OnlineMedEd: Surgery: Subspecialty - "Skin Cancer"

Question 1

List the risk factors for the development of skin cancer.

Answer 1

Patient characteristics:

• Prominent sun exposure (often occupational, as with construction workers, sailors, farmers)
• History of sunburns or easy burning
• Fair-skinned, fair-haired

Location frequently exposed to sun:

• Face
• Arms
• Neck

Question 2

Which of the benign skin cancers invades locally?

Answer 2

Both!

Question 3

Describe the appearance and history of basal cell carcinoma.

Answer 3

• Appearance: pearly, telangiectatic

* History: ulcer that doesn’t heal and bleeds easily

Question 4

How do you treat BCC and SCC?

Answer 4

There are two options:

• Excisional biopsy: arms
• Mohs: face or neck

Radiate SCC for mets.

Question 5

Which of the benign skin cancers can metastasize?

Answer 5

Squamous cell carcinoma

Because of this, also radiate SCC.

Question 6

Describe the physical appearance of squamous cell carcinoma.

Answer 6

• Red papule
• Hyperpigmented
• Well-defined
• Ulcerated

Question 7

If a skin lesion has ______________, you do not need to biopsy it.

Answer 7

hair

Question 8

Go through the ABCDE of worrisome melanoma characteristics.

Answer 8

• Asymmetric
• Borders irregular/indistinct
• Color dark
• Diameter > 5 mm
• Evolution over time

Question 9

Diagnose melanoma with ______________.

Answer 9

punch biopsy for low-suspicion or excisional biopsy for high-suspicion

Question 10

Explain the margin guidelines for melanoma excision.

Answer 10

First, take a punch biopsy to measure the depth of invasion:
• < 0.5 mm: 0.5 cm margin
• 1.0 mm - 2.0 mm: 1 cm margin with sentinel lymph node biopsy if tracer is positive
• 2.0 mm to 4.0 mm: 2 cm margin with SLNB
•> 4.0 mm: metastatic; debulk only for symptom relief