7. Skin Tumours Flashcards
1
Q
A
= Salmon plaque with silvery scales
2
Q
A
= Topical doxycycline
3
Q
A
= He has a BCC which should be managed with surgical excision.
4
Q
A
= SCC
5
Q
A
= Tumours in people of older age.
6
Q
Outline the changes associated with actinic damage?
A
7
Q
What are the causes of Actinic Damage?
A
8
Q
What is Sun Sensitivity?
- Who are the sun sensitive patients?
- What causes abnormal photosensivity?
A
- Sun sensitivity describes how susceptible an individual is to the effects of solar radiation.
- It is genetically determined and is measured by how quickly an individual develops redness (or sunburn) on exposure to ultraviolet light.
- Patients who are genetically predisposed show signs of sun damage at an early age.
9
Q
What is Sunburn?
- Skin Phenotypes?
A
10
Q
Solar Keratoses
- Description?
- Location?
- Variation?
- Risks?
- Treatments? (6)
A
11
Q
Basal Cell Carcinoma
- 6 Clinical variants?
- Epidemiology?
A
Basal Cell Carcinoma
- BCC is the most common skin cancer found in the Australian population.
- It is a locally invasive non-melanocytic cancer with low potential to metastasize.
12
Q
What type of BCC is this?
- 6 Clinical Features?
A
= Nodular BCC
13
Q
What type of BCC is this?
- 5 Clinical Features?
A
= Superficial BCC
14
Q
What type of BCC is this?
- 4 Clinical Features?
A
= Ulcerative BCC
15
Q
What type of BCC is this?
- 6 Clinical Features?
A
= Morphoeic BCC
16
Q
What type of BCC is this?
- 4 Clinical Features?
A
= Pigmented BCC
17
Q
What type of BCC is this?
- 3 Clinical Features?
A
= Recurrent BCC
18
Q
List 4 Differentials for Nodular BCC?
A
19
Q
List 5 Differentials for Superficial BCC?
A
20
Q
List 4 Differentials for Pigmented BCC?
A
21
Q
List 1 Differential for Morphoeic BCC?
A
= Scar tissue
22
Q
List 4 Differentials for Ulcerative BCC?
A
23
Q
Describe the Assessment of BCC as either High or Low Risk.
- 5 Clinical Risk Factors?
- 2 Pathological Risk Factors?
A
24
Q
List the 7 Treatment options for BCC?
A
25
**Management of BCC**
- Surgical Excision?
- Liquid nitrogen cryotherapy?
- Curettage and Cautery?
- Topical Imiquimod (Aldara cream)?
- Photodynamic therapy (PDT)?
- Mohs Micrographic surgery?
**Radiation treatment**
- Suitable for definitive treatment of high-risk tumours and also as adjunctive treatment following surgical treatment of high-risk tumours.
- The main high-risk tumour indications are recurrent BCCs and SCCs, incomplete excision, perineural invasion, and where surgery would produce more disfigurement than radiation.
- Also suitable for lower risk tumours in certain situations, especially older patients who are unfit for surgery.
26
**Squamous Cell Carcinoma**
- Background?
- Epidemiology & Risk Factors?
27
**Squamous Cell Carcinoma**
- Clinical Features?
- Pathogenesis: Sun exposure? Viral transformation? Rare causes of cutaneous SCC?
28
**Squamous Cell Carcinoma**
- List 8 Differential diagnoses for well to moderately differentiated SCCs?
- List 5 Differential diagnoses for poorly differentiated SCCs?
29
- Outline the management of Cutaneous SCC?
- Outline the management of Advanced SCC?
- Follow-up?
**Management – Follow-up**
- Regular follow up of SCC patients is necessary to examine the scar for recurrence, to palpate the draining lymph nodes, and to check for new, unrelated lesions.
- If draining lymph nodes are enlarged, fine needle aspiration may confirm metastasis.
- However, if this investigation is inconclusive, excisional lymph node biopsy is required.
- The management of lymph node metastases involves surgical excision and/or wide field radiotherapy.
30
**Keratoacanthoma**
- Definition?
