Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• The deeper the penetration, the worse the outcome.
• We used to use histologic landmarks.
• superficial dermis
• reticular dermis
• subcutaneous fat
• Now we go strictly with a depth measurement.
• The cut-off is 0.76 to 1.5 mm for moderate risk lesions, as measured from the top of the granular cell layer of the epidermis.
• Although cytology (degree of differentiation) is important, it is secondary to the depth of penetration.
• The old stage vs grade thing. Stage is numero uno.
• Identifying the sentinel lymph node.