[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
what does it mean if excision biopsy shows Breslow <2mm and what would you do for it?
stage I → follow up + advice
what do you do if excision biopsy shows non-cancerous lesion on histology?
discharge
scaly, crusted lesions that bleed easily. dx?
squamous cell carcinoma (SCC)
what are the risk factors for developing SCC?
- smoking
- sun exposure
- male
- Bowen’s disease
where in the body does SCC occur?
sun exposed areas, often lips, forearms and lower legs
what is the Rx for SCC?
topical chemo or excision
SCC rarely metastasises. true/false?
true
pearly nodule, ‘rolled’ and erythematous edge. dx?
basal cell carcinoma (BCC)
what are the risk factors for developing BCC?
- sun exposure
- Fitzpatrick skin type I
- previous SCC
where in the body does BCC occur?
sun exposed areas, often head and neck
what is the Rx for BCC?
topical chemo or excision
recurrence is not uncommon for BCC. true/false?
true
multiple flat, light-brown plaques, waxy surface along the scalp or back. dx?
sebhorreic keratosis
multiple scaly, thick plaques on sun exposed areas. dx?
actinic / solar keratosis
a hard, raised growth with an ulcerated centre that began as a boil. dx?
keratoacanthoma
what is the 1st line ix for a melanoma?
excision biopsy and Breslow thickness
what should be done for lesions suspicious of melanoma (>3 points)?
excised and sent to histology to guide staging
nodal involvement in melanoma?
stage III
metastasis in melanoma?
stage IV
BCC and SCC are rarely fatal but what rx would they both need?
excision / topical chemotherapy
