15. Skin Cancer Incidence and Mortality Source: Cancer Statistics 2000, American Cancer Society Nonmelanoma: (basal and squamous cell) Melanoma: 1,300,000 New Cases Deaths 47,700 7,700 Deaths New Cases Deaths 1,900
46. A blond, blue eyed, 69 year old sailor has a non-healing, indolent 1.5 cm. ulcer n the lower lip, that has been present, and slowly enlarging for the past 8 months. He is a pipe smoker, and he has no other lesions or physical findings. What is it? - Squamous cell carcinoma. How is the diagnosis made? - Biopsy, as described before. Treatment: he will need surgical resection with wider (about 1 cm.) clear margins . Local radiation therapy is another option.
47. A red headed 23 year old lady who worships the sun, and who happens to be full of freckles, consults you for a skin lesion on her shoulder that concerns her. She has a pigmented lesion that is asymetrical, with irregular borders, of different colors within the lesion, and measuring 1.8 cms. What is it? – The classical ABCD that alerts you to melanoma or a forerunner (dysplastic nevus). Management: full thickness biopsy at the edge of the lesion, .5 cm local excision if superficial melanoma (Clarks’ levels one or two, or under 0.75 mm), wide local excision with 2 or 3 cm. margin if deep melanoma.