MS II week 8

Question 1

what is the second most cause of skin cancer

Answer 1

squamous cell carcinoma

20% of non melanoma skin cancers

Question 2

where do SCCs occur

Answer 2

sun exposed areas of the skin with low mets in light skinned people
dark skinned: non sun exposed
CUTANEOUS SURFACE
MOSTLY HEAD AND NECK

Question 3

where do dark skinned people get SCC

Answer 3

legs
anus
chronic inflammation areas

Question 4

what type of sun exposure increases risk to SCC

Answer 4

cumulative UVB exposure 5-10

Question 5

what type of sun exposure increases BCC melanoma

Answer 5

intense intermittent sun exposure

Question 6

UVB radiation

Answer 6

more burning

Question 7

interval between inital skin damage and appearance of tumor

Answer 7

• scc as early as six week and as many as 60 years

Question 8

what toxin exposure is associated wit hSCC

Answer 8

arsenic exposure

Question 9

what blood type has more scc risk

Answer 9

type O

Question 10

types of SCC

Answer 10

• SCC in situ
• erythroplasia of Queyrat
• invasive
• well diff

Question 11

Scc in situe

Answer 11

well demarkated, scaly patch or plaque

slow growing

Question 12

Invasive SCC

Answer 12

painful or itchy.

Question 13

well differentiated

Answer 13

.5-1.5 may or may not ulcerate

indurated or firm hyperkeratotic papulse or nodule

Question 14

what is a poor prognostic sign for scc

Answer 14

perineural invasion

Question 15

Oral SCC presentation

Answer 15

ulcer
nodule 
indurated plague.  
erythroplakia
leukoplakia

Question 16

keratoacanthoma

Answer 16

resemble SCC,

rapid initial growth, dome shaped with crater with keratotic core

Question 17

verrucus carcinoma

Answer 17

subtype of scc: well defined exphytic cauliflower

Question 18

scc of lip

Answer 18

nodules, ulcers white plaque

Vermillion border!!!

Question 19

sites of mets for scc

Answer 19

reginal lymph
lungs
liver, brain skin bone
skin

Question 20

what to assess with SCC

Answer 20

for perineural invasion
tumor depth
tumor differentiation.
punch biopsy

Question 21

what spreads easier, SCC or BCC

Answer 21

Scc: 5-10%
mets: .003

Question 22

what makes SCC lower risk

Answer 22

small
not into subcutaneous
from actinic keratosis
no high risk features

Question 23

what is the most common fatal form skin cancer

Answer 23

malignant melanoma.
5th most common in men
7th in women

Question 24

how thick with melanoma incrase lilky to die from mates

Answer 24

> 2.0mm

Question 25

Atypical nevi:

Answer 25

those with atypicahave increased risk of malignant melanoma.

Question 26

what sun exposure mss

Answer 26

intermittent exposure and sunburn in childhood.

tanning beds

Question 27

growth phases for malignant melanoma

Answer 27

• radial: horizontal phase

- Vertical: mets potential

Question 28

what type of melanoma have no radial horizontal phase.

Answer 28

Nodular: type only vertical

Question 29

what are the 4 major subtypes of melanoma?

Answer 29

in situ
- superficial spreading: 70% slow, 
- acral lentiginous
- lentigo maligna
Invasive
- nodular : 37%

Question 30

where does superficial spreading melanoma occur

Answer 30

men: trunk
women: legs
upper back: both

Question 31

nodular melanoma locations

Answer 31

trunk legs, arms and scalk

elderly

Question 32

Lentigo malingna

Answer 32

mostly elderly in chronicly exposed skin. look like ae spots.

Question 33

acral lentiginous melanoma

Answer 33

palmar
plantar
subungal

Question 34

what melanoma is most common amoung asians and african americans

Answer 34

acrral lentiginous

Question 35

prognostic factors for melanoma

Answer 35

• tumor thickness*** most importaint
  mitotic rate
• ulceration

Question 36

how to biopsy

Answer 36

punch,
never shave, cant measure depth
wide local excision: 
narrow margin excision
mohs : if comes back positive