Skin Cancer and Related Lesions-Case

Case - Skin Cancer

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This document discusses various skin conditions and lesions, as well as their management and treatment options. <br /><br />The first case presented is a 34-year-old man with a pigmented subungual lesion beneath the left thumb nail bed. The considerations are whether the lesion is benign or malignant and whether observation or biopsy is the appropriate next step. If the lesion is suspicious, with irregular borders, persistence, destruction of the nail, or ulceration, a full thickness biopsy is recommended. If the pathology reveals a malignant melanoma with a Breslow depth of 0.7 mm, the recommended surgical management would be excision with a 1 cm margin. However, if the depth is 1.8 mm, further management options need to be considered.<br /><br />The second case involves a 63-year-old man with a growth on the dorsal hand. The considerations are again whether the lesion is benign or malignant, and the options for surgical management. For nonmelanoma skin cancers such as squamous cell carcinoma (SCC) or basal cell carcinoma (BCC), treatment typically involves excision, with Mohs surgery being an option for recurrent or high-risk lesions. The margins for excision are 4 mm for lower-risk lesions and 6 mm for high-risk lesions. In this case, with a resection resulting in a wound with exposed extensor tendons, options for reconstructing the defect include Integra, a skin substitute, or flap coverage.<br /><br />The document briefly discusses two other conditions: pyogenic granuloma and pyoderma gangrenosum. Pyogenic granuloma is a benign vascular lesion characterized by friable, rapid growth. Treatment options include silver nitrate or surgical excision. On the other hand, pyoderma gangrenosum is an ulcerative condition often associated with systemic diseases. Surgical intervention should be avoided, with treatment involving the use of steroids and immunosuppressives.<br /><br />Overall, this document provides information on the management and treatment options for various skin conditions and lesions, ranging from melanoma to nonmelanoma skin cancers to other less common conditions.

Keywords

skin conditions

lesions

management

treatment options

pigmented subungual lesion

benign or malignant

surgical management

melanoma

squamous cell carcinoma

basal cell carcinoma