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Skin Cancer and Skin Care.Pptx !"#$"!%& Presentation Contents •! What Is Skin Cancer? What Causes It? •! Precursors To Skin Cancer Skin Cancer and Skin Care •! Types Of Skin Cancer JULIE A. HODGE, MD, MPH • Treatment Of Skin Cancer ASSISTANT CLINICAL PROFESSOR, UC IRVINE ! PRIVATE PRACTICE, FULLERTON •! Skin Cancer Prevention and Skin Care 2 What Is Skin Cancer? Skin Cancer Facts Skin cancer is a malignant condition that begins with the uncontrolled Skin cancer is the most common form of cancer in the United States. growth of abnormal cells typically in the top layer of the skin. There are two broad categories of skin cancers: !"#$$"$$$% Melanoma Non-melanoma More than 3.5 million skin cancers Both can occur when skin DNA damaged by ultraviolet radiation (UVR) is not in over two million people are diagnosed annually. properly repaired by the immune system. 4 Skin Cancer Facts Types Of Skin Cancer There are Three Main Types of Skin Cancers: One in five Americans will develop skin cancer in the course of a lifetime. Basal Cell Squamous Cell Melanoma Carcinoma Carcinoma More than 25 Americans die each day from skin cancer, primarily melanoma (the deadliest form of %&'$ skin cancer). More than one person dies of !""#"""$ !-#""".$ melanoma every hour. $ $ ()**)+,$ $ $ $ $ $ cases diagnosed cases diagnosed casesMelanoma diagnosed The survival rate for patients whose melanoma is every year detected early is about 99%. The survival rate falls every year every year 99% to 15% for those with advanced disease. 5 !& !"#$"!%& Precursors To Cancer Actinic Keratosis !!Actinic keratosis (AK), also known as solar keratosis, is the most common precancer.! !!Up to 10 percent of AKs become squamous cell carcinomas (SCCs) and 40-60 percent of SCCs begin as untreated AKs. Actinic Keratosis Squamous Cell Carcinoma (SCC) What to Look For: !! Small crusty or!horn-shaped scaly bumps !""#"""$/0121$3,,40**5$ that arise on or beneath the skin surface. ! !! Squamous cell carcinoma (SCC) is the second most common skin cancer, with about 700,000 !! Often red, but may be tan, pink, red, a combination of colors, or the same color cases diagnosed in the US each year. as your skin. ! Up to10 percent of SCCs spread !! Sometimes itch; can also become inflamed ! and occasionally bleed. to distant tissues and organs. Squamous cells !! Usually grow from 1/8” – 1/4” (2mm – 4mm), ! SCC causes about 2,500 deaths per year. but can be larger. ! Cross section of skin 9 10 SCC: What To Look For Squamous Cell Carcinoma !! A wart-like growth that crusts and occasionally bleeds. !! An open sore that bleeds and crusts, persisting for weeks. !! An elevated growth with a central depression that occasionally bleeds. !! A persistent, scaly red patch with irregular borders that may crust or bleed. 11 #& !"#$"!%& Common Skin Cancer Areas Basal Cell Carcinoma (BCC) Squamous cell carcinomas, basal Balding Scalp cell carcinomas and actinic keratoses most often appear on parts of the body that Face Ears %#'""#"""$/0121$3,,40**5$ and Lips have sustained chronic sun Basal cell carcinoma is the most common exposure over many years: Shoulders and Neck form of skin cancer, with about 2.8 million cases diagnosed annually in the US. Basal cells are abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line Backs of Hands the deepest layer of the epidermis (the and Forearms outermost layer of the skin). Cross section of skin 13 14 Melanoma Basal Cell Carcinoma !! Melanoma is the deadliest form of skin cancer, but when caught early is almost always curable. !! Moles with certain characteristics – the ABCDEs – are early warning signs of melanoma. A B C D E Asymmetry Border Color Diameter Evolving 16 Melanoma Seborrheic keratosis $& !"#$"!