4 - Derm - Non-melanoma skin cancers + Benign skin tumours - Pre-malignant cutaneous tumours

Question 1

2 types of pre mal cut tumours

Answer 1

actinic keratoses
intraepidermal carcinoma (IEC/Bowens disease)

Question 2

AK - also known as? affects how many over 60? risk of SCC?

Answer 2

solar keratoses
1/5 people over 60 in UK
risk of SCC is 10-15% in pts with >10 AK’s

Question 3

AK clinical features - colour? where? how many? Sx?

Answer 3

pink/brown macules/papules, erythematous +/- yellow/brown/silvery scaling

sun exposed sites mostly

single or multiple

pain, itchiness

Question 4

mgmt of AK - 3 main parts

Answer 4

cryotherapy, imiquimod/5-FU, photodynamic therapy

Question 5

mgmt - needed? what is generally unnecessary? when is it necessary?

Answer 5

not always needed - 25% regress spontaneously

gen unnecessary - curettage and cautery/surgical excision
- unless suspect SCC, recurrent AK, cutaneous horn (keratin projection)

Question 6

intraepidermal ca - (Bowens) - describe pathology - growth?

Answer 6

full thickness epidermal dysplasia

slowly grows, can become invasive SCC

Question 7

clinical features of IEC

Answer 7

sharply demarcated, scaly erythematous patch/plaque
slow grow, solitary
like psoriasis
commonly on legs

Question 8

IEC mgmt - 3 main principles

Answer 8

cryotherapy (caution on face)
imiquimod/5-FU
photodynamic therapy

Question 9

IEC mgmt - 3 other things

Answer 9

biopsy - to rule out SCC

curettage and cautery, surgical excision