Non-melanoma skin cancers and benign skin tumours Flashcards
What are solar keratoses also known as?
Actinic keratosis
What are the features of a solar keratotic lesion?
Dysplasia
Keratosis
How common are solar keratoses?
Very common,
1 in 5 over 60yrs
What is the risk with solar keratoses?
May progress to SCC. less than 1 in 1000
What does a squamous cell carcinoma in situ not cross into?
The dermis
What does non-melanoma skin cancer (NMSC) refer to?
SCC
BCC
and some other less common skin cancers
Where is the basal layer?
The layer of epidermis adjacent to the border with the dermis
What % of NMSCs are basal cell carcinomas?
80%
What are the subtypes of BCC’s?
Nodular
Superficial
Morpheic/sclerosing
Pigmented
What is a morphoeic BCC also known as?
sclerosing BCC
Which is more common: melanoma or NMSC?
NMSC
What is the metastatic potential of BCC’s?
Low, but locally invade
How fast do BCC’s grow?
Fairly slowly (takes months to years before diagnosed usually)
What are the symptoms associated with BCC’s?
They are usually asymptomatic
Which parts of the body are BCC’s able to occur on?
Any part (more common on face or trunk)
What are the classical signs of a BCC?
Pearly white rolled edges
Telangectasia
Sunken or ulcerated
What is a common site for BCCs and SCCs to arise?
Sites of chronic inflammation,
wounds,
scars
Which subtype of BCC has the greatest risk of recurrence?
Morphoeic BCC
What % of non-melanoma skin cancers are squamous cell carcinomas?
20%
Do squamous cell carcinomas metastasize?
Yes, to regional lymph nodes first
What is the 5-year survival survival for SCCs?
No mets - 85%
w/mets - 25%
Which lesions clinically mimic SCC’s?
keratoacanthoma’s
Which genetic syndrome can predispose you to BCCs?
Gorlin’s syndrome
What type of viral infection can predispose to SCCs?
Human papillomavirus (HPV)
What margin should be used for BCC surgical excision?
≥4mm and as deep as subcutaneous fat
What is Mohs’ micrographic surgery?
When during surgery slices of tissues are examined histologically to guide further surgery
What are the treatment options for BCC’s?
Simple surgical excision
Mohs’ micrographic surgery
Radiotherapy
Imiquimod
Photodynamic therapy
What is imiquimod?
topical immune-response modulator used in the treatment of low risk BCCs
What is Efudix?
5-fluorouracil cream
What is diclofenac gel?
diclofenac is an NSAID
diclofenac gel is used in actinic keratoses treatment
What are the precursors to SCC?
Actinic keratosis
Intraepidermal carcinoma (aka SCC in-situ)
What layer of cells do SCCs, actinic keratosis and intra-epidermal carcinoma all originate from?
Prickle cell layer
What clinical technique is there to aid diagnosis of BCCs?
Gentle stretch the skin and the pearly white rolled edges will be more obvious
Are mucosal or cutaneous SCC’s more likely to metastasise?
Mucosal SCCs
What are the treatment options for SCC’s?
Simple surgical excision
Mohs’ micrographic surgery
Radiotherapy
What is the treatment for actinic/solar keratosis?
Cryotherapy
Curettage and cautery
5-fluorouracil cream (Efudix)
Diclofenac gel (Solaraze)
Imiquimod
Photodynamic therapy
What is Bowen’s disease also known as?
SCC in-situ, intraepidermal carcinoma
What is the treatment of SCC in-situ?
Same as for actinic/solar keratosis:
Cryotherapy
Curettage and cautery
5-fluorouracil cream (Efudix)
Diclofenac gel (Solaraze)
Imiquimod
Photodynamic therapy
What is a cutaneous horn made of?
Compacted keratin
What maybe at the base of a cutaneous horn?
actinic/solar keratosis
SCC in-situ
SCC
What is the management for a cutaneous horn?
Excision