- Clinical Features?
- Treatment?
31
**Bowen's Disease (SCC In-Situ)**
- Background?
- Clinical Features?
- Pathogenesis?
**Pathogenesis**
- Related to excessive UV exposure and is relative to skin type.
- If lesions are multiple or seen in relatively sun-protected skin, consider the possibility of past exposure to arsenic, radiation, or an underlying genetic disorder.
32
**Bowen's Disease (SCC In-Situ)**
- Diagnosis?
- 9 Differentials?
- Prognosis?
- Treatment?
**Diagnosis**
- Histological diagnosis
- All layers of the epidermis are dysplastic in Bowen’s disease.
- In actinic keratosis, there is only partial thickness dysplasia within the epidermis.
**Prognosis**
- Bowen's disease is a slow progressive condition.
- Up to 10% of lesions of Bowen's disease may progress to SCC if left untreated, although this invasive transformation may take many years to occur.
33
= It is a rare form of skin cancer (FALSE)
34
= Keratoacanthoma
35
= SCC
36
= Pityriasis versicolour
37
= SCCs on the arm are more likely to metastasize than SCCs on the lip (FALSE)
38
39
40
41
42
43
= Nodular melanoma
44
= She will require a wide local excision with a surgical margin of 2cm.
45
= Nodular melanoma can often be misdiagnosed as non-melanoma skin cancer (FALSE)
46
= Hair follicles
47
= Dysplastic neavus carries a small individual risk of transformation into melanoma.
48
Epidemiology of Melanoma?
49
4 Clinical Variants of Melanoma?
50
**Superficial Spreading Melanoma**
- Epidemiology?
- Risk Factors?
- Clinical Features?
51
**Lentigomaligna Melanoma**
- Epidemiology?
- Risk Factors?
- Clinical Features?
52
**Acral Lentiginous Melanoma**
- Epidemiology?
- Risk Factors?
- Clinical Features?
53
**Nodular Melanoma**
- Epidemiology?
- Risk Factors?
- Clinical Features?
54
What history are you going to take from a patient with suspected melanoma?
55
**What are Radial Growth Phase Melanomas?**
- Which 3 types begin with this?
- ABCDEs of melanoma?
56
**What are Vertical Growth Phase Melanomas?**
- Which types begin with this?
- EFGs?
57
**Common Acquired Melanocytic Naevi**
- Differentiating features from Melanoma?
- Clinical features?
- Classification?
58
**Spitz Naevi**
- Description?
- Clinical features?
59
**Congenital Naevi**
- Differentiating Features/Description?
- Clinical Features?
60
**Halo Naevi**
- Differentiating Features/Description?
- Clinical Features?
61
**Solar Lentigines**
- Differentiating Features/Description?
- Clinical Features?
62
**Freckles (Ephelides)**
- Differentiating Features/Description?
- Clinical Features?
63
**Blue Naevi**
- Differentiating Features/Description?
- Clinical Features?
64
**Dysplastic Naevi**
- Description?
- Clinical Features?
- Treatment?
65
**Seborrhoeic Keratosis**
- Description?
- Clinical features?
- Treatment?
66
**Skin Tags**
- Description?
- Clinical features?
- Treatment?
67
**Dermatofibroma**
- Description?
- Clinical features?
- Treatment?
68
**Sebaceous (Epidermoid) Cyst**
- Description?
- Clinical features?
- Treatment?
69
**Sebaceous Hyperplasia**
- Description?
- Clinical features?
- Treatment?
70
**Campbell de Morgan spots**
- Description?
- Clinical features?
- Treatment?
71
How are suspicious lesions diagnosed?
What is Breslow thickeness?
72
What are the different surgical margins required depending on Breslow thickness?
73
**Outline the treatment options for melanoma.**
- When would you consider a sentinel lymph node biopsy?
74
Which sunscreen ingredients are:
a. Reflective?
b. Absorptive?
75
What is SPF?
76
= She will require a wide local excision with a surgical margin of 2cm
77
= Lentigo maligna melanoma occur in the elderly and are associated with cumulative sun exposure.
78
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