Malignant Tumors of the Skin

Question 1

In reagards to UV light exposure and CA risk, SCC incidence correlates best with _____, while BCC occurrence corresponds better with _____.

Answer 1

total, lifetime ultraviolet radiation exposure; intermittent sunlight exposure and severe sunburns

Question 2

How many skin cancers are diagnosed annually?

Answer 2

3.5 million CAs in 2 million people

Question 2

What is Ipilimumab?

Answer 2

a human monoclonal Ab that blocks CTLA-4; melanoma tx

Question 3

_____ is the earliest form of squamous cell skin cancer.

Answer 3

Squamous cell carcinoma in situ (Bowen’s disease)

Question 3

Name 10 risk factors for getting skin CA.

Answer 3

1. UVR 2. fair sin 3. being a male 4. chemicals (arsenic, industrial agents) 5. radiation 6. having had a skin CA already 7. phototherapy 8. skin diseases 9. immunosuppression 10. HPV 11. smoking (SCC)

Question 4

Name a drug for BCC that targets smoothened.

Answer 4

Vismodegib

Question 5

What is the major risk factor for Squamous cell carcinoma in situ (Bowen’s disease)?

Answer 5

sun exposure

Question 6

Ultraviolet radiation, ionizing radiation, arsenic, or polycyclic hydrocarbons can all cause _____.

Answer 6

AKs

Question 6

_____ accounts for about 3% of skin cancer cases but causes a large majority of skin cancer deaths.

Answer 6

Melanoma

Question 7

What is a Marjolin’s ulcer?

Answer 7

an SCC that begins within scars, skin ulcers, or other areas of chronic injury

Question 8

What is Squamous cell carcinoma in situ (Bowen’s disease)?

Answer 8

the earliest form of SCC

Question 8

What is the most common NMSC (non-melanoma skin cancer)?

Answer 8

BCC

Question 8

Another system, called ____, describes how far a melanoma has penetrated into the skin instead of actually measuring it.

Answer 8

the Clark level

Question 8

How does a BRAF mutation occur?

Answer 8

it’s acquired, not inherited

Question 10

In which cell layer does BCC arise?

Answer 10

in the stratum basalis

Question 12

____ is the most common pre-malignant skin lesion.

Answer 12

Actinic Keratosis

Question 12

Name an oral BRAF inhibitor- tx for melanoma.

Answer 12

Vemurafenib

Question 13

Is an SCC or BCC more likely to invade the adipose and spread to the lymph nodes?

Answer 13

SCC, but this is still rare

Question 13

Another system, called the Clark level, describes _____ instead of actually measuring it.

Answer 13

how far a melanoma has penetrated into the skin

Question 14

Bowen disease looks like _____.

Answer 14

scaly, reddish patches that may be crusted

Question 14

What drug is a human monoclonal Ab that blocks CTLA-4; a melanoma tx?

Answer 14

Ipilimumab

Question 15

SCCs occur much more commonly in ____, especially _____.

Answer 15

immunosuppressed patients; organ transplant patients

Question 16

Where does SCC arise in the skin? On the body?

Answer 16

in the superficial epidermis; sun exposed areas

Question 17

What does SCC stand for?

Answer 17

squamous cell carcinoma

Question 19

What is the name for an SCC that begins within scars, skin ulcers, or other areas of chronic injury?

Answer 19

a Marjolin’s ulcer

Question 21

What is the most common form of BCC?

Answer 21

nodular (75% of total)

Question 23

Name 3 general tx for AKs.

Answer 23

1. cryotherapy 2. photodynamic therapy 3. topicals (5-fluorouracil, Imiquimod, Diclofenac, Ingenol mebutate)

Question 25

Within 5 years of being diagnosed with basal cell cancer, ____ of people develop a new skin cancer.

Answer 25

35% to 50%

Question 26

What is the endothelial malignancy triggered by HHV-8?

Answer 26

Kaposi's sarcoma

Question 27

What is Vemurafenib?

Answer 27

an oral BRAF inhibitor- tx for melanoma

Question 28

The most important indicator of prognosis for all subtypes of melanoma is the \_\_\_\_, which is the maximal thickness of tumor invasion.

Answer 28

Breslow depth

Question 30

After treatment, basal cell carcinoma can recur in \_\_\_\_.

Answer 30

the same place on the skin

Question 31

Where do BCCs often occur?

Answer 31

on the head and neck (sun exposed areas)

Question 32

A mutation in the ____ is found in many melanomas.

Answer 32

BRAF gene

Question 33

\_\_\_\_\_ may appear as growing lumps, often with a rough surface, or as flat, reddish patches that grow slowly.

Answer 33

Squamous cell carcinoma

Question 34

Actinic Keratosis eventually develops into \_\_\_\_.

Answer 34

SCC

Question 35

What does AK stand for?

Answer 35

Actinic Keratosis

Question 36

\_\_\_\_ occur much more commonly in immunosuppressed pts, especially organ transplant patients.

Answer 36

SCCs

Question 37

Squamous cell carcinoma may appear as _____ that grow slowly.

Answer 37

growing lumps, often with a rough surface, or as flat, reddish patches

Question 38

Why does BCC occur?

Answer 38

mutations in the hedgehog pathway (patched, smoothened, or hedgehog)

Question 39

\_\_\_\_\_ often appear as flat, firm, pale areas or as small, raised, pink or red, translucent, shiny, waxy areas that may bleed after minor injury.

Answer 39

Basal cell carcinomas (BCC)

Question 39

What is a Keratoacanthoma?

Answer 39

a solitary lesion of sun exposed skin type of SCC cup-shaped invagination of the epidermis with keratin-filled central crater

Question 41

The most important indicator of prognosis for all subtypes of melanoma is the Breslow depth, which is \_\_\_\_\_.

Answer 41

the maximal thickness of tumor invasion

Question 43

Actinic keratoses are distributed in areas of _____ and are characterized by _____ which are often easier to palpate than to visualize.

Answer 43

increased sun exposure; hyperkeratosis and erythematous papules

Question 44

What causes Actinic Keratosis (AK)?

Answer 44

ultraviolet radiation, ionizing radiation, arsenic, or polycyclic hydrocarbons

Question 46

About 3 out of 4 skin cancers are \_\_\_\_\_.

Answer 46

BCCs

Question 47

Melanoma accounts for about ____ of skin cancer cases but causes a large majority of skin cancer deaths

Answer 47

3%

Question 48

SCC in situ appears as _____ which is sharply demarcated from the surrounding skin.

Answer 48

an erythematous, hyperkeratotic patch or plaque

Question 49

\_\_\_\_\_ looks like scaly, reddish patches that may be crusted.

Answer 49

Bowen disease

Question 50

What is: a solitary lesion of sun exposed skin type of SCC cup-shaped invagination of the epidermis with keratin-filled central crater

Answer 50

a Keratoacanthoma