BCC and SCC

Question 1

Basal cell carcinoma

Answer 1

Cancer of the epidermal keratinocytes

aka rodent ulcer

Question 2

What gene is mutated in BCC

Answer 2

PTCH tumour suppressor gene

Question 3

Risk factors for BCC

Answer 3

UV radiation
Skin type 1 
History of childhood sunburn, skin cancer
Increasing age
Male Sex
Immunosuppression
Genetics e.g. Gorlin Syndrome

Question 4

Clinical features of BCC

Answer 4

80% found on the head and neck
Slow growing
May bleed or ulcerate
Rarely metastasises

Question 5

Most common malignant skin cancer

Answer 5

Basal Cell Carcinoma

Question 6

Differential Diagnoses

Answer 6

Sebaceous gland hyperplasia
Squamous cell carcinoma
Malignant melanoma (pigmented BCC)

Question 7

Types of BCC

Answer 7

Nodular (most common
Cystic
Superficial
Morphoeic
Keratotic
Pigmented

Question 8

Complications of BCC

Answer 8

Local tissue invasion

Question 9

Treatment for BCC

Answer 9

Surgery
Radiotherapy
Cryotherapy
Photodynamic therapy
Topical therapy

Question 10

Surgical treatment options for BCC

Answer 10

Excision (gold standard)
Mohs micrographic surgery
Curettage and cautery (for small BCCs)

Question 11

Topical treatment for BCC

Answer 11

Flurouracil

Imiquimod

Question 12

Squamous Cell Carcinoma

Answer 12

Cancer of the epidermal keratinocytes

Question 13

Second most common skin cancer

Answer 13

Squamous Cell Carcinoma

Question 14

Risk factors of SCC

Answer 14

Excessive exposure to UV radiation 
Smoking
History of skin cancer
Pre-malignant skin disease e.g. actinic keratoses
Chronic inflammation e.g. leg ulcers
Immunosuppression
Human Papilloma Virus (HPV)
Genetics

Question 15

Clinical features of SCC

Answer 15

Keratotic nodule
Ill-defined borders
May ulcerate
May crust, bleed, itch and painful
Found in sun-exposed sites
Can metastasise

Question 16

Differentials for SCC

Answer 16

Actinic Keratosis
Bowen’s Syndrome
Keratoacanthoma
Basal Cell Carcinoma

Question 17

Actinic Keratosis

Answer 17

Erythematous, scaly papules or plaques

Due to chronic UV exposure

Question 18

Most common SCC precursor

Answer 18

Actinic Keratoisis

Actinic Keratosis –> Bowel’s Disease –> SCC

Question 19

Treatment of Actinic Keratosis

Answer 19

Cryotherapy

Question 20

Bowen’s disease

Answer 20

SCC in situ

Whole epidermis contains atypical keratinocytes

Question 21

Treatment for Bowens Disease

Answer 21

Surgery
Cryotherapy
Photodynamic therapy
Topical Therapy

Question 22

Topical therapy for Bowens Disease

Answer 22

Fluorouracil

Imiquimod

Question 23

Treatment for SCC

Answer 23

Surgery
Radiotherapy
Cryotherapy

Question 24

Surgical treatment for SCC

Answer 24

Excision (gold standard)
Mohs micrographic surgery
Curettage and cautery

Question 25

High risk SCC

Answer 25

Diameter ≥2cm

Thickness ≥2mm

Question 26

BCC summary

Answer 26

Most common skin cancer
No precursor
Surgery is the treatment of choice
Less likely to metastasise
Lower mortality rate

Question 27

SCC Summary

Answer 27

Second most common skin cancer
Precursor’s include actinic keratoses and Bowen’s disease
Surgery is the treatment of choice
More likely to metastasise
Higher mortality rate