[Derm] Skin Cancer Flashcards
what is a melanoma?
neoplasm originating from melanocytes in the epidermis
a score of 3 or more points in the scoring criteria warrants a 2 week referral. what is the major criteria?
(2 points each)
- change in size
- irregular colour
- irregular shape
a score of 3 or more points in the scoring criteria warrants a 2 week referral. what is the minor criteria?
(1 point each)
- diameter >7mm
- inflammation
- oozing
- change in sensation
what mnemonic can you use to identify suspicious features?
ABCDE A - asymmetry B - borders C - colour D - diameter (>7mm) E - exposed area / elevated / evolving
where can a melanoma metastasise to?
lungs, liver, brain, bone
what is the 5 year survival for melanoma?
90% in stage I-II
20% in stage IV
what are the risk factors for developing melanoma?
- prolonged sun exposure
- sunbed use
- Fitzpatrick skin type 1
- freckles
- moles
- FHx
- previous skin cancer
- > 50 years of age
- xeroderma pigmentosum
what are the types of melanoma?
- superficial spreading (70%)
- nodular (15%)
- lentigo (10%)
- amelanotic (8%)
- acral lentiginous (5%)
a lesion suspicious of melanoma is referred to dermatology. what do you do if there is suspicion of nodal involvement or metastasis?
excision biopsy + SLNB +/- met screening
SLNB = sentinel lymph node biopsy
what does a +ve met screen tell you and what would you do for it?
stage IV → resect if possible → chemotherapy → metastatectomy → palliative input
what does a -ve met screen tell you and what would you do for it?
stage III → lymph node dissection + adjuvant chemo
a lesion suspicious of melanoma is referred to dermatology. what do you do if there is no suspicion of nodal involvement or metastasis?
excision biopsy
what do you do if excision biopsy shows Breslow >2mm?
SLNB
what do you do if SLNB is +ve?
met screen
what does a -ve SLNB mean and what would you do for it?
stage II → follow up + advice