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Dermatology > Lecture 8 Skin Cancer > Flashcards

Lecture 8 Skin Cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

Name non melanoma skin cancer

A

BCC and SCC

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2
Q

Risk factors for non-melanoma skin cancer

A
  • UV radiation
  • Photochemotherapy (PUVA)
  • Chemical carcinogens
  • Ionising radiation
  • Human papilloma virus
  • Familial cancer syndromes
  • Immunosuppression
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3
Q

Features of BCC

A
  • Slow growing
  • Locally invasive
  • Rarely metastasise
  • Can be pigmented or morphoeic
  • Pearly rolled edge
  • Telangiectasia
  • Central ulceration
  • Arborising vessels on dermoscopy
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4
Q

Treatment of BCC

A

Excision-gold standard
Curettage
Imiquimod
Mohs surgery

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5
Q

What treatment would you use for locallybadvanced BCC that’s not suitable for surgery or radiotherapy

A

Vismodegib

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6
Q

How does Vismodegib work

A
  • Selectively inhibits abnormal signalling in the Hedgehog pathway (molecular driver in BCC)
  • Can shrinks tumour and heal visible lesions in some
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7
Q

Side effects of Vismodegib

A

– Hair loss, weight loss, altered taste

– Muscle spasms, nausea, fatigue

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8
Q

What is SCC

A
  • Derived from keratinising squamous cells
  • Usually on sun exposed sites
  • Can metastasise and ulcerate
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9
Q

How is SCC treated

A

Excision

Radiotherapy

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10
Q

What is considered a high risk SCC

A 
–	Immunosuppressed
–	>20mm diameter
–	>4mm depth
–	Ear, nose, lip, eyelid
–	Perineural invasion
–	Poorly differentiated
Follow up needed
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11
Q

What is a Keratoacanthoma

A

Variant of squamous cell carcinoma

Erupts from hair follicles in sun damaged skin

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12
Q

How is Keratoacanthoma treatd

A

Surgical excision

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13
Q

Risk factors for melanoma

A

Keratoacanthoma

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14
Q

What is the ABCDE rule

A 
Asymmetry
Border
Colour
Diameter
Evolution
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15
Q

What is the 7 point checklist

A

features
• Change in size
• Change in shape
• Change in colour

Minor features
•	Diameter more than 5 mm
•	Inflammation
•	Oozing or bleeding
•	Mild itch or altered sensation
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16
Q

How can skin lesions be examined

A

Using dermoscope

17
Q

Name subtypes of melanoma

A 
Superficial spreading malignant melanoma
Lntigo maligna melanoma (in situ)
Nodular melanoma
Acral lentiginous melanoma
Ocular melanoma
18
Q

Treatment of melanoma

A 
•	Urgent surgical excision
–	Subtype
–	Breslow thickness
•	Wide local excision
•	Sentinel lymph node biopsy
•	Chemotherapy – almost never
•	Radiotherapy - rarely
•	Immunotherapy – metastasis or adjuvant therapy
19
Q

What are the 2 main groups of cutaneous lymphoma

A
  • Secondary cutaneous disease from systemic/nodal involvement
  • Primary cutaneous disease – abnormal neoplastic proliferation of lymphocytes in the skin
20
Q

Primary cutaneous lymphoma can be divided into what 2 groups

A

Cutaneous T cell lymphoma

Cutaneous B cell lymphoma

21
Q

What is the most common CTCL

A

Mycosis fungoides
– More common in older patients
– More common in men than women

22
Q

What is the stages of development of mycosis fungoides

A

Patch
Plaque
Tumour
Metastatic

23
Q

What is Sezary syndrome

A 
–	CD30+ lymphoproliferative disorders
–	Subcutaneous panniculitis like T cell lymphoma
–	CTCL affecting skin of entire body
o	Skin thickened, scaly and red
o	Itchy++
–	Lymph node involvement
–	Sezary cells in peripheral blood
o	Atypical T cells
24
Q

What are the 3 types of cutaneous B cell lymphoma

A
  • Cutaneous follicle centre lymphoma
  • Cutaneous marginal zone lymphoma
  • Cutaneous diffuse large B Cell lymphoma
25
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
26
Q

What is total skin electron beam therapy

A
  • Type of radiotherapy consisting of very small electrically charged particles
  • Delivers radiation primarily to superficial layers i.e. Epidermis and Dermis
  • Spares deeper tissues and organs
27
Q

What are the stages of extracorporeal photophoresis

A

• Step 1
– Patients blood is drawn and leucocytes collected
• Step 2
– Collected white cells mixed with psoralen which makes the T-Cells sensitive to UVA radiation
• Step 3
– Exposed to UVA radiation, damaging diseased cells
• Step 4
– Treated cells re-infused back to patient

28
Q

What is cutaneous metastases

A
  • Can be secondary to primary skin malignancy such as melanoma or due to primary solid organ malignancy
  • Most commonly breast, colon and lung
29
Q

what is the management of cutaneous metastases

A
  • Treat the underlying malignancy
  • Local excision
  • Localised radiotherapy

Dermatology (11 decks)

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