Biopsy is one of most common diagnostic tests in evaluation of skin lesions. Techniques
include punch, incisional, excisional, and shave biopsies.
Other diagnostic procedures include stains and cultures for fungal, bacterial, and viral
Health promotion activities for good skin health include asvoidance of environmental
hazards, adequate rest and exercise, and proper hygiene and nutrition.
Sun safety includes sun avoidance, especially during midday hours, protective clothing,
Actinic keratoses, basal cell carcinoma, squamous cell carcinoma, and malignant
melanoma are problems associated with sun exposure.
o Is a premalignant form of squamous cell carcinoma affecting nearly all the older
o A typical lesion is an irregularly shaped, flat, slightly erythematous papule with
indistinct borders and an overlying hard keratotic scale or horn.
o Treatment includes cryosurgery, fluorouracil (5-FU), surgical removal, tretinoin
(Retin-A), chemical peeling agents, and dermabrasion.
Skin cancer is the most common malignant condition. Patients should be taught to self-
examine their skin monthly.
The cornerstone of self-skin examination is the ABCD rule. Examine skin lesions for
Asymmetry, Border irregularity, Color change/variation, and Diameter of 6 mm or more.
Risk factors for skin cancer include fair skin type (blonde or red hair and blue or green
eyes), history of chronic sun exposure, family history of skin cancer, and exposure to tar
and systemic arsenicals.
Nonmelanoma skin cancers do not develop from melanocytes, as melanoma skin cancers
do. Instead, they are a neoplasm of the epidermis. Most common sites are in sun-exposed
Basal cell carcinoma (BCC):
o Is a locally invasive malignancy from epidermal basal cells.
o Is the most common type of skin cancer and the least deadly.
o Tissue biopsy is needed to confirm the diagnosis.
o Treatments of electrodessication and curettage, cryosurgery, and excision all
have cure rate of more than 90%. Squamous cell carcinoma (SCC):
o Is a malignant neoplasm of keratinizing epidermal cells.
o Is less common than BCC.
o Can be very aggressive, has the potential to metastasize, and may lead to death if
not treated early.
o Pipe, cigar, and cigarette smoking area are also risk factors for SCC; therefore
SCC is also found on mouth and lips.
o Biopsy is performed when a lesion is suspected of being SCC.
o Treatment includes electrodesiccation and curettage, excision, radiation therapy,
intralesional injection of 5-FU or methotrexate, and Mohs’ surgery.
o Is a tumor arising in melanocytes.
o Melanomas can metastasize to any organ.
o Is the most deadly skin cancer, and its incidence is increasing faster than that of
any other cancer.
o Individuals should consult health care provider if moles or lesions show any
clinical signs (ABCDs) of melanoma.
o Melanoma can also occur in eyes, meninges, and lymph nodes.
o Suspicious lesions should be b