Skin Tumors - Malignant

+ Actinic Keratosis
= Pathogenesis: Long-term sun-exposure
= Clinical Presentation: Pink/brown, rough patches, of about 1cm in
diameter, ulceration, easy bleeding
= Histology: Budding, atypia (hyperchromatic change), dermis with
lymphocyte infiltration
= DDX: seborrheic keratosis, verruca vulgaris, keratoacanthoma, bowen's
disease, squamous cell carcinoma
= TX: surgery, electrodessication, curretage, liquid nitrogen cryotherapy
(surgery preferred as biopsy can be done simultaneously)

+ Bowen's Disease (intra-epidermal carcinoma)
= Pathogenesis: might be due to arsenic poisoning (esp when multiple
lesions are present. single lesions are commonly due to
sun exposure)
= Clinical Presentation: pink/brown patchy lesion with crusting and
bleeding.
= Histology: entire skin layer involved. dermis with leukocyte
infiltration.
= DDX: psoriasis, discoid eczema, superficial BCC

+ Basal Cell Carcinoma
= Pathogenesis: sun exposure, long-term friction, xray. aresenic, genetic
= Clinical Presentation: nodular ulcerative type most common (rodent ulcer)
pigmented tyupe (most common). fibrosing type,
superficial type.
= TX: MOHS surgery, simple excision (most common), radiation therapy,
oral retinoids, systemic chemotherapy

+ Squamous cell carcinoma
= Pathogenesis: UV exposure, radiation,

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