Common Skin Cancers Flashcards
What is the most common form of cancer in the United States.
Skin Cancer. more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.
What are the 3 Common Skin Cancer Types
- basel cell, 2. squamous cell, 3. Melenoma
Non-melanoma Skin Cancer RISK FACTORS
Basal Cell Carcinoma
- fair skinned individuals in geographic areas with higher UV exposure
- Mostcommon malignancy in the US
- UV radiation is the most common cause of BCC
- Anestimated 2.8 million are diagnosed annually in the US
- Also occur after ionizing radiation, arsenic or polycyclic hydrocarbon exposure
Most common malignany in US
BCC. Rarely fatal
What are the known mutations that lead to BCC?
loss of function of PTCH1 which normally acts to block smoothened (SMO) a transmembrane protein. Treat w/ Vismodegib, an inhibitor of smoothened. [hedgehog]
the most common precancer leading to BCC?
Actinic Keratosis
List Actinic Keratosis treatment options
-Cryosurgery
-Topical5-fluoruracil
• TopicalImiquimod
• TopicalDiclofenac
• Photodynamictherapy
• Sunprotection
List skin malignancies in order of most common to least common
BCC>SCC>Melanoma
What kind of pts have SCC?
immunosuppressed pts, especially organ transplant pts
SCC risk factors
UV damage, thermal injury, radiation, HPV, burn scars (Marjolin’s ulcer) and chronic injury (i.e. EB)
BCC subtypes
Nodular (75%): Micronodular, Pigmented (6%). Superficial (15%). Infiltrative (5%). Sclerosing/
Morpheaform (3%).
SCC subtypes
SCCinsitu(Bowen’sdisease) • Keratoacanthoma
• InvasiveSCC
Keratoacanthoma clinical features
Distribution- primarily sun-exposed skin
• Rapid growth over 6-8 weeks
• Size- 1-3 cm
• Crateriform endophytic and exophytic nodule with central keratin plug
• Complications- deep invasion without regression in 10-20%
SCC in situ characteristics
Only in epidermis, HPV link (genitalia), scaly, reddish patches/plaques. NOT pigmented. Typically found on chronically exposed sun; less commonly on genitalia.
Non-melanoma Skin Cancer treatment
CryoRx, 5-FU, Imiquimod, Curettage(cautery), Excision, Mohs Surgery, RadioRx.
Malignant Melanoma ABCD guidelines
ABCDE=assymetry, border irregularity, color variation, diameter>6mm, evolution(changes over time).
T or F: One person dies of melanoma every hour
true
T or F: Of the 7 most common cancers in the US, melanoma is the only one whose incidence is increasing (1.9% annually)
true
Melanoma distribution
Distribution
– Blacks- acral and mucosa
– Men- back
– Women- legs (torso in females age 15-29, perhaps due to tanning)
Breslow Depth, what is it?
Tumor invasion in millimeters
List Clarks Levels
I Epidermis II Papillary Dermis III Mid Dermis IV Reticular Dermis V Subcutaneous fat
Malignant Melanoma Treatment options?
M in situ: excision w 5mm margins.
M w 1mm depth: sentinel node bx to determine prognosis w 10-20mm margin. >4mm: adjuvant Rx (IE INF)
What are the mutations in melanoma?
Frequency of Mutations in Melanoma: -BRAF 50% (tx: Vemurafeni b, BRAF inhibitor)
-NRAS 20%
T or F: Ultraviolet radiation (UVR) is a proven human carcinogen classified as Group 1
True
T or F: Just one indoor tanning session increases risk of melanoma by 20%; each additional session increases the risk 2%
True
Skin Cancer Prevention methods
– Sun avoidance (stay inside and play videogames)
– Sun protective clothing (Long-sleeved shirt) – Shade
– Sunscreen
– Sombrero (Wide-brimmed Hat)…why?
– Sunglasses
T or F: Windows protect against UVB, but do not filter UVA.
true
Will sunscreens limit the amount of vitamin D I get?
Individuals concerned about not getting enough vitamin D should discuss with their doctor the options for obtaining vitamin D through foods and/or a vitamin supplement
