The Big Three: BCC, SCC and Melanoma

The Big Three – BCC, SCC, and Melanoma is a comprehensive course that delves into the clinical and dermoscopic aspects, biopsy techniques, pathology interpretations, and treatment strategies for the three major skin cancers. Delivered by Dr. Hamilton Ayres, the course combines evidence-based guidelines, practical insights, and real-world cases.

Unit 1: Basal Cell Carcinoma (BCC)
This unit explores the clinical and dermoscopic characteristics of BCC, the most common form of skin cancer. Topics include:
- Recognition of subtypes such as nodular, superficial, and morphoeic BCC.
- Diagnostic techniques, including partial biopsies and dermoscopy.
- Treatment options, from excisions with appropriate margins to non-surgical methods like imiquimod and photodynamic therapy.
- Case studies to emphasise practical decision-making and patient counselling.

Unit 2: Topical Therapies
This unit examines topical treatment options for skin cancer and precancerous lesions. It covers:
- Mechanisms of action, efficacy, and application techniques for therapies like 5-fluorouracil (5-FU), imiquimod, and diclofenac sodium.
- Field-directed treatments for solar keratosis and their role in reducing the progression to SCC.
- Pros and cons of non-surgical treatments, illustrated through patient case studies and outcomes.

Unit 3: Squamous Cell Carcinoma (SCC)
Participants learn to identify and manage SCC, emphasizing early detection and appropriate intervention. Key topics include:
- Dermoscopic features and biopsy techniques to distinguish SCC from other lesions.
- Treatment modalities such as excision with wide margins, curettage, cryotherapy, and radiotherapy for advanced cases.
- Understanding high-risk factors like perineural invasion and lesions on high-risk sites (e.g., ears, lips).
- Case discussions that underscore the clinical nuances of treating SCC effectively.

Unit 4: Melanoma
The final unit focuses on melanoma, the deadliest form of skin cancer. This unit includes:
- Recognition of clinical changes, dermoscopic patterns, and warning signs like asymmetry and rapid growth.
- Biopsy techniques to ensure accurate diagnosis and staging.
- Interpretation of pathology reports, including Breslow depth and sentinel lymph node biopsy considerations.
- Guidelines for wide excision margins based on melanoma thickness and referral pathways for advanced cases.
- Real-world scenarios demonstrating the critical importance of early detection and comprehensive care.

This course equips healthcare providers with the expertise to diagnose, treat, and manage BCC, SCC, and melanoma effectively, ensuring optimal patient outcomes in skin cancer medicine.