Text A. Basal Cell Carcinoma

Basal cell carcinoma is a cancer that originates in the lowest layer of the epidermis.

Basal cell carcinoma usually develops on skin surfaces that are exposed to sunlight. The tumors begin as very small, shiny, firm, raised growths on the skin (nodules) and enlarge very slowly, sometimes so slowly that they go unnoticed as new growths. However, the growth rate varies greatly from tumor to tumor with some growing as much as ½ inch in a year. Basal cell carcinomas may ulcerate or form scabs in the center. They sometimes grow flatter and look somewhat like scars. The border of the cancer sometimes takes on a pearly white appearance. The cancer may alternately bleed and form a scab and heal, leading a person to think that it’s a sore rather than a cancer. Actually, this alternate bleeding and healing is often a significant sign of basal cell carcinoma or squamous cell carcinoma.

Rather than spread (metastasize) to distant parts of the body, basal cell carcinomas usually invade and destroy surrounding tissues. When basal cell carcinomas grow near the eye, mouth, bone, or brain, the consequences of invasion can be serious. Yet, for most people, they simply grow slowly into the skin. Nonetheless, removing the carcinomas early can prevent extensive damage to the underlying structures.

Diagnosis and treatment

A doctor can often recognize a basal cell carcinoma simply by looking at it. A biopsy (removal of a tissue specimen and examination under a microscope) is the standard procedure for con­firming the diagnosis.

In the office, a doctor can usually remove all the cancer by scraping and burning it with an electric needle (curettage and electrodesiccation) or by cutting it out. Before performing these procedures, the doctor anesthetizes the area. Rarely, radiation treatment is used. For recurrent tumors and scar-like basal cell carcinomas, microscopically controlled surgery (Mohs' surgery) may be required.

Creams used to treat the cancer, such as fluorouracil, aren't considered appropriate therapy because they sometimes allow the cancer to spread under the healed surface of the skin.

Notes:

scab корка

border край

pearly похожий на жемчуг

 

Text B. Squamous Cell Carcinoma

Squamous cell carcinoma is cancer that originates in the middle layer of the epidermis.

Squamous cell carcinoma usually develops on sun-exposed areas but may grow anywhere on the skin or in places such as the tongue or the lining of the mouth. It may develop on skin that appears normal or skin that has been damaged – even many years earlier - by sun exposure (actinic keratosis).

Squamous cell carcinoma begins as a red area with a scaly, crusted surface that doesn't heal. As it grows, the tumor may become somewhat raised and firm, sometimes with a wart-like surface. Eventually, the cancer becomes an open sore and grows into the underlying tissue.

Most squamous cell carcinomas affect only the area around them, penetrating deep into nearby tissues. But some spread (metastasize) to distant parts of the body and can be fatal.

Bowen's disease is a form of squamous cell car­cinoma that's confined to the epidermis and hasn't yet invaded the underlying dermis. The affected skin is red-brown and scaly or crusted and flat, sometimes looking like a patch of psori­asis, dermatitis, or a fungal infection.

Diagnosis and treatment

When doctors suspect squamous cell carci­noma, they perform a biopsy (removal of a tissue specimen and examination under a microscope) to differentiate this skin cancer from similar-look­ing diseases.

Squamous cell carcinoma and Bowen's disease are treated by removing the tumor using the same methods described for basal cell carcinoma. Ac­tinic keratosis, a warty irregularity on the skin surface that may turn into squamous cell carci­noma, is often treated by destroying it with liquid nitrogen or by applying fluorouracil cream that kills the rapidly dividing skin cells.

Note:

wart бородавка

Text C. Melanoma

 

Melanoma is a cancer that originates in the pigment-producing cells of the skin (melanocytes).

Melanoma can begin as a new, small, pigmented skin growth on normal skin, most often on sun-exposed areas, but nearly half of the cases de­velop from existing pigmented moles. Unlike other forms of skin cancer, melanoma readily spreads (metastasizes) to distant parts of the body, where it continues to grow and destroy tissue.

