Malignant Skin Disorder PowerPoint PDF

Malignant Skin Disorder BY ABIODUN-OJO O.E Introduction Skin cancer occur as a result of uncontrolled and unorderly skin cells growth. Normally, new skin cells form when cells grow old and die or when they become damaged. This collection of cells may be non-cancerous (b...

Malignant Skin Disorder BY ABIODUN-OJO O.E Introduction Skin cancer occur as a result of uncontrolled and unorderly skin cells growth. Normally, new skin cells form when cells grow old and die or when they become damaged. This collection of cells may be non-cancerous (benign) or cancerous (which may spread to nearby tissue or other areas of the body). Types This is divided into three major subtypes; Basal cell carcinoma Squamous cell carcinoma Melanoma Introduction Contd... N.B: Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer and are sometimes called “non-melanoma skin cancer.” Melanoma is not as common as basal cell or squamous cell carcinomas but is the most dangerous form of skin cancer. If left untreated or caught in a late-stage, melanomas are more likely to spread to organs beyond the skin, making them difficult to treat and potentially life- limiting. Basal cell carcinoma Basal cell cancer is most common type of skin cancer as a result of sun-damage with most lesions occurring in sun-exposed areas. Basal cell cancer is the most common type of skin cancer in the world. In most people, it grows slowly, usually does not spread to other parts of the body and is not life-threatening. Warning signs of BCC An open sore that does not heal, and may bleed, ooze or crust. The sore might persist for weeks, or appear to heal and then come back. A reddish patch or irritated area, on the face, chest, shoulder, arm or leg that may crust, itch, hurt or cause no discomfort. A shiny bump or nodule that is pearly or clear, pink, red or white. The bump can also be tan, black or brown, especially in people of color, and can be mistaken for a normal mole.  A small pink growth with a slightly raised, rolled edge and a crusted indentation in the center that may develop tiny surface blood vessels over time. A scar-like area that is flat white, yellow or waxy in color. The skin appears shiny and taut, often with poorly defined borders. This warning sign may indicate an invasive BCC. Squamous cell carcinoma Squamous cell cancer is most commonly seen on sun- exposed areas of skin including the hands, face, arms, legs, ears, mouths, and even bald spots on the head. It is the second most common. This skin cancer can also form in areas such as mucus membranes and genitals. Squamous cell carcinoma in-situ (in-situ means the cancer is still only in the epidermis and have not invaded deeper layer) is also known as Bowen disease and it is earliest form of skin cancer Warning Signs A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds An elevated growth with a central depression that occasionally bleeds. It may rapidly increase in size. An open sore that bleeds or crusts and persists for weeks Melanoma Melanoma is the deadliest form of skin cancer and can develop in any area of the body. It can even form on the eyes and internal organs. The upper back is a common site in men; legs are a common site in women. This is the most serious type of skin cancer because it can spread to other areas of the body. Signs and symptoms of melanoma include: A brown-pigmented patch or bump. A mole that changes in color, size or that bleeds. The ABCDE rule (Mnemonic to aid in melanoma characteristics) Asymmetry: irregular shape. Border: blurry or irregularly shaped edges. Color: mole with more than one color. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. Diameter: larger than a pencil eraser (6 mm). Evolution: enlarging, changing in shape, color, or size. Bleeding, itching or crusting, may be a warning sign.  A is for ASYMMETRY  B is for BORDER  C is for COLOUR  D is for DIAMETER or DARK  E is for EVOLVING (Before and After) Other types of skin cancer Merkel cell carcinoma (MCC): It is rarely of skin cancer. It starts when cells in skin start to grow out of control. MCC tends to grow quickly and can be hard to treat if it spreads beyond the skin. Kaposi sarcoma (KS): This is a cancer cell that that develops from the cell that line lymph or blood vessel. It usually appears as tumor on the skin or mucosal surface. The affected areas are called lesions and they cause serious problems (life-threatening) when in the lungs, liver or digestive tract.  