Non-Melanoma Skin Cancers Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

What are the main types of NMSCs?

A

70% - Basal Cell Carcinoma (BCC)

30% - Squamous Cell Carcinoma (SCC)

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2
Q

Compare the growth and spread of BCC/SCC?

A

BCC - slow growing, locally invasive and rarely metastasise

SCC - Fast Growing and frequently metastasise

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3
Q

What are the risk factors for NMSCs?

A
UV radiation
Photochemotherapy (e.g. Guttate Psoriasis)
Chemical Carcinogens
X-ray/thermal radiation
HPV
Familial cancer Syndromes
Immunosuppression

Smoking is also associated with SCCs

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4
Q

How do basal cell carcinomas look?

A

Nodular with a pearly rolled edge
Telangiectasia (visible vessels)
Central ulceration
Branching vessels on dermoscopy

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5
Q

What would an unusual Basal cell carcinoma look like?

A

BCCs can be pigmented
then can also be morpheic (Firm, pallor, white area. A bit scar like), these have mostly grown down and through the skin so much less visible

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6
Q

What are the treatments for BCCs?

A

Gold standard is surgical excision
- Best way is Moh’s Surgery

Curretage

Vismodegib

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7
Q

Explain moh’s surgery?

A

tumour scooped out bit by bit with the pathologist checking between cuts whether you’ve reached the margin yet

so its used when the cancer is morpheic making it harder to determine the margins
And when the tumour is nearing imporant stuff like nerves. vessels or the eye and you want to minimise the excised tissue

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8
Q

When is curettage indicated for BCC?

A

If the patient is too old or frail for surgery

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9
Q

How does Vismodegib work?

A

It inhibits abnormal signalling in the hedgehog pathway, which is the molecular driver for BCCs

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10
Q

When do you use vismodegib, and what can it cause?

A

For BCCs unsuitable for surgery such as advanced or metastatic tumours

It can cause hair loss, weight loss, taste abnormalities, fatigue, nausea and muscle spasms

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11
Q

How do SCCs appear?

A

Fast growing
Tender growths either scaly/crusted or fleshy
They may ulcerate

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12
Q

How do you treat SCCs?

A

Excision +/- radiotherapy

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13
Q

What is a keratoacanthoma?

A

A variant of SCC

erupts from follicles in sun damaged skin and grows rapidly. It may shrink after a few months

Requires Surgical excision

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14
Q

Differentiating BCCs & SCCs?

A

BCCs take a long time to grow
They have a pearly rolled edge, frequent central ulceration and telangiectasia

SCCs take a matter of months to grow
They are scaly/crusted or fleshy and feel tender

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15
Q

Older patients often present with rough scaly patches, particularly on sun-damaged areas e.g. ears or hands. what are they?

A

Actinic Keratoses

They are extremely common pre-malignant lesions that may develop into SCC

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16
Q

How would you manage actinic keratoses?

A

They need to be treated to pre-empt SCC.

Cryotherapy
Curretage
Diclofenoc Gel
Imiquimod

17
Q

A patient comes in with irregular scaly erythematous plaque. This is?

A

Bowen’s Disease

An intraepidermal SCC, example of a pre-malignant lesion

18
Q

How would you treat Bowen’s Disease?

A

Pre-empt SCC

Cryotherapy
Curretage + thermal ablation

Photodynamic therapy

Imiquimod

19
Q

How does photodynamic therapy wokr

A

Apply a photosensitizing agent to the cancer then apply a red light

20
Q

What is imiquimod

A

An immune response modifier that stimulates cytokine release.

It’s used on pre-malignant lesions like Bowen’s Disease & Actinic Keratoses.

Takes up to 6 wks to work and can cause significant inflammation

21
Q

Finally what is a melanoma in situ?

A

A small melanoma confined to the epidermis and so unable to metastasise
Its a pre-malignant lesion and must be excised before it gains the ability to metastasise