Cancer as a disease-skin caner

Question 1

What is it the name given to a large area of lentigo maligna that has a smaller area within it that has become invasive?

Answer 1

Lentigo maligna melanoma

Question 2

WHat melanoma is represented

Answer 2

Lentingo maligna

Question 3

What are the main cell types in the epidermis?

Answer 3

Keratinocytes Melanocyts Langerhans Cells Merkel Cells

Question 4

Name a disease that predisposes to SCCs and HPV induced warts (that can become incredibly keratotic).

Answer 4

Epidermodysplasia Veruciformis

Question 5

What are the consequences of UV therapy for psoriasis?

Answer 5

Increased risk of skin cancer UV can act on keratinocytes and cause DNA damage If the Langerhans cells have been depleted then they will be unable to knock out the damaged cells so they could persist and become cancerous

Question 6

What is it called when you get a vertical proliferation of malignant melanocytes?

Answer 6

Nodular malignant melanoma

Question 7

Describe the appearance of BCCs and their development

Answer 7

They are pearly, have a rolled edge and often have arborising telangiectasia, develop slowly, inavde tissue but do not metastasise and they are common on the face

Question 8

Features of genes that are affected by UV damage and how

Answer 8

UV damage to DNA leads to mutations in specific genes involved in :

• cell division
• DNA repair
• cell cycle arrest

Question 9

WHat is this image showing

Answer 9

Lentingo maligna melanoma

Question 10

State the types of skin cancer that come under each of the following types: a. Keratinocyte derived b. Melanocyte derived c. Vasculature derived d. Lymphocyte derived

Answer 10

a. Keratinocyte derived Basal Cell Carcinoma Squamous Cell Carcinoma b. Melanocyte derived Malignant Melanoma c. Vasculature derived Kaposi Sarcoma – endothelium of lymphatics Angiosarcoma – endothelium of blood vessels d. Lymphocyte derived Mycosis fungoides(lymphoma in the skin)

Question 11

WHAt is the coomon genetic change and consequence that occur between cancers like skin cancer

Answer 11

Accumulation of genetic mutations uncontrolled cell proliferation

Question 12

What type of melanoma produced no melanin?

Answer 12

Amelanotic melanoma

Question 13

State two examples of genetic syndromes that massively increase the risk of getting skin cancer.

Answer 13

Gorlin’s Syndrome – regular BCCs Xeroderma Pigmentosum – increased risk of BCC, SCC and malignant melanoma

Question 14

How can UVA promote skin carcinogenesis?

Answer 14

Forms cyclobutane pyrimidine dimers (but less effectively than UVB) Also generates free radicals that can damage DNA

Question 15

What is a keratoacanthoma?

Answer 15

It is either a benign lesion or a benign version of an SCC It grows rapidly but then disappears There is no risk of metastasis

Question 16

Which viruses are associated with Kaposi sarcoma?

Answer 16

HHV8 HIV

Question 17

What is a superficial spreading malignant melanoma?

Answer 17

Lateral proliferation of malignant melanocytes They invade the basement membrane so there is a risk of metastasis

Question 18

What is the prognosis of melanoma based on?

Answer 18

Breslow thickness – thickness from the top of the tumour to the bottom, measured in mm

Question 19

Give two examples of viruses that can lead to skin cancer?

Answer 19

HHV8 HIV

Question 20

Label

Answer 20

Question 21

What happens to keratinocytes in sunburn?

Answer 21

The UV damage leads to keratinocyte apoptosis The apoptotic cells in UV overexposed skin are called sun burn cells

Question 22

What is a basal cell carcinoma (BCC) and what are itheir two main causes

Answer 22

Malignant tumour arising from keratinocytes in the basal layer of theepidermis, sun exposure and genetics

Question 23

Which system is used to categorise people based on their skin type and sensitivity to UV?

Answer 23

Fitzpatrick Phenotypes

Question 24

Name a condition that is caused by a defect in nucleotide excision repair.

Answer 24

Xeroderma pigementosum

Question 25

How can you tell whether an SCC is well differentiated?

Answer 25

If the lesion has a keratin horn then it shows that the keratinocytes can still produce keratin and so they are well differentiated

Question 26

WHat melanoma is represented

Answer 26

superficial spreading malignant melanoma

Question 27

List features of Mutations that cause cancer

Answer 27

1.Mutations that stimulate uncontrolled cell proliferation

Eg abolishing control of the normal cell cycle (p53 gene)

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2.Mutations that alter responses to growth stimulating / repressing factors

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3.Mutations that inhibit programmed cell death (apoptosis)

c