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Current Surgical Diagnosis & Treatment, 12th Edition, Ch. 43, 46.
1. Discuss characteristics of skin lesions, which suggest malignancy.
2. Describe the etiology and incidence of basal cell and squamous cell carcinomas.
3. Discuss the clinical characteristics, treatment methods and prognosis for basal cell carcinoma.
4. Discuss the clinical characteristics, treatment and prognosis for squamous cell carcinoma.
5. List the predisposing factors for and the four categories of melanoma.
6. Describe the major prognostic variables for melanoma including Clark’s level and Breslow’s depth.
7. Identify possible areas of metastasis of melanoma and outline steps to determine extent of disease.
8. Outline local regional and systemic therapies for malignant melanoma.
1. A 59-year-old white male presents with a pigmented skin lesion on his right lateral thigh. He states the lesion has been present for approximately 3 years, but has grown darker in color over the last 9-12 months. He has no other complaints. He is healthy with no significant medical problems. He takes no medications. On physical examination, his vital signs are normal. Chest exam is unremarkable. Abdominal exam is normal. On examination of the extremities, there is a 1.5 cm pigmented lesion on the right lateral aspect of his distal thigh. There are no other pigmented lesions noted. Examination of the groin reveals no adenopathy. An excisional biopsy is performed under local anesthesia revealing a Clark’s level 3 melanoma with thickness of 2mm.
2. A 39-year-old white male presents with several small-pigmented lesions surrounding a previous site of melanoma excision from the forearm two years ago.
3. A 69-year-old white male presents with a 1 cm ulcerated lesion on the tip of his nose.
4. A 59-year-old farmer presents with a 1 cm ulcerated lesion on the right lateral aspect of his lower lip. Punch biopsy reveals squamous cell carcinoma.
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