Malignant melanoma Flashcards
what is the aetiology behind malignant melanoma?
Genetic predisposition in CDKN2A
BRAF mutation
what are risk factors for melanoma?
sun exposure
fair skin
tanning beds
what is the most carcinogenic UV ray?
B
why is UV bad?
causes formation of pyrimidine dimers between T and C bases
what are four types of melanoma?
lentigo maligna melanoma
superficial spreading melanoma
nodular melanoma
acral melanoma
how often gets lentigo maligna melanoma?
chronically sun exposed older people
what is the development of superficial spreading melanoma?
a radial growth phase before true invasion
what is the appearance of superficial spreading melanoma?
irregular pigmented asymmetrical patch with an irregular edge
normally black or brown
what are symptoms of superficial spreading melanoma?
A radial growth phase
Itch/discomfort
Contact bleeding
what is the most common type of melanoma?
superficial spreading
what is nodular melanoma?
A brown/black/grey lump that bleeds/ozzes
what is acral melanoma?
A pigmented patch on the sole/palm/nail/nail fold
what is the nail change in acral melanoma called?
hutchinsons nail sign
what is the management of stage 0-2 melanoma?
- WLE with margins of:
stage 0:0.5cm
stage 1: 1cm
stage 2:2cm
stage 0 and can’t have WLE: consider topical imiquimod
what is the management for stage 3 melanoma?
SNB+ lymphadenectomy
if there is unresectable or metastatic melanoma what is the treatment option?
talimogene laherparepvec
what is the most important prognostic indicator in dermatological malignancy?
breslows thickness
what advise can you give to a patient to reduce their risk of future skin cancers?
learn to recognise early signs
regularly examine the skin
arrange annual checks with the GP
sun protection
what is kaposis sarcoma?
a malignant vascular tumour
what are causes of kaposis sarcoma?
HIV/AIDS
human herpes virus 8
what is the appearance of kaposis sarcoma?
red, purple or brown blotches around the skin
typically on the legs
what is the treatment of kaposis sarcoma?
excision and biopsy
HAART in HIV/AIDs
what are indications for chemotherapy or interferon alpha in kaposis sarcoma?
widespread skin involvement with >25 lesions
extensive oral disease
systemic oedema
