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- 1. Skin Cancer Diagnosis and Management Dr Rob Paver Medical Director Skin and Cancer Foundation Westmead
- 2. Skin Cancer Statistics Skin Cancer accounts for more than 80% of newly diagnosed cancer in Australia 2 out of 3 Australians will be diagnosed with skin cancer in their lifetime (DHA 2010) GP’s in Australia have about 1 million patient consultations per year for skin cancer related concerns Australia’s incidence of skin cancer is the highest in the world and nearly 4 times the rate of Canada, USA and UK (Australian Institute of Health and Welfare Cancer in Australia 2001)
- 3. Non Melanoma Skin Cancer More than 430,000 patients are treated each year for non melanoma skin cancer 296000 BCC 138000 SCC (2008) More than 400 die of NMSC per year(2008) Skin cancer is our most expensive cancer NMSC cost the government $264,000,000 in 2001 Melanoma cost $30,000,000 in 2001 (more now) (Australian Institute of Health and Welfare Cancer in Australia 2001)
- 4. Non Melanoma Skin Cancer Actinic Keratoses Basal Cell Carcinoma Squamous Cell Carcinoma Benign Differential Diagnoses Treatment Options
- 5. Actinic Keratoses Macular – telangiectatic Papular – keratotic Hypertrophic – hyperkeratotic Cutaneous Horn Single, few or multiple
- 6. Actinic Keratoses Multiple Macular Single Papular Cutaneous Horn Hypertrophic
- 7. Actinic Keratoses Keratotic Actinic Cheilitis Diffuse Macular Diffuse Inflammatory
- 8. Differential diagnoses of Actinic Keratoses – Seborrhoeic Warts Verrucal Standard Superficial Skin Tags
- 9. Differential diagnoses of Actinic Keratoses – Seborrhoeic Warts Verrucal Lichenoid Macular Multiple
- 10. Differential diagnoses of Actinic Keratoses Bowens Disease Superficial BCC’s Actinic Porokeratoses Lupus Erythematosus
- 11. Differential diagnoses of Actinic Keratoses Stucco Keratoses Seborrhoeic Dermatitis
- 12. Treatment Options for Actinic Keratoses Cryotherapy Solaraze Efudix Aldara PDT Chemical Peel Laser resurfacing Curettage and cautery Excision
- 13. Cryotherapy
- 14. Solaraze (3%Diclofenac gel) Apply bd for 2 to 3 months Cease for a week if too inflamed Adverse effects - local irritation - like NSAID: bleeding etc Efficacy - less effective than Efudix but may have less noticeable inflammation
- 15. Efudix bd for 3 weeks
- 16. Aldara for Solar Keratoses Dose: 3x per week for up to 16 weeks with 1 week holidays from Rx for severe inflammation Always titrate the duration of treatment against the severity of response Adverse effects: local inflammation, hypopigmentation, headache and flu like illness Efficacy: longer lasting response than efudix/solaraze, but higher cost and variable response
- 17. Aldara
- 18. PDT Good field treatment Painful More expensive Need special equipment
- 19. Resurfacing / Chemical Peel
- 20. Basal Cell Carcinoma Superficial Multifocal Nodular Noduloulcerative Micronodular Pigmented Morphoeic Infiltrative Recurrent
- 21. Superficial - Basal Cell Carcinoma
- 22. Nodular – Basal Cell Carcinoma
- 23. Ulcerative - Basal Cell Carcinoma
- 24. Pigmented and Micronodular BCC
- 25. Morphoeic - Basal Cell Carcinoma
- 26. Infiltrating - Basal Cell Carcinoma
- 27. Recurrent - Basal Cell Carcinoma
- 28. Recurrent - Basal Cell Carcinoma
- 29. Differential Diagnoses of BCC Dermal Nevus Bowens Granuloma Annulare Syringomas
- 30. Differential Diagnoses of BCC Nevus Sebaceous Dermatofibroma Dermatofibroma Amyloidosis Sebaceous Hyperplasia
- 31. Differential Diagnoses of BCC Achrocordon SCC Amelanotic Melanoma Minimally Pigmented Nevus
- 32. BCC Treatment Options Cryotherapy Curettage and Cautery Aldara PDT Excision Radiation Therapy Mohs Surgery
- 33. Cryotherapy
- 35. Aldara (Imiquimod) Primary Superficial BCCs 5x per week for 6 weeks Treatment Holidays if too inflammatory 80% cure rate
- 36. Aldara – Before, During, After
- 37. This is presentation is continued in the next file…