Skin cancer - Basal cell carcinoma, squamous cell carcinoma, and melanoma: Nursing

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Transcript
Skin cancer is the growth and proliferation of abnormal cells in the skin, and the most common types include basal cell carcinoma, squamous cell carcinoma, and melanoma.
Let’s start with the anatomy and physiology of the skin, which is divided into three main layers: the hypodermis, dermis, and the epidermis. The hypodermis is made of fat and connective tissue that anchors the skin to the underlying muscle and acts as a cushion that protects underlying tissues from trauma. Above the hypodermis is the dermis, containing hair follicles, nerve endings, as well as sweat glands, and blood vessels. And just above the dermis is the epidermis, which itself has multiple cell layers that are composed of developing cells called keratinocytes.
Now, keratinocytes start their life at the lowest layer of the epidermis, called the stratum basale or basal layer. As keratinocytes in the stratum basale mature, they migrate into the next layers of the epidermis, called the stratum spinosum, stratum granulosum, stratum lucidum, and finally, the stratum corneum, which is the uppermost and thickest epidermal layer. Now, the stratum basale also contains the melanocytes, which produce a pigment called melanin, that gives each individual their skin color. At the same time, melanin acts as a natural sunscreen, because its protein structure dissipates, or scatters UVB light.
So, the cause of skin cancer is mutations in skin cells, which can arise due to a variety of factors. The most important environmental risk factor is excessive UV radiation exposure, either from the sun or sunlamps and tanning booths. In general, light skinned clients are considered to be at a higher risk of developing skin cancer, and the risk increases with cumulative sun exposure over time. Other risk factors include exposure to occupational chemical carcinogens, like arsenic or coal tars; and the presence of premalignant skin lesions. These include actinic keratosis, which might develop into squamous cell carcinoma; and atypical or dysplastic nevi or moles, which can develop into melanoma
Some viral infections like human papillomavirus; and situations that cause immunosuppression like having HIV, or receiving prolonged treatment with glucocorticoids after organ transplantation, also increase the risk of skin cancer. Additionally, there are medications that increase skin sensitivity to UV radiation, like thiazide diuretics and tricyclic antidepressants. There are also genetic risk factors that include conditions like albinism and xeroderma pigmentosum, where clients are genetically predisposed to develop skin cancer even without the presence of environmental risk factors.
Summary
Skin cancer is a type of cancer that develops in the cells of the skin. Three main types of skin cancer are basal cell carcinoma (the most common), squamous cell carcinoma (the second most common), and the least common but most deadly, melanoma. The most important risk factor is excessive UV exposure from the sun or tanning beds, while other risk factors include light skin tone, premalignant conditions, exposure to carcinogens like arsenic or coal tar, and immunosuppression.
Diagnosis of skin cancer is made with a tissue biopsy and treatments can include physically removing cells with a high risk of developing into skin cancer. Tumor cells are also commonly removed and treated with radiation, chemotherapy, or immunotherapy. Nursing goals include early detection of suspicious lesions and providing supportive care during treatment. Client and family education emphasizes self-care, skin cancer prevention, and self-monitoring, and when to seek medical attention.