Name: Ahern: EES: Video 02-02: Skin Lesion Examination

Description: Ahern: EES: Video 02-02: Skin Lesion Examination

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Duration: T00H02M34S

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Upload Date: 2022-02-23T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
Well, I think a general examination for skin cancer, the most important thing, once you've taken a history, obviously a prior history of the skin cancer, it's important, is then to have adequate lighting and offer to fully examine the patient. So you examine what the patient is most concerned about, but then give a full examination. You need good lighting, and I would suggest magnification of whatever form you like.
OK. What are the physical characteristics that you look for in one of those lesions to differentiate what the lesion is and maybe to give you a clue to the effect that it's malignant, or if it's an unusual lesion? So someone, they might come and say, I've got a melanoma. And come and say that they're INAUDIBLE. It could be a sarcoma.
It could be anything. Well, looking at BCCs, which make up 70% to 80% of all the skin cancer we see in Australia, the two common forms that we see used to be referred as the nodulocystic. They tend to be smooth and round symmetrical nodules. They may have visible telangiectases. And the pearly edge that we talk about is certainly an entity more enhanced by stretching the skin around it.
The second one would be a superficial basal cell carcinoma. More commonly seen on the trunk, but can be seen anywhere. Tends to often be a red, non-scaly patch. It can very nondescript. It can be no different from a patch of psoriasis or eczema but typically doesn't have scale. Now, a squamous cell carcinoma tends to be like a nodular BCC. Tends to be a nodule, but it can be a plaque.
And often, there is scale, hence the name, squamous cell carcinoma. One of the things, I think, about squamous cell carcinoma is whether it's painful or tender to touch. Do we look at those sorts of things-- very hot, inflamed, that type of thing? Tenderness to touch is not a strong symptom. But it's a good, I'd say, sign to elicit tenderness. What we're often trying to distinguish is people, particularly of Anglo-Celt descent, with extreme sun damage.
And they have multiple solar keratoses or actinic keratoses, which may be considered a precursor lesion, or part of the spectrum from Bowen's disease, which is in situ squamous cell carcinoma to squamous cell carcinoma. Typically, a squamous cell carcinoma, if you touch it and push on it, especially on the backs of the hands, will elicit tenderness. And a patient may volunteer that, or you may actually elicit it as a clinical sign.
Pain is a symptom. Tenderness is a sign.

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