garden weed, may be effective against Basal cell carcinoma.

What is the prognosis of Basal cell carcinoma?
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Prognosis of majority of cases is good if there is complete removal.

Sclerosing lesions are harder to treat because they invade deeper into the tissues.

What are the preventive measures for Basal cell carcinoma?
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1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats). Use sunscreens.

2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.

3.Patients with family history of skin cancer should be reviewed yearly

A Simple Guide to Melonoma

A Simple Guide to Melonoma
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What is Melonoma?
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Melanoma is a progressive neoplastic tumor of melanocytes which are found mainly in the skin and can be present in the eye and the intestine.

It is a rare but dangerous cancer because of its rapid growth.

Who is affected by Melonoma?
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Melonoma is more common in :

1.People with fair skin than in those with darker skin.

2.People with multiple atypical nevi(moles)

3.Persons born with giant congenital melanocytic nevi(moles)

4.People who spend time outdoors under the sun than those staying indoors.

5.People with a family history of melanoma

What is the Cause of Melonoma?
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A. Familial:

Familial cases of melanoma with autosomal dominant genes are more common especially in fair skin people.

B.Sun exposure:

Exposure to the sun is one of the most common causes of melanoma.

Risk factors are:

1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

What are the types of Melanoma?
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Types of primary melanomas:

1.superficial spreading melanoma

2.nodular melanoma

3.acral lentiginous melanoma

4.lentigo maligna melanoma

Melanomas occuring in non-skin areas:

5.clear cell sarcoma (Soft Parts)

6.mucosal melanoma (Intestines)

7.uveal melanoma (Eye)

What are the Symptoms and signs of Melanoma?
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Symptoms & Signs:
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A skin mole which has the following features:

1.Asymmetrical features

2.Border of the mole is irregular.

3.Color: black, blue or brown with occasional reddish and white areas

4.Diameter: Any mole with a diameter of > 5 mm has a higher chance to become melanomas

5.Elevation: The mole is usually raised above the skin.

Any change in the mole appearance may suggest malignancy

Bleeding and ulcerations are late signs.

Loss of skin markings may be present.

There is rarely pain.

How do you make the Diagnosis of Melanoma?
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1.Moles that are irregular in color or shape

2.Excision biopsy of the suspected mole.

3.Lactate dehydrogenase (LDH) tests are used to detect metastases

4.chest X-rays - to exclude spread to lungs

4.CT, MRI, PET scans of body to exclude metastases.

What are the complications of Melanoma?
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Metastases or spread of the melanoma can spread through the lymphatic or blood vessels to:

1.lymph nodes - if detected early and removed, survival rate is better

2.skin and lungs - have a better survival rate

3.brain , bone and liver - have the worst survival rates

What is the treatment of Melonoma?
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Surgery is the only treatment for localized cutaneous melanoma.

The skin lesion must be totally removed with an adequate margin of surrounding skin and tissue.

The biopsy will include the epidermal, dermal, and subcutaneous layers of the skin,in order to determine the depth and any infiltration outside the lesion.

The lymph nodes nearest to the lesion are also removed.

Disseminated melanoma (Cancer has spread to other parts of body) requires chemotherapy.

Radiation therapy is also used after surgery for patients with local melanoma or for patients with un-operable distant metastases.

Immuno-therapy with interleukin-2 or interferon has also been used with encouraging good results.

Gene therapy is a new area where the genes are manipulated to help kill the melanoma cells.

What is the prognosis of Melonoma?
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Prognosis depends on the following factors:
1.tumor thickness

2.depth related to skin

3.type of melanoma,

4.ulceration presence

5.lymphatic spread

6.tumor infiltrating lymphocytes (if present, prognosis is better),

7.location of lesion,

8.distant metastasis

Early diagnosis, biopsy and surgery usually means better prognosis.

Prognosis also depends on the depth and thickness of the melanoma.
The smaller the thickness of the melanoma the better is the prognosis.

Regional node spread and distant metastases usually suggest poor prognosis.

What are preventive measures for Melanoma?
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1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats)

2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.

3.Patients with family history of skin cancer should be reviewed yearly

4.Israeli scientists from the Oncology Institute of the Hadassa Medical Center in Jerusalem in June 2008 announced the development of a new vaccine which can prevent recurrences and increase survival rates for melanoma patients.

A Simple Guide to Lipoma

A Simple Guide to Lipoma
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What is Lipoma?
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Lipoma is a benign tumor which consists of well circumscribed fatty tissue.


Who is affected by Lipoma?
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Lipoma is more common in women than in men.

A possible reason is that women has more fatty tissue than men.

Lipomas can also be found all over the body:
1.subcutaneous

2.subfascial

3.subsynovial

4.intrarticular

5.intramuscular

6.perosteal

7.subserous

8.submucous

9.extradural


What is the Cause of Lipoma?
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Lipoma is a well encapsulated round swelling consisting fats cell which are not distinguishable from normal fat cells.

Possible causes are:

1.hereditary - more common in some families than others

2.injury to fatty tissue - stimulation for the fat cells to grow and accumulate at one site.


What are the Symptoms and signs of Lipoma?
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Symptoms :

1.slow growing round soft tissue swelling on the skin

2.mutiple swellings may also be present.

3.painless

Signs:

1.swelling are well demarcated and rounded

2.Soft tissue felt on palpation.

3.May grow to considerable size.


How do you make the Diagnosis of Lipoma?
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1.round well encapsulated swelling

2.soft on palpation

3.Unlike sebaceous cyst doe not have an central blocked opening

4.Ultrasound may used to confirm the presence of fatty tissue and not a cyst or malignant tumor

5.Biopsy of the swelling will confirm presence of fat cells


What are the complications of Lipoma?
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The lipoma may grow to considerable size over tima and can cause blockage to neighbouring organs:

1.intestinal obstruction at the abdominal area

2.difficulty in breathing especially near the trachea

3.In rare cases lipoma may become malignant liposarcoma


What is the treatment of Lipoma?
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The only treatment is surgical excision of the lipoma.

Small lipomas may left alone if they are slow growing and does not impinge on the nearby organs.


What is the prognosis of Lipoma?
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The prognosis is usually excellent.

Recurrence at the smae spot is rare but do occur due to regrowth of the blood vessel supplying the lipoma.

Rarely a lipoma may undergo malignant degeneration and become liposarcoma.