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finals > dermatology > Flashcards

dermatology Flashcards

1
Q

what layer of the skin is affected by basal cell carcinoma?

A

the basal layer of the epidermis

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2
Q

what is the prognosis of BCC and why?

A

good because they develop slowly and rarely metastasise

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3
Q

what are the 3 main types of basal cell carcinoma?

A

nodular BCC
superficial BCC
morpheaform BCC

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4
Q

what is the most common type of BCC?

A

nodular BCC

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5
Q

where does nodular BCC usually present?

A

on the face

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6
Q

what is the clinical appearance of nodular BCC?

A

pearly shiny papule or nodules w/ small telangiectasis and rolled edges and someones a depressed centre

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7
Q

what is the second most common type of BCC?

A

superficial BCC

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8
Q

how does superficial BCC usually present?

A

as a plaque or patch of well defined scaly pink skin

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9
Q

where do superficial BCCs usually present?

A

on the trunk or extremities

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10
Q

what is the least common type of BCC?

A

morpheaform BCC

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11
Q

how does morpheaform BCC usually present?

A

as a poorly defined pale scar or indurated plaque

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12
Q

which type of BCC has the worst prognosis and why?

A

morpheaform BCC because it can subclinically destroy surrounding tissue

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13
Q

what is the main treatment goal of BCC?

A

complete removal

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14
Q

other than complete surgical resection what are the other management options for BCC?

A

topical 5 fluoro-uracil
cryotherapy
photodynamic therapy

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15
Q

where does squamous cell carcinoma occur?

A

in the squamous keratinocytes in the epidermis (the outermost layer of the skin)

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16
Q

where do SCCs most commonly occur?

A

in sun exposed areas such as the lips, back of hands, upper part of face or scalp

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17
Q

what are the 3 characteristic features of SCC?

A

bleeding
itching
crusting

18
Q

what are the 2 pre cancerous lesions that can progress to SCC?

A

Bowens disease
actinic keratosis

19
Q

what is Bowens disease?

A

SCC in situ - the cancerous cells are confined to the epidermis

20
Q

what is actinic keratosis?

A

a pre cancerous scaly lesion

21
Q

what is the first line management for Bowens disease?

A

restrictive therapies:
- cryotherapy
- topical 5 fluoro-uracil

22
Q

what is the first line management for invasive SCC?

A

surgical excision w/ minimum of 4mm margins

23
Q

what is the treatment of choice of SCC in cosmetically sensitive areas?

A

Mohs surgery

24
Q

what causes melanoma?

A

uncontrolled proliferation of melanocytic stem cells

25
Q

what are the 3 growth phases of melanoma?

A

in situ: the tumour is confined to the epidermis

invasive: the tumour has spread to the dermis

metastatic: the tumour has spread to other tissues

26
Q

what are the 4 subtypes of melanoma?

A

superficial spreading melanoma
nodular melanoma
lentigo maligna melanoma
aural lentiginous melanoma

27
Q

what is the most common subtype of melanoma?

A

superficial spreading melanoma

28
Q

how does superficial spreading melanoma progress?

A

initially grows horizontally (radial growth phase) and this presents as a flat irregular pigmented lesion that slowly enlarges

as invasion continues, growth may become vertical

29
Q

what is the most aggressive subtype of melanoma?

A

nodular melanoma

30
Q

how does nodular melanoma progress?

A

malignant cells invade vertically, presenting as a nodule that grows rapidly (weeks to months)

often bleeds or ulcerates

31
Q

what is lentigo maligna?

A

a precursor lesion to lentigo maligna melanoma that is directly related to sun damage

32
Q

how does lentigo maligna present?

A

as a patch of discoloured skin that grows slowly and becomes more atypical

33
Q

where does acral lentigenous melanoma occur?

A

on the palms, soles or under the nails

34
Q

how does acral lentigenous melanoma present?

A

as a flat pigmented lesion that slowly enlarges

35
Q

what is breslows thickness?

A

a measure of the thickness of invasive melanoma in mm from the granular layer to the deepest tumour layer

36
Q

at what breslows thickness is a sentinel node biopsy needed?

A

> 0.8mm

37
Q

what is the management of stage 0 melanoma (in situ)?

A

wide local excision w/ at least 0.5cm margin

38
Q

what is the management of stage 1 melanoma (melanoma <2mm thickness)?

A

wide local excision w/ at least 1cm margin

39
Q

what is the management of stage 2 melanoma (melanoma >2mm thickness or >1mm thickness w/ ulceration)?

A

wide local excision w/ at least 2cm margins

40
Q

what is the management of stage 3 melanoma (melanoma spread to involve local lymph nodes)?

A

wide local excision w/ lymphaedenectomy

41
Q
A
42
Q
A

finals (25 decks)

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