The less a melanoma has grown into the skin, the greater the chance of curing it. If a melanoma has grown deep into the skin, it’s more likely to spread through the lymph and blood vessels and can cause death within months or a few years. The course of the disease varies greatly and appears to depend on the strength of the body’s immune defenses. Some people survive in apparent good health for many years despite the spread of the melanoma.

Diagnosis and treatment

When melanoma is suspected, a biopsy is performed. Small growths are removed entirely, but only a small piece is removed from larger growths. In either case, a pathologist examines the tissue microscopically to determine if the growth is a melanoma.

Surgery can remove the entire melanoma; if the melanoma hasn’t spread, the cure rate approaches 100 % however, anyone who has had a melanoma is at risk of developing others. Therefore, such people need regular skin examinations.

Although chemotherapy is used to treat melanomas that have spread, cure rates are low, and the condition is often fatal. However, experimental treatment with interleukin-2 immunotherapy has yielded promising results.

Note:

yield давать результаты

 

EXERCISES

 

Exercise 1. Make up sentences of your own using the following words and phrases from the texts to the chapter “Superficial Skin Disorders”.

 

to be common, dry skin, to result from, to remain on the skin, can lead to infection, a drug related to smth., to be prescribed for, recurring disease, to be susceptible, to cover large areas of the body, a protective barrier against injury and infection, to stimulate the formation of smth., to be misdiagnosed, to confirm a diagnosis, a skin biopsy, ultraviolet light, to respond to different forms of therapy, to have serious side effects, to begin gradually or suddenly, to result in, the skin rash, cycles of outbreaks, to be needed to, to suffer from, prolonged treatment.

 

Exercise 2. Study the texts from the chapter “Dermatitis” and say whether these statements are right or wrong. Correct them if they are wrong.

1. Dermatitis is an inflammation of the upper layer of the skin, causing blisters, redness, swelling and usually itching.

2. When dermatitis results after a person touches certain substances and then exposes the skin to sunlight, the condition is called occupational dermatitis.

3. The effects of psoriasis range from a mild, short-lived redness to severe swelling and blisters.

4. Determining the cause of contact dermatitis is easy because the possibilities are endless.

5. To prevent infection and avoid irritation, a person should clean the area regularly with water and gentle soap.

6. Contact dermatitis of the hands results from repetitive tasks, and contact with chemicals.

7. Fungal infection is an uncommon cause of an eruption on the feet.

8. The best treatment of chronic dermatitis is to remove the chemical that is irritating the skin.

9. Bacterial infections that may develop in open skin sores are treated with antihistamines.

10. Many conditions can make atopic dermatitis worse, including emotional stress, bacterial skin infections and contact with irritating clothing.

11. Though contact dermatitis may closely resemble seborrheic dermatitis in infants, doctors try to distinguish between them because their complications and treatments are different.

12. To help control the itching, doctors prescribe antihistamines to be taken by mouth and corticosteroid creams to be rubbed gently on the affected area.

 

Exercise 3. Match mechanism a – l with function 1 – 10. One function has three mechanisms.

 

Function Mechanism

 

1. protection against water loss a. collagen and elastin in the

dermis

2. protection against micro-organisms b. conversion of subcutaneous fat

3. screen from UV rays c. erection of hairs

4. shield against mechanical abrasion d. greasy horny layer

5. monitoring of the environment e. nerve endings in the dermis

6. formation of vitamin D f. epidermal melanin

7. temperature regulation g. sweat production

8. energy storage h. evaporation of sweat

9. excretion of mainly salt and water i. increased cell division and replacement

10. protection against stretching j. synthesis from 7-dehydrocholesterol

k. compounds from sweat and sebaceous glands

i. control of dermal blood flow

 

Exercise 4. Learn the definition of the following special terms.

 

integumentary system – the skin (the largest organ in the body) and its associated structures, including hair, nails, and sweat and sebaceous glands.

 

epidermis – the protective outer layer, which contains pigment-forming cells that determine skin colour.

 

dermis (also called derma, corium, and cutis) – the middle layer, which contains blood vessels, sweat glands, and nerves that convey sensation.

 

subcutis (or subcutaneous layer) – the layer below the dermis. It contains blood vessels, nerves, and connective tissue for padding, insulation against heat and cold, and storage of food and water.

