cancer Flashcards
what is an AK
chronic sun exposure –> premalignant lesion –> SCC
features AK
small, crusty, scaly // pink, red, brown // sun exposed areas eg forehead
1st topical mx AK + what can be co-prescribed
flurouracil cream 2-3 weeks // topical hydrocrtoisone following
2nd line topical mx AK
topical diclofenac // topical imiquimod
3rd line mx AK
cryotherapy or curettage and cautery
what is bowens disease
precancerous dermatosis –> SCC
symptoms bowens
10-15mm // slow growing // sun-exposed sites // looks like a red scab
mx Bowens (3)
5FU - BD for 4 weeks // cryotherapy // excision
RF SCC
sunlight UVA eg lots of time in the sun // AK or bowens // immunosuppresed eg renal transplant // ulcers
features SCC
sun exposed sites // rapid growing painless ulcers // cauliflower appearance // bleeding
indicators of poor prognosis SCC
poorly differentiated // > 20mm diameter // > 4mm depth // immunosuppresed patient
mx SCC
excision with 4mm marging if <20mm // if >20mm then 6mm margins
what surgery for SCC can be done on cosmetic sites
Mohs micrographic surgery
chance of mets SCC vs BCC
SCC = 3-5% // BCC = v rare
features BCC
nodular // sun exposed // pearly, flesh coloured papule with telangiectasia // can ulcer –> crater
RF BCC
burning
wht is most common cancer in western world
BCC
mx BCC
surgical // curettage // cryotherapy // imiquimod or 5FU // radiotherapy // Vismodegib
most –> least common melanoma
superficial spreading –> nodular –> lentigo –> acral
lesion, age, area superficial spreading melanoma
arms, legs back, chest // young people // changing mole
main criteria for melanoma
change in size, shape, colour // diameter >7mm, inflamm, oozing, altered sensation
symptoms nodular melanoma
middle aged people
lesion, age, area nodular melanoma
middle aged people // sun exposed // red or black lump which oozes or bleeds
lesion, age, area lentigo melanoma
older people // sun exposed // same as superficial melanoma
lesion, age, area acral lentiginous melanoma
nails, palms, soles // darker skin // subungal pigmentation
mx melanoma
excision + biopsy –> maybe re-excision
prognostic + excision marker melanoma
breslow thickness
5 year survival breslow thickness <0.75mm vs >4mm
<0.75 = 95-100% // >4 mm = 50%
mx malignant melanoma
sentinal node, chemo
what is mycosis fungoides
T cell lymphoma of skin
symptoms mycosis fungoides
itchy, red patches // varying colour
what is kaposis sarcoma + what does it look like
vascular + lymph tumour // purple nodule
