Squamous cell carcinoma (SCC)
- Usually develops from an actinic keratosis in an area that has been exposed to the sun.
- Initial thickening of the skin develops into a raised, indurated plaque that becomes nodular and fixed.
- Margin of the ulcer may be raised and everted.
- The lesion grows more rapidly than a basal cell carcinoma.
- A biopsy may be taken to confirm diagnosis.
- The treatment of choice is excision with histological confirmation of removal.
- Cryotherapy, curettage and cautery may prove satisfactory.
- Radiotherapy is usually successful.
Fish tank granuloma
- Often a history of cleaning an infected fish tank.
- Caused by Mycobacterium marinum.
- A pink or purple nodule or pustule forms, which ulcerates or forms an abscess.
- A swab culture can confirm the infection.
- Treatment choices are rifampicin with ethambutol, co-trimoxazole forte or minocycline.
- Patients should be advised to cover any open wounds before working in suspect water, and to use antibiotic soaps to wash their hands.
Contributed by Dr Jean Watkins, a GP in Ringwood, Hampshire