Stream 2 Skin Cancer and Tumours - Common worrying possible skin cancers

Topics to be covered in the Certificate Course.

BCC
SCC
Keratoacanthoma
Lichenoid keratosis
Melanoma

Melanoma 

As a Dermatology Nurse you may be asked  to recognise the types of solar keratoses and the various types of basal and squamous cell skin cancers. However the most dangerous skin cancer in the body is a melanoma. (There is actually another one called a Merkel cell carcinoma that is worse but leave that for now.) Most people think these arise from pre-existing moles but only about 40% do. The other 60% arise de novo as a new black lesion on the skin. Of course as in everything in medicine, not all melanomas are black. The most dangerous melanoma of all is the amelanotic melanoma that presents as a pink nodule on the back of males. They can look very non specific like a dermal nevus and as such are usually ignored until they grow quite thick and reach the lymphatics deeper in the skin and the blood vessels and spread elsewhere before they are cut out.

As in most things in dermatology once you have seen a few images of them you will get the idea of what is normal and what is not. Various instruments have been employed to try to help in the diagnosis of melanoma and the most useful is an instrument called the dermatoscope. This gives a view of the underlying pigment distribution in a pigmented lesion and can be exceedingly useful in diagnosing melanoma and conversely noting that a pigmented lesion is a benign lesion. We will look at dermatoscopes when discussing melanomas in a later module.