Which of the following statements is correct?
* Scaly lesions under the breast are likely to be solar keratoses
* A indurated scaly lesion should be treated by cryotherapy
*! An enlarging red scaly plaque may be either squamous or basal cell carcinoma
* Invasive squamous cell carcinoma generally arises within a wart
Explanation: An enlarging erythematous scaly plaque may be various inflammatory lesions (usually eczema or psoriasis), superficial basal cell carcinoma or in situ squamous cell carcinoma. Indurated keratinocytic skin tumours are best removed surgically or referred to a dermatologist for evaluation. Solar keratoses arise in sun-exposed sites, most often face and hands; scaly lesions under the breasts are more likely to be seborrhoeic keratoses.
Which of the following descriptions represents a nodular basal cell carcinoma?
* A rapidly growing dome-shaped nodule with a keratinous core
*! A slowly growing pearly plaque that may ulcerate
* A tender scaly patch on the hand
* A scar-like indurated plaque
Explanation: A nodular basal cell carcinoma is generally best described as a slowly growing pearly papule, plaque or nodule, often with central ulceration or crusting.
Choose the best treatment for the lesions illustrated from the list below:
Mix and match:
: Surgical excision || This large ulcerated nodule is a clinically undifferentiated skin tumour and should be treated by wide surgical excision. An initial biopsy may help determine excision margins.
: Cryotherapy || The red scaly lesion is most likely a solar keratosis and should be treated by cryotherapy. If it fails to respond, consider a superficial basal cell carcinoma, biopsy or refer to a dermatologist.
:Topical steroid cream