3 - skin cancers Flashcards
what are 3 important types of skin cancers?
- basal cell carcinoma
- squamous cell carcinoma
- melanoma
what is ABCDE for pigmented lesions?
A = asymmetry
B = border (irregular)
C = colour
D = diameter
E = elevation
does basal cell or squamous cell grow slower?
BCC slower than SCC
which types skin cancer more associated with severe intermittent sun exposure?
BCC & melanoma
which types of skin cancer more associated with chronic cumulative sun exposure?
SCC
where is basal cell carcinoma?
basal cell layer keratinocytes
- also called rodent ulcer since if leave long enough looks like rat been chewing away
what is history & clinical feature of basal cell carcinoma?
HISTORY = slow growing, just won’t heal (cycle of scabbing up & breaking down again)
FEATURES = rolled/pearly shiny edge, central ulceration, telangiectasia (thread like blood vessel)
what is prognosis like for basal cell carcinoma?
excellent, locally invasive but don’t metastasis (if gonna get skin cancer - want this one)
what are 3 sub types of basal cell carcinoma? treatment of each type?
- nodular = big lump = need cut out
- superficial = excellent prognosis, not threatening so topical treatment
- infiltrative = not clear edge & on face so can be tricky = need Mohs surgery
what is Mohs surgery?
(under local anaesthetic & take few mm round then will wait for few hours until sample processed then check to make sure that all gone, repeat until clear margins all the way round - need skin graft & fancy repair)
= done in infiltrative BCC
what is location of squamous cell carcinoma? prognosis?
= supra-basal keratinocyte
prognosis is worse as potential to metastasise
what is history & clinical presentation of squamous cell carcinoma?
HISTORY = grow quick, change quick, painful/tender
PRESENTATION = depends how differentiated cells are, can be scaly or ulcerated or red/yellow - often on sun damaged areas
what is commonest skin cancer in immunosuppressed?
SCC
what are precursors to SCC?
- actinic keratosis = partial thickness dysplasia of epidermis (crusty yellow)
- bowen’s disease = whole epidermis dysplastic - thick & red plaques
= these both progress to SCC, treat topically unil SCC then remove surgically
what is melanoma prognosis? where?
= cancer of melanocytes (form moles)
- worst prognosis of skin cancers (potential to metastasise)
what is presentation of melanoma?
- pigmented lesion, itchy, bleeding
- everyone has moles so just need to look out for changes & worrying signs like ABCDE of pigmented lesions = asymmehtrical, irregular border, >6mm diameter, elevation
what changes of moles are signs of concern?
- change in shape, size or colour
- sensory change
- bleeding
- inflammation
- diameter >6mm
what are types of melanoma?
- superficial spreading = large flat irregularly pigmented (common)
- nodular = aggressive, rapidly growing, ulcerate & bleed
- lentigo maligna melanoma = invasive, sun damage so face, neck, scalp
- acral lentiginous melanoma = palms, soles, nails, progress quick
what are 2 growth phases of melanoma cancer?
radial = initial growth - no metastatic & curable
vertical = metastatic potential (depth) = breslow thickness
what is breslow thickness?
it’s measurement of vertical growth/depth of tumour
- deeper the tumour = bigger the breslow thickness = worse prognosis
what is sentinel node biopsy for melanoma treatment?
- sentinel node biopsy (inject die into skin where melanoma is, follow to 1st lymph node and then cut lymph node to check if spread) if high breslow thickness
- this done at same time as wide excision
