Disease Profiles: Skin Cancer Flashcards
What does the ABCD checklist stand for in assessing a possible melanoma?
Asymmetry, border, colour, diameter
Melanomas in intermittently sun-exposed skin may have what mutation?
BRAF
Define the vertical growth phase in melanomas
The melanoma cells invade the dermis forming an expansile mass with mitosis
Which form of BCC begins as a reddish, dome-shaped nodule with a translucent surface and telangiectasia, and then can expand to appear necrotic and ulcerated in the central area creating a rolled edge?
Nodular BCC
How is infiltrative BCC managed?
Resection
Where is acral/mucosal lentiginous melanoma found?
Acral regions - hands, feet, ears and nose
Mucosal regions
What is xeroderma pigmentosum?
Genetic disorder involving defective nucleotide excision repair, which predisposes to skin cancer
Name a treatment which can increase the response time of a BRAF inhibitor
MEK inhibitor
Which form of BCC is flatter and expands gradually, appearing red, scaly, and with a slightly raised ‘whipcord’ margin?
Superficial BCC
Which skin cancer is associated with severe sunburn in childhood?
Melanoma
Which form of BCC infiltrates tissues more widely and has poorly defined margins?
Infiltrative BCC
Which is the most common skin cancer in immunosuppressed patients?
Squamous cell carcinoma
Where is lentigo maligna melanoma commonly found?
Sun damaged face/neck/scalp
What is actinic keratosis?
Partial thickness dysplasia of epidermal keratinocytes
Where is Bowen’s disease most commonly found?
Lower leg of older woman (but can occur at any chronically exposed site)
What is keratoacanthoma?
Self-resolving SCC
Name a genetic therapy for melanomas caused by c-kit mutations
Imatinib
Which skin cancer will present as a warty or hyperkeratotic lump or ulcer on sun-damaged skin?
Squamous cell carcinoma
What is the first-line treatment for SCC precursor lesions?
Topical therapies - cryotherapy, 5-flurouracil, imiquimod, PDT
What is oculocutaneous albinism?
Autosomal recessive absence/defect of tyrosinase resulting in absence of melanin, which predisposes to skin cancers
Which skin cancer arises from melanocytes?
Melanoma
Define the radical growth phase in melanomas
The phase of growth in which macules expand either entirely in situ or with dermal microinvasion
What is the Breslow depth?
Deepest tumour from the granular layer in mm, used to classify melanoma and predict survival
Which type of skin cancer is a c-kit mutation sometimes found in?
Acral melanoma
Which skin cancer can present as a slow-growing, pearly nodule with superficial telangiectasia, or as a non-healing ulcer, or a scaling plaque?
Basal cell carcinoma
Where is superficial spreading melanoma most commonly found?
Trunk and limbs
What is Bowen’s disease?
Squamous cell carcinoma in situ - full thickness dysplasia of epidermal keratinocytes
What is the first line treatment for melanoma?
Excision, also sentinel node biopsy if tumour >1mm or there is lymph node metastases
Name the four types of melanoma
Superficial spreading, acral/mucosal lentiginous, lentigo maligna, nodular
How does BRAF act as a proto-oncogene?
If mutated, BRAF drives cell proliferation by up-regulating MEK and ERK
Which skin cancer arises from basal keratinocytes?
Basal cell carcinoma
Which HPV type is most commonly associated with dysplasia and squamous cell carcinoma?
Type 16
Name a genetic therapy for melanomas caused by BRAF mutations
Vemurafenib
Which is the most common type of skin cancer?
Basal cell carcinoma
Which type of BCC is shown in the picture?
Pigmented BCC
What is a ‘rodent ulcer’?
Basal cell carcinoma with central ulceration
Which form of melanoma does not have a radical growth phase?
Nodular melanoma
Why are melanomas more likely to metastasize than keratinocyte skin cancers?
Melanocytes are motile cells that move around
How is superficial BCC managed?
Topical therapies - cryotherapy, 5-flurouracil, imiquimod, PDT
How is BCC usually managed?
Excision
What is the first line treatment for SCC?
Usually excision, some may be treated topically (not invasive, smaller)
Which type of skin cancer can present as superficial, nodular or infiltrative?
Basal cell carcinoma
Where is nodular melanoma most commonly found?
Trunk, sites are varied
Why is ulceration of a melanoma a strong adverse indicator?
Higher risk of metastasis
