Curriculum standards
Knowledge guides
LG13: Skin tumours and skin cancers
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.
Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.
Presentations
- Erythronychia
- Malignancies:
- genital
- oral
- Mass:
- multiple
- solitary
- Melanonychia
- Mucous membrane red / white patch
- Nodule:
- multiple
- subcutaneous
- ulcerating
- Papule, solitary
- Patches, multiple
- Plaque:
- multiple
- solitary
- Yellow spots
Conditions
-
Cutaneous:
- lymphomas
- manifestation of internal malignancies, such as:
- bowel cancer
- leukaemia cutis
- metastatic breast
-
Skin tumours:
- benign:
- adipose tissue
- adnexal
- bone
- cysts
- ductal
- epithelial
- fibrohistiocytic
- fibrous
- follicular
- melanocytic
- neural
- sebaceous
- nail
- malignant:
-
adipose tissue:
- liposarcoma
- adnexal
- ductal
-
epithelial:
- basal cell carcinoma
- squamous cell carcinoma
- fibrous and fibrohistiocytic melanocytic:
- melanoma
- Merkel cell carcinoma
- nail
-
adipose tissue:
- Paget disease, including mammary and extramammary basal cell carcinoma
- benign:
PCH
- Cutaneous and vascular tumours in childhood
- Cutaneous presentation of haematological malignancies in children
- Presentation of cancer predisposition syndromes in childhood
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
-
Nodules:
-
multiple:
- cutaneous
- mucosal
- subcutaneous
-
solitary:
- cutaneous
- mucosal
- subcutaneous
-
multiple:
-
Papules:
- multiple
- solitary
Conditions
-
Follicular tumours and associated conditions, such as:
- Bazex syndrome
- Birt–Hogg–Dubē syndrome
- Brooke–Spiegler syndrome
- Cowden syndrome
- Genital premalignant and malignant conditions
- Kaposi sarcoma
- Muir–Torre syndrome
- Oral mucosal premalignant and malignant conditions
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Genetics of cutaneous tumours:
- benign
- malignant
Clinical assessment tools
- Identify psychological or developmental factors before undertaking painful procedures, and modify approach
Investigations
- Histology reports
- Radiographic imaging
- Staging
Procedures
-
Biopsy:
- nail unit
- scalp
- skin
- Dermoscopy
-
Removal of skin tumours using methods such as:
- cautery
- curettage
- excision
- saucerisation
- Indications for Mohs micrographic surgery
- Margins of excision in different skin tumours, working knowledge of surgical instrumentation and nomenclature, and suture materials and needles
- Utilisation of different biopsy modalities for different types of lesions
Management (including, but not limited to)
- Cryotherapy
- Curettage:
- cautery
- Electrosurgery
- Excisions
- Intralesional injections, such as cytotoxic drugs
- Laser
- Mohs micrographic surgery
- Photodynamic therapy for solar keratoses and superficial basal cell carcinoma
- Saucerisation
- Topical immunotherapy / chemotherapy