BCC and SCC

Question 1

What is another name for Basal Cell carcinomas? (BCC)

Answer 1

rodent ulcers

Question 2

Metastases are extremely rare in BCC. TRUE/FALSE?

Answer 2

TRUE
BCCs = slow-growth and local invasion

Question 3

Describe the main features of a nodular BCC

Answer 3

• On sun-exposed sites (head/face/neck)
• pearly, flesh-coloured papule with telangiectasia
• may later ulcerate leaving a central ‘crater’

Question 4

Management of BCC

Answer 4

• surgical removal
• curettage
• cryotherapy
• topical cream: imiquimod, fluorouracil
• radiotherapy

Question 5

What percentage of SCCs metastasise?

Answer 5

Metastases are rare
=> 2-5% of patients.

Question 6

Risk factors for SCC

Answer 6

• sunlight/ UVA therapy exposure
• actinic keratoses/ Bowen’s disease
• immunosuppression
• smoking
• chronic leg ulcers
• genetic conditions e.g. xeroderma pigmentosum, oculocutaneous albinism

Question 7

Features of SCC

Answer 7

• sun-exposed sites
• rapidly expanding, painless, ulcerated nodules
• cauliflower-like appearance
• areas of bleeding

Question 8

Treatment of SCC

Answer 8

Surgical excision

Question 9

What size should the margins be when an SCC is excised?

Answer 9

4mm margins if lesion <20mm 6mm margins if lesion >20mm

Question 10

What surgical technique can be used to get clear margins in areas which are cosmetically important?

Answer 10

Moh’s Microscopic Surgery

• each slice is taken and looked at under microscope to look for clear margin

Question 11

What factors create a poorer prognosis in SCC?

Answer 11

• large diameter >20mm or depth >4mm
• poorly differentiated cells
• immunosuppressed patient