Home » Surgical Notes » Pathology » General Pathology

Skin

Layers of the skin

Function of skin

  1. Physical barrier
  2. Filtration of light / ionising radiation
  3. Secretion: sweat, contains Igs and is acidic due to lactic acid
  4. Commensals - protects against pathogens
  5. Immunological - Langerhan's cells
  6. UV light generates vitamin D

 

Skin Cancer

  1. Squamous cells
  2. Malignant melanoma
  3. Basal cell carcinoma
  4. Merkel cell tumour

Risk factors for skin cancer

  1. Congenital
    • Familial syndromes - BK mole syndrome
    • xeroderma pigmentosum
  2. Acquired
    • UV light - skin grading (1) chalk white burns easily (2) fair tans difficulty (3) fair tans easily (4) olive (5) brown (6) black
    • Ionising radiation
    • Chemical carcinogens (tars, dyes, rubber products)
    • Viruses - HPV
    • Immunosuppression

 

 


 Subtypes Grading Treatment
BCC (above lips)
  • Nodular
  • Cystic
  • Pigmented
  • Superficial spreading
  
  • Local excision with 3-7mm margin
SCC (below lips)    
  • Local excision with 5-10mm margin +/- block dissection of draining lymph nodes
MM
  • Superficial spreading (64%)
  • Nodular (12-25%)
  • Lentigo maligna (7-15%) with best prognosis
  • Acral lentiginous (10-13%)
  • Amelanotic

Breslow Thickness
<1mm
1 - 2mm
2 - 4mm
>4mm

Clarke Levels

I: epidermis
II: papillary dermis
III: papillary/reticular junction
IV: reticular dermis
V: subcutanous fat
  • Local excision with 10mm margin if 1mm depth
  • Local excision with 20mm margin if 2mm depth
  • Local excision with 30mm margin if 3mm depth

 

 

‹ SinusupSpread of infection ›