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Rovner

MALIGNANT TUMORS

  1. Basal Cell Carcinoma--sun induced. Minimal metastatic potential

    1. Nodular--pearly, telangiectatic borders. "Rodent" ulcer.

    2. Superficial--eroded, scaling pink plaques.

  2. Squamous Cell Carcinoma

    1. Sun-induced--little metastatic potential. Often arise from existing actinic keratosis. Indurated pink scaling plaques.

    2. Mucosal--dangerous with high metastatic potential.

    3. in situ--Bowen's Disease. Well defined psoriasiform plaque in sun exposed area(s).

  3. Melanoma

    1. Types

      1. Superficial Spreading
      2. Nodular
      3. Lentigo maligna (Hutchinson's freckle)
              1. Lentigo maligna melanoma
      4. Acro-lentiginous
    2. Prognosis
      1. Type
      2. Location ("BANS" areas)
      3. Depth
        1. Clark's level
        2. Breslow scale:

      Depth

      %Survival (5 yr)

      0--.75 mm

      98-100%

      .75--1.5 mm

      90--95%

      1.5--3.0 mm

      50--75%

      over 3.0 mm

      less than 50%
    3. Treatment
                1. wide local excision
                2. ?lymph node dissection- [sentinel lymph node]
                3. chemotherapy
                4. immune modulation