%& Treatment Options Treatment Options Cryosurgery Topical Medications Used for treating: AK, Used for treating: AK, BCC, SCC •! Solaraze® ! A cotton-tipped applicator or spray gun ! A gel combining hyaluronic acid with the anti-inflammatory drug filled with liquid nitrogen, cooled to -40°C diclofenac may be effective as well for actinic keratoses. or below, is applied to the lesion for several seconds. •! Ingenol Mebutate (Picato®) A newly FDA approved gel, is the first topical therapy to treat AKs After 1-3 weeks, the dead tissue sloughs in just two to three days. off. •! 5-fluorouracil (5-FU) (Carac®, Efudex®) Cryosurgery is the most A cream or solution is the most widely used topical treatment. commonly used treatment for individual •! Imiquimod (Aldara®, Zyclara®) Aks. A cream which stimulates the immune system to produce cancer- fighting interferon. 19 20 Treatment Options Treatment Options Excisional Surgery Used for treating: BCC, SCC, Melanoma Mohs Micrographic Surgery! Used for treating: BCC, SCC, Melanoma !! The physician administers a numbing local anesthetic before excising the cancer !! The visible tumor, along with a very thin layer of healthy tissue, is excised, frozen and immediately and a safety margin with a scalpel. examined under a microscope for malignant cells. The area is then closed with stitches. ! The procedure is repeated until the last layer of tissue Curettage-electrodesiccation ! examined is tumor-free. This procedure allows for the removal Used for treating: AK, BCC, SCC of the smallest amount of healthy tissue while assuring that all tumor cells have been removed. !! The growth is scraped off with a curette,! a ring-shaped instrument, before a burning, !! Once clear, the area is often closed with reconstructive high-frequency current is applied to the techniques to insure the best possible cosmetic outcome. lesion to destroy any residual tumor and Mohs surgery generally has the highest cure rates to control bleeding. of any treatment. Curettage Electrodesiccation 21 22 Skin Care Aging !! Intrinsic !!Skin cancer prevention !! Minor appearance change but functional abnormalities !!Prevention of photoaging !! Photoaging ! Major appearance change and photocarcinogenesis ! Restore and preserve barrier function ! ! !! Designed to safeguard the genome !! Cancer is the result of a failure of this process '& !"#$"!%& Prevention and Therapy Sun Protection !! “ The idea is to die young as late as possible” !! Broad spectrum sunscreen UVA/UVB SPF 30 or more !! Ashley Montagu, anthropologist (1905-1999) !! Sun protective clothing- hats !! Tilley !! Rash guards for swimming !! Get vitamin D through diet and supplements !! Under 70yrs 600 iu Vit D3, Over 70yrs 800 iu vit D3 Sunscreen Sunscreen (& !"#$"!%& Prevention and Therapy Prevention and Therapy ! Nicotinamide (vit B3) 500mg twice a day ! !!Avoid harsh soaps, use soft water !! Australian study: reduced incidence of BCC 20%, SCC 30% and AK 11% after 1 year !!Want an acid pH !!Superfatted soaps (Dove, Caress, !! Antioxidants Tone, Basis) !!Topical vitamins C and E, green tea !!Oral Heliocare (Polypodium leucotomos) !!Be careful of bath oils as they may increase risk of falling Prevention and Therapy Prevention and Therapy !Reduce pressure, friction, shearing ! !Moisturizers forces ! !!Ceramides !!Stay cool and dry !!Alpha/beta hydroxy acids (glycolic, salicylic, !!Skin protectants lactic acids) !!Aquaphor, Vaseline !!CeraVe, Cetaphil, Eucerin, Aveeno, Neutragena, Amlactin !!Zinc oxide- Triple Paste, Desitin Solar Purpura Dermend !! Retinol. Retinol helps renew and rejuvenate the look of skin !""#$#%&'&()*+%$",$&-%)#'*.$ ,"#+%$/0%$("$(-'**'*.$",$(-%$ !! Alpha Hydroxy Acids (AHA) &1'*$)*/$+-)*.%&$'*$(-%$%2)&('+$ !! Arnica Oil 34%#&$ !! Ceramides !! Niacinamide !! Phytonadione (a form of vit K) !! Use twice a day on forearms and hands %& !"#$"!%& Topical Treatments Other Treatments !!Retinoids !!Liquid nitrogen !!Growth factors !!Chemical peels !!Lightening agents !!Lasers/ Intense pulsed light !!Fillers – face and hands !!BOTOX !!Latisse Julie Hodge, MD, MPH 1440 N. Harbor Blvd, Ste 300, Fullerton 714 526-SKIN (7546) !!www.juliehodgemd.com !!Facebook Julie A. Hodge, M.D. )&.
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