Podcast: Play in new window | Download
Kaposi’s Sarcoma
- A systemic disease caused by herpes virus 8
- Most often have lesions on the skin surface.
- Typically a very slow developing illness, but in conjunction with the AIDS virus it progresses very quickly.
- These lesions became linked directly with AIDS during the 1980’s.
Clinical Presentation
-
Skin lesions
- Flat or raised
- Purple
- Widespread or in one area of the body
-
GI lesions
- Difficulty swallowing
- Wieght loss
-
Pulmonary lesions
- Difficulty breathing
- Cough
- Chest pain
- Hemoptysis
Labs and Studies
- Tissue biopsy is necessary for diagnosis
Treatment
- There is no cure
-
Treating the immunodeficiency is the primary concern.
- Lesions often begin to shrink with first antiretroviral therapy in AIDS patients.
- Local treatment is possible for patients with limited skin involvement
- Radiation
- Cryotherapy
Basal Cell Carcinoma
- The most common skin cancer
- Considered malignant due to its local destructive properties, but it almost never metastasizes.
Clinical Presentation
-
A single lesion described as
- Raised
- Shiny or pearly
- Ulcerated
- There are many different presentations including an appearance similar to eczema or acne scar making the initial diagnosis more difficult.
- Found mostly in sun exposed areas of the skin like the ears, nose and face, but up to 1/3 are found in non sun exposed areas.
Labs and Studies
- Clinical diagnosis is the basis of diagnosis
- Biopsy will confirm diagnosis
Treatment
-
Mohs surgery
- Surgical removal of the tumor with microscopic examination of the tissue before repair of the site.
- Radiation may be an option in older patients
Squamous Cell Skin Carcinoma
- Second most common skin cancer
- Occur primarily in sun exposed areas
- Often malignant
Clinical Presentation
- A growing non healing rough, bumpy, scaly patch
- Lesions have a variable appearance
- Non healing lesion on sun exposed area is suspicious
- 90% are found on the head and neck
Labs and Studies
- Skin biopsy
Treatment
- Prevention is key
- Sun protection
- Mohs surgery
- Chemotherapy
- Radiation
Melanoma
- A malignant tumor made up of melanocytes
- Far less common than basal cell carcinoma
- Causes up to 75% of deaths from skin cancer
Clinical Presentation
- Lesions most commonly found on sun exposed surfaces.
- Change in shape, size or color of an existing mole
- New moles
- ABCDEEFG
- Asymmetry
- Borders are irregular
- Color changes
- Diameter greater than 6 mm
- Evolving over time
- Elevated above the skin
- Firm
- Growing
- ABCDEEFG
Labs and Studies
- Biopsy
- Tumor thickness is the most important part of predicting survival rates
- CT/PET scan for malignancies
Treatment
– Prevention is key
– Sun protection
– Surgical excision
