Malignant Skin Disorders and Their Types

Malignant Skin Disorder

• Skin cancer arises from uncontrolled and disordered skin cell growth.
• Normally, new skin cells replace old or damaged ones.
• A collection of cells may be benign (non-cancerous) or cancerous (able to spread to other body parts).

Types of Malignant Skin Cancer

• Basal cell carcinoma (BCC)
• Squamous cell carcinoma (SCC)
• Melanoma

Introduction Continued

• BCC and SCC are the most common types of skin cancers, sometimes called "non-melanoma" skin cancers.
• Melanoma, while less common than BCC or SCC, is the most dangerous type as it can rapidly spread to other parts of the body.
• Untreated or late-stage melanoma often makes treatment difficult and can be life-threatening.

Basal Cell Carcinoma (BCC)

• BCC is the most common type of skin cancer, often resulting from sun damage.
• Lesions typically appear in sun-exposed areas.
• BCC generally grows slowly and often doesn't spread to other body parts.
• It is, in most cases, not life-threatening.

Warning Signs of BCC

• Persistent, non-healing sores that may bleed, ooze, or crust
• Red, irritated patches on face, chest, shoulders, arms, or legs, with potential for crusting, itching or pain
• Pearly, translucent, or pinkish bumps or nodules on the skin, sometimes mistaken for moles (especially in those with darker skin tones).
• Shiny, taut skin with poorly defined borders
• A small pink growth with raised, rolled edges, and a crusted indentation in the center that may develop tiny blood vessels (possibly invasive BCC).
• A scar-like area that is flat and waxy or white in color

Squamous Cell Carcinoma (SCC)

• SCC commonly develops on sun-exposed areas, including face, hands, arms, legs, ears, and mouth.
• SCC is second most common type of skin cancer.
• It sometimes occurs in mucous membranes and genitals.
• Early stages of SCC are known as Bowen disease.

Warning Signs of SCC

• Persistent, scaly, red patches with irregular borders that might crust or bleed
• Elevated growths with central depressions that bleed or grow rapidly
• Open sores that bleed or crust and persist for weeks

Melanoma

• Melanoma is the deadliest form of skin cancer and can develop anywhere on the body, including eyes and internal organs.
• Upper back is a common site in men; legs are common in women.
• It is highly capable of spreading to other body parts.

Warning Signs of Melanoma

• Brown or dark-pigmented patches or bumps
• Moles that change in color, size, or bleed

Melanoma Characteristics (ABCDE rule)

• Asymmetry: Irregular shape
• Border: Blurred or irregularly shaped edges
• Color: Multiple colors (brown, tan, black, red)
• Diameter: Larger than a pencil eraser (6mm) or greater
• Evolution: Changes in size, shape, or color over time; bleeding, itching, or crusting

Other Types of Skin Cancer

• Merkel cell carcinoma (MCC): Rare skin cancer that grows quickly and may be hard to treat if it spreads outside the skin
• Kaposi sarcoma (KS): Cancer that develops from cells lining lymph or blood vessels, often appearing as tumors on skin or mucous membranes. In the lungs, liver, or digestive tract, this can cause serious problems, potentially life-threatening.
• Cutaneous lymphoma: Begins within the body's immune system cells (lymphocytes).
• Skin adnexal tumor: Grows within skin appendages like hair follicles or skin glands.

General Warning Signs of Cancer (Beyond Skin Cancer)

• Abnormal periods/pelvic pain
• Changes in bowel habits (constipation, diarrhea, blood in stool)
• Bloating
• Breast changes (lumps, dimpling, discharge)
• Chronic cough
• Chronic headache
• Difficulty swallowing (dysphagia)
• Excessive bruising
• Frequent fevers or infections
• Persistent pain (no clear cause)
• Oral changes (sores, lesions)
• Skin changes (shift in mole appearance)
• Postmenopausal bleeding
• Stomach pain or nausea
• Unexplained weight loss
• Unusual lumps

Etiology (Causes) of Skin Cancer

• Heredity
• Solar exposure (interrupts cell division)
• Large amounts of UV radiation exposure
• Exposure to greater amounts of X-rays
• People with moles
• Exposure to arsenic (in the environment and food)
• Immunosuppressant medications
• Precancerous skin lesions

Diagnostic Findings

• Physical examination
• Family and medical history
• Biopsy (tissue sample evaluation by a pathologist)
• Imaging tests (MRI, CT, mammography, etc.)

Nursing Diagnosis and Management

• Nursing Diagnosis: Disturbed body image related to skin color changes, and risk for impaired skin integrity related to radiation or chemotherapy effects
• Nursing Management: Management depends on the stage of cancer; it involves physical assessment of the client.

Advice and Management

• Stay out of sun during peak hours and wear sunscreen
• Assess skin for side effects of therapy (breakdown, healing delays)
• Encourage gentle skin patting, not rubbing or scratching
• Wash skin with soap and water if any anti-cancer agents are spilled on the skin.
• Provide emotional and psychological support
• Provide pre- and post-operative care

Medical Management (Treatment Methods)

• Biopsy: A tissue sample is taken to determine a disease's presence, cause, or extent. This method can remove small, limited cancers restricted to the skin's surface.
• Cryotherapy: Liquid nitrogen is used to freeze cancerous skin cells, causing them to slough off after treatment
• Excisional surgery: Removal of tumors; surrounding healthy tissue is removed to ensure all cancer is eliminated.
• Mohs surgery: First, the visible tumor is removed. Then, thin layers of skin cancer cells are cut away and examined under a microscope. It helps save normal tissue as much as possible.
• Curettage and electrodesiccation: Tool with a sharp edge scrapes cancer cells. Then the area is treated with an electric needle to destroy any remaining cancer cells.
• Chemotherapy and Immunotherapy: Medications kill cancer cells; some chemotherapy medications are applied directly to the skin topically.
• Radiation therapy: Strong energy beams are used to kill cancer cells or stop them from growing.
• Photodynamic therapy: Skin is treated with medication and exposed to blue or red light to destroy pre-cancerous cells, leaving healthy cells unaffected.

This quiz covers important information about malignant skin disorders, particularly various types of skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Understand the characteristics, commonality, and treatment implications of these conditions.