Skin tumors
I-Introduction:
Skin tumors (skin tumors) are benign or malignant lesions that develop in one of the layers of the skin.
They are common in adults; their progression is generally slow.
II-Anatomical reminder:
The skin is made up of three layers: epidermis – dermis – hypodermis.
The skin covers the entire body and reproduces its external shapes (surface anatomy).
The dermis rests on the hypodermis which provides the junction with the subcutaneous anatomical structures
Skin constitution
Skin tumors
III-Risk factors / Precancerous lesions:
A- Sun exposure and pigmentation:
A major risk factor, the risk increases with time and intensity
Harmful effects of UVB radiation: premature aging of the skin
B- Precancerous dermatological lesions:
-Old scars (burns)
-Chronic ulceration (leg ulcer)
– Actinic keratoses: observed in exposed areas, appear as yellowish or brownish macules of a few mm and cm. Without treatment, they develop into squamous cell carcinoma in 12 to 25% of cases.
C-Toxic factors:
-Polycyclic aromatic hydrocarbons (tars, mineral oils)
-Arsenic: professional, dietary, medicinal (Fowler’s liquid formerly used in psoriasis)
D – Iatrogenic factors:
– PUVA therapy (per-osal psoralen + UVA exposure)
10 years of exposure = risk of squamous cell carcinoma
– Immuno-suppressive therapies: Azathioprine (used in kidney transplant patients)
– Ionizing radiation: radiodermatitis
– HIV+ subject: high risk
E-Genetic predisposition factors:
→Basal cell nevus: Autosomal dominant syndrome which combines: maxillary cysts, ectopic calcifications, multiple basal cell carcinoma and sometimes other tumors (sarcomas)
→Xeroderma pigmentosumm: Hereditary condition of autosomal recessive transmission, characterized by:
– Premature skin aging due to photosensitization
– DNA repair deficiency
– Precancerous lesions and carcinoma appear early (8 years)
→Albinism:
Congenital melanin deficiency characterized by increased sensitivity to UV
→ Vercuciform epidermolysis:
Autosomal recessive transmission, characterized by flat or warty skin lesions of viral origin (Papilloma virus)
IV-Main skin tumors:
1- Benign tumors:
Represented by:
Papillomas, warts, condylomas
Noevus (beauty spots)
NB: Any skin lesion that has appeared recently and is changing in size, shape or colour should be examined…BIOPSY+++
2- Malignant tumors:
– Basal cell carcinoma: exclusively cutaneous in location
– Squamous cell carcinoma: located in the skin or mucosa, its local development is aggressive.
– Melanoma: developed at the expense of melanocytes, it appears in the form of a flat black or dark brown spot, aggressive cancer
– Kaposi’s sarcoma: occurs in patients infected with HIV, it is characterized by the development of spots on the skin, mouth, nose, throat, blood vessels, etc.
V-Oral cavity tumors:
1/ Lip tumors:
Easily accessible to the eye, they must be detected early. They are developed at the expense of the labial skin, the labial mucosa or the vermilion
2/Tongue tumors:
Tongue cancer: to be feared +++
Seat: mobile tongue or base of the tongue
Most common histological type: squamous cell carcinoma
Risk factors: tobacco, alcohol, HPV infection
3/Gingival tumors:
-Benign: papilloma, hemangioma
-Malignant: squamous cell carcinoma (risk of frequent invasion of the maxillary bone)
VI-Treatment of skin tumors:
It is essentially surgical. Surgery allows histological control of the excised specimen.
Surgery for skin tumors ranges from simple outpatient excision-suture to two-stage excision with plastic reconstruction under general anesthesia, depending on the procedure to be performed.
Treatment of malignant tumors may involve radiotherapy (basal cell carcinoma and squamous cell carcinoma) and chemotherapy (inoperable squamous cell carcinoma).
Key points:
- Know how to detect a suspicious skin lesion
- Any budding, ulcerated lesion in the oral cavity requires a biopsy.
- Distinguishing between benign and malignant tumors
Wisdom teeth may need to be extracted if they are too small.
Sealing the grooves protects children’s molars from cavities.
Bad breath can be linked to dental or gum problems.
Bad breath can be linked to dental or gum problems.
Dental veneers improve the appearance of stained or damaged teeth.
Regular scaling prevents the build-up of plaque.
Sensitive teeth can be treated with specific toothpastes.
Early consultation helps detect dental problems in time.