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Dermatology > Dermatology - skin cancer > Flashcards

Dermatology - skin cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What are examples of non-melanoma skin cancer?

A

Basal cell cancer

Squamous cell cancer

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2
Q

What is the more common non-melanoma skin cancer?

A

Basal cell cancer

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3
Q

What are the risk factors for non-melanoma skin cancer?

A 
UV radiation
Photochemotherapy - PUVA
Chemical carcinogens
X-ray and thermal radiation
HPV
Familial cancer syndromes
Immunosuppression
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4
Q

What are the features of basal cell carcinoma?

A

Slow growing
Locally invasive
Rarely metastasise

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5
Q

What are the types of basal cell carcinoma?

A

Nodular: pearly rolled edge, telangiectasia, central ulceration, arborising vessels on dermoscopy
Superificial
Pigmented
Morphoeic

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6
Q

What is the treatment for basal cell carcinoma?

A

Excision
Curettage
Vismodegib

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7
Q

What is the gold standard treatment for BCC?

A

Exicision

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8
Q

What is Mohs surgery?

A

Precise surgical technique to remove skin cancer

Thin layers of cancer-containing skin progressively removed and examined

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9
Q

What are indications for Mohs surgery?

A 
Site
Size
Subtype
Poor clinical margin definition
Recurrent
Perineural or perivascular involvement
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10
Q

What is the drug treatment for BCC?

A

Vismodegib

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11
Q

What are the indications for use of Vismodegib?

A

Locally advanced BCC not suitable for surgery or radiotherapy
Metastatic BCC

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12
Q

What does Vismodegib do?

A

Selectively inhibits abnormal signalling in the Hedgehog pathway (molecular driver in BCC)
Can shrink tumour and heal visible lesions in some

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13
Q

What are the side effects of Vismodegib?

A

Hair loss, weight loss, altered taste, muscle spasms, nausea, fatigue

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14
Q

What is squamous cell carcinoma derived from?

A

Keratinising squamous cells

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15
Q

Where is SCC usually found?

A

Sun exposed sites

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16
Q

What are the features of SCC?

A

Can metastasise
Faster growing than BCC, tender, scaly/crusted or fleshy growths
Can ulcerate

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17
Q

What is the treatment for SCC?

A

Excision +/- radiotherapy

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18
Q

What is a high risk SCC?

A 
Immunosuppressed
>20mm diameter
>4mm depth
Ear, nose, lip, eyelid
Perineural invasion
Poorly differentiated
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19
Q

What is keratoacanthoma?

A

Variant of SCC

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20
Q

Where does keratoacanthoma come from?

A

Erupts from hair follicles in sun damaged skin

21
Q

What is the treatment for keratoacanthoma?

A

Surgical excision

22
Q

What are the risk factors for malignant melanoma?

A

UV radiation
Genetic susceptibility: fair skin, red hair, blue eyes, tendency to burn
Familial melanoma

23
Q

What is the ABCDE rule for melanoma?

A 
A = asymmetry
B = border
C = colour
D = diameter 
E = evolution
24
Q

What is the 7 point checklist for malignant melanoma?

A 
Major features:
*Change in shape
*Change in size
*Change in colour
Minor features:
*Diameter more than 5mm
*Inflammation
*Oozing or bleeding
*Mild itch or altered sensation
25
Q

What is the bedside tool for assessing melanoma?

A

Dermoscopy

26
Q

What is biologic progression of melanoma?

A 
Benign nevus
Dysplastic nevus
Radial growth phase
Vertical growth phase
Metastatic melanoma
27
Q

What are some of the different types of melanoma?

A 
Superifical spreading malignant melanoma
Lentigo maligna melanoma
Nodular melanoma
Acral lentiginous melanoma
Subungal melanoma
Ocular melanoma
28
Q

What is the treatment for melanoma?

A 
Urgent surgical excision
Wide local excision
Sentinel lymph node biopsy
Chemotherapy/immunotherapy
Regular follow up
Primary and secondary prevention
29
Q

What is the scale for measuring the depth of a melanoma?

A

Breslow thickness

30
Q

What are the drugs for malignant melanoma?

A

Ipilimumab
Pembrolizumab
Vemurafenib
Dabrafenib

31
Q

What are the two forms of cutaneous lymphoma?

A

Primary cutaneous disease - abnormal neoplastic proliferation of lymphocytes in the skin
Secondary cutaneous disease - from systemic/nodal involvement

32
Q

What are the two types of primary cutaneous disease?

A

Cutaneous T cell lymphoma

Cutaneous B cell lymphoma

33
Q

Which cutaneous lymphoma is more common?

A

Cutaneous T cell lymphoma

34
Q

What are the two most common types of cutaneous T cell lymphoma?

A

Mycosis fungoides

Sezary syndrome

35
Q

What is the most common cutaneous T cell lymphoma (CTCL)?

A

Mycosis fungoides

36
Q

What are the stages of mycosis fungoides (MF)?

A
  1. Patch: flat, red, dry oval lesions, usually covered sites, may itch, difficult to differentiate from eczema/psoriasis
  2. Plaque: patches become thickened and generally itch
  3. Tumour: large irregular lumps, arise from existing plaques or normal skin, more likely to have metastatic spread
  4. Metastatic
37
Q

What are the investigations for mycosis fungoides?

A 
Bloods for sezary cells
CT imaging (staging)
38
Q

What is Sezary syndrome also known as?

A

Red man syndrome

39
Q

What are the features of Sezary syndrome?

A

Skin thickened, scaly, red, very itchy

40
Q

What are Sezary cells?

A

Atypical T cells

41
Q

What is the treatment for cutaneous lymphoma?

A 
Topical steroids
PUVA or UVB
Localised radiotherapy
Interferon
Bexarotene
Low dose Methotrexate
Chemotherapy
Total skin electron beam therapy
Extracorporeal photophoresis
Bone marrow transplantation
42
Q

What is total skin electron beam therapy?

A

Type of radiotherapy consisting of very small electrically charged particles, delivers radiation to superficial layers: epidermis and dermis
Spares deeper tissues and organs

43
Q

What is extracorporeal photophoresis?

A

Patients leukocytes collected and made sensitive to UVA radiation which damages diseased cells, treated cells reinfused back into patient

44
Q

What is cutaneous metastases secondary to?

A

Primary skin malignancy e.g. melanoma

Primary solid organ malignancy

45
Q

What is the treatment for cutaneous metastases?

A

Treat underlying malignancy
Local excision
Local radiotherapy
Symptomatic

46
Q

What are the commonest skin cancers?

A

BCC, SCC

47
Q

What is the most serious skin cancer?

A

Melanoma

48
Q

What are rarer skin cancers?

A

Skin lymphomas

Skin metastases

Dermatology (9 decks)

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