 

allergy – an abnormal sensitivity to a particular substance so that contact with it produces an antigen-antibody reaction. For example, ragweed makes the person allergic to it (sneeze).

 

antihistamine – a medicine that counteracts the effect of histamine (a substance normally present in the body and in certain foods), which sometimes causes an allergic reaction. Antihistamines relieve the allergic symptoms.

 

Exercise 5. Discuss the meaning of the following special terms.

 

pruritus, pediculosis, ichthyosis, psoriasis, lichen planus, eczema, atopic dermatitis, neurodermatitis, hyperhidrosis, rosacea, alopecia, candidiasis, vitiligo, melanoma.

 

Exercise 6. Match each word part with its definition. Use a dictionary for help.

 

1. ab- across; between; through

2. di- difficult; bad

3. dia- fungus

4. dys- hard

5. hist- near or beside; abnormal

6. hypo- abnormal or diseased condition

7. mal- under; below normal

8. myc- double; twice; two

9. –osis away; from

10. para- tissue

11. peri- bad; ill

12. scler- around

 

Exercise 7. Answer the following questions to the texts from Section “Skin Disorders”.

 

1. What are some important functions of the skin?

2. Which layer of skin contains the sweat glands, and what do these glands do to help the human body?

3. What causes Lichen planus?

4. What types of dermatitis do you know?

5. What are the common symptoms of psoriasis?

6. What is the difference between contact dermatitis and atopic dermatitis?

7. What may be done in case of drug rashes?

8. What are the most common symptoms of alopecia?

9. What is candidiasis caused by?

10. What are the most dangerous symptoms of sunburn depending on the type of skin pigment?

11. Who is more susceptible to skin cancer? Name some types of skin cancer.

12. What are some common allergies, and how are they treated? Discuss an allergic condition that you are familiar with. How is it controlled?

 

Exercise 8. Match each verb below with the meaning that it usually has in a medical setting.

1. accompany ___ put

2. administer; render_____ give (first aid, etc.)

3. assume ___ go with

4. consult ___ recognize differences

5. determine ___ cause

6. distinguish ___ reduce (make less)

7. induce keep something from happening

8. minimize regain health after illness (get well)

9. place conclude; decide

10. prevent ___ suppose; believe

11. recover ___ ask for someone's opinion or advice

12. suspect ___ believe something is true because of good evidence

 

Exercise 9. Write the medical meaning of each group of the letters below.

PUVA

AIDS

UVR

UV rays

UVB rays

UVF

UVL

PABA

SPF

 

Exercise 10. Underline the correct word or phrase to complete each sentence.

 

1. Psoriasis is a) a recurring itchy disease, starts as a rash of small discrete bumps; b) a recurring disease recognizable by silvery scaling bumps and various-sized plaques.

2. Lichen planus usually starts as a) one or more small psoriatic plaques that become excessively flaky; b) a rash of small discrete bumps that then combine and become rough, scaly plaques.

3. Contact dermatitis is an inflammation caused by a) contact with a particular substance; b) contact with chemicals.

4. Atopic dermatitis is a) a chronic, itchy inflammation of the top layer of the skin; b) a chronic, itchy inflammation of the upper layer of the skin that often develops in people who have asthma.

5. Toxic epidermal necrolysis typically begins with a) a painful red area that quickly spreads; b) reddened patches and blisters erupting more often on the palms of the hands and on the face.

6. Alopecia can result from a) genetic factors, aging and systemic diseases; b) a previous inflammatory condition of the skin or, in rare instances, may represent a hereditary condition.

7. Vitiligo is a condition in which a) no melanin is formed; b) a loss of melanocytes results in smooth, whitish patches on skin.

8. Basal cell carcinoma usually develops on a) sun-exposed areas but may grow anywhere on the skin or in places such as the tongue or the lining of the mouth; b) skin surfaces that are exposed to sunlight.

 

Exercise 11. Speak on the following.

 

1. Different Types of Dermatitis.

2. Sebaceous Gland Disorders.

3. Baldness. Symptoms and Treatments.

4. Skin Cancers.

 

SECTION 8