Cutaneous lymphoma: it starts in the white blood cell called lymphocytes which are part of the immune system. Skin adnexial tumor: Tumor that start in hair follicle or skin glands General warning signs of cancer Abnormal periods or pelvic pain: Most women have the occasional irregular period or cramps. Persistent pain or changes in mestrual cycle can be a sign of cervical, uterine or ovarian cancer. Changes in bowel habits: persistent constipation or diarrhea; black or red blood in the stool; black, tarry stools; more frequent urination; and haematuria. Bloating: bloating for more than two weeks can be a sign of ovarian cancer, as well as various gastrointestinal cancers. Breast changes: These include a lump, dimpling, discoloring, changes around the nipple or unusual discharge. Chronic coughing: A cough that persists for more than two weeks, especially a dry cough, can be a sign of lung cancer. General warning signs contd... Chronic headache: headache that lasts more than two weeks and doesn't respond to the usual medications can be caused by a brain tumor. Dysphagia: feeling as though food is getting stuck in the throat or trouble swallowing for more than two weeks,. Excessive bruising: bruises in unusual places that haven't been bumped can indicate various blood cancers. Frequent fevers or infections: Spiking a fever over and over, or going from one infection to the next can indicate an immune system that's been rendered more susceptible by lymphoma or leukemia. Oral changes: Persistent sores or lesions or painful areas in the mouth.  Contd... Skin changes: A shift in the appearance of a mole or birthmark Pain that lasts: Persistent pain anywhere in the body that has no clear cause and doesn't respond to standard treatments. Persistent fatigue: A sudden, lasting change in energy level, no matter how much rest can be a sign of leukemia or lymphoma. Postmenopausal bleeding: There are a number of reasons for this, but if it persists, may want to check for cervical or uterine cancer. Stomach pain or nausea: Unusual discomfort that lasts more than two weeks c. Unexplained weight loss: Weight fluctuates but the loss of weight when not dieting or the loss of appetite. Unusual lumps: Any new lump or mass should be evaluated. Etiology of skin cancer Heredity Solar exposure can interrupt this process causing cells to divide at an unusual rate. Large amount of exposure to ultraviolet radiation. Exposure to greater amount of x-rays. People with moles Exposure to arsenic which is a metal found in the environment and in our food. Immunosuppressant medications Precancerous skin lesions Diagnostic findings Physical examination, family and medical history Biopsy with an interpretation by a pathologist Imaging test such as MRI, CT, mamography scan e.t.c Management and treatment Nursing Diagnosis Disturbed body image related to skin colour changes evidenced by client’s verbalization. Risk for impaired skin integrity related to effects of radiation and chemotherapy Nursing management Management depends upon the stage of cancer; Physical assessment of the client.  Advice client to stay out of sun when its rays are strongest and wear a sunscreen. Assess skin frequently for side effects of cancer therapy; note breakdown and delayed wound healing Encourage patient to pat skin dry rather than vigorous rubbing and scratching. Wash skin immediately with soap and water if antineoplastic agents are spilled on an unprotected skin. Give emotional and psychological support. Medical management Biopsy A tissue removed from a living body to discover the presence, cause, or extent of a disease. This alone can remove all the cancer tissue if small and limited to skin’s surface only. Cryotherapy It uses liquid nitrogen to freeze skin cancer. The dead cells slough off after treatment. Excisional surgery Involves removing the tumor and some surrounding healthy skin to be sure all cancer has been removed. Excisional surgery This surgery involves removing the tumor and some surrounding healthy skin to be sure all cancer has been removed. Mohs surgery the visible, raised area of the tumor is removed first, then a thin later of skin cancer cells are removed. The layer is examined under a microscope immediately after removal. Mohs surgery removes only diseased tissue, saving as much surrounding normal tissue as possible. It’s most often used to treat basal cell and squamous cell cancers Curettage and electrodesiccation The technique uses an instrument with a sharp looped edge to remove cancer cells as it scrapes across the tumor. The area is then treated with an electric needle to destroy any remaining cancer cells. Chemotherapy and immunotherapy Chemotherapy uses medications to kill cancer cells. Anticancer medications can be applied directly on the skin (topical chemotherapy). Radiation therapy uses radiation (strong beams of energy) to kill cancer cells or keep them from growing and dividing. Photodynamic therapy The skin is coated with medication and a blue or red fluorescent light then activates the medication. Photodynamic therapy destroys precancerous cells while leaving normal cells alone. THANK YOU