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Derm > Non-Melanoma Skin Cancers and Benign Skin Tumours > Flashcards

Non-Melanoma Skin Cancers and Benign Skin Tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

How common is non-melonoma skin cancer?

A

the commonest cancer in UK

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2
Q

What are examples of non-melanoma skin cancer?

A

basal cell carcinoma (BCC)

squamous cell carcinoma (SCC)

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3
Q

What are the precursors of SCC?

A

Actinic keratosis Intraepidermal carcinoma

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4
Q

What are the risk factors for developing non-melanoma skin cancer?

A

Long term UV light exposure
Fair skin type
Increasing age
Immunosuppression
Genetic - goblins syndrome (BCCs), xeroderma pigmentosum
Sites of chronic inflammation, wounds, scars
Human papillomavirus (SCC)

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5
Q

How common is BCC?

A

80% of all non melanoma skin cancers

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6
Q

How does BCC present?

A

slow growing, locally invasive usually asymptomatic most common location is head and neck but may also be present on non sun-exposed areas

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7
Q

How serious is a BCC?

A

very low metastatic potential but locally invasive

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8
Q

What are the BCC subtypes?

A

Nodular Superficial Morpheic/Sclerosing Pigmented

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9
Q

What are the signs seen that suggest a BCC?

A 
well defined
erythematous
papulonodules or plaques
ulcerating crust
telangectasia 
pearly white rolled edge
may bleed, become fibrotic and scar
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10
Q

What are the factors that lead to increased risk of recurrence in basal cell carcinoma?

A

Increasing tumour size Tumour site - lesions on central face are at higher risk of recurrence
Poorly defined clinical margins
Histological subtype
Histological features of aggression (perineurial and perivascular invasion)
Previous treatment failure - recurrent lesions are at higher risk of further recurrence

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11
Q

What are the treatment options for BCC?

A

Simple excision
Mohs’ micrographic surgery
Surgical, histological margins not examined (destructive methods) - curettage and cautery, cryotherapy

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12
Q

What are the non-surgical treatment options for BCC?

A

Radiotherapy
Imiquimod (Aldara)
Photodynamic therapy

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13
Q

How common are SCC?

A

20% of all skin cancer

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14
Q

Do SCC metastise?

A

can metastasise

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15
Q

What are the survival rates of SCC?

A

overall 5 year survival - 75-90% for metastatic disease - 25%

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16
Q

What are the factors that increase metastatic potential in SCC?

A

Site - ear, lip
Size >2cm
Depth - thicker>thinner
Aetiology - non sun exposure sites, areas of chronic inflammation
Differentiation - poorly>moderately>well differentiated Immunosuppression
Mucosal SCC > cutaneousSCC
Perineural invasion

17
Q

How can SCC appear?

A

skin coloured nodule with central keratin

fleshy nodule with eroded surfacenon healing ulcer

18
Q

What are the treatment options for SCC?

A

Simple excision
Mohs’ micrographic surgery
Radiotherapy

19
Q

What is actinic keratosis?

A

also known as solar keratosis very common dysplastic lesions with small risk of progression to SCC

20
Q

What is the treatment for actinic keratosis?

A 
cryotherapy 
5-fluorouracil cream (efudix) 
curettage and cautery 
photodynamic therapy 
diclofenac gel (solareze) 
imiquimod
21
Q

What is an intraepidermal carcinoma (IEC)?

A

bowen’s disease
intraepithelial carcinoma
squamous cell carcinoma in-situ
full thickness epidermal dysplasia

22
Q

What are the treatment options for IEC?

A 
5-fluoouracil cream (efudix) 
cryotherapy curettage and cautery 
excision 
photodynamic therapy 
imiquimod
23
Q

What is a cutaneous horn?

A

compacted keratin may have AK/IEC/SCC at the base can be benign

24
Q

How should a cutaneous horn be treated?

A

excise lesion - histology

25
Q

What are the other types of NMSC?

A

merkel cell carcinoma
Microcystic adnexal carcinoma
Lymphoma

26
Q

What are the management considerations for all NMSC?

A

should be managed by MDT

Sun protection advice should be given to anybody with skin cancer/pre-malignant lesions

27
Q

Who is involved in the skin cancer MDT?

A

Dermatologist, plastic surgeon, histopathologist, radiotherapist, specialist nurse

28
Q

How do superficial BCC present?

A

erythematous patch or plaque commonly on trunk may be slightly ulcerated

29
Q

What are the differential diagnosis for BCC?

A 
nummular eczema
psoriasis 
bowens disease 
tine corpora 
mycosis fungoides
30
Q

How does nodular BCC present?

A

round, spherical, oval, dome shaped papule or nodule with pearly translucent appearance soft to firm consistency

31
Q

What are the differentials for nodular BCC?

A

intradermal naevus

sebaceous hyperplasia

Derm (10 decks)

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