Skin Flashcards

1
Q

Where does melanoma usually start, where does it go to

A

Starts in epidermis (localised for many years)

Goes into dermis (deep invasion, vertical growth phase)

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2
Q

Where does melanoma commonly metastasise to

A

Brain

Bone

Liver

Lung

Adrenals

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3
Q

What are the risk factors for melanoma

A

UV radiation exposure

Naturally light skin

Nevi (moles)

Family history

Personal history of melanoma

Immunosuppression

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4
Q

What is superficial spreading melanoma

A

Most common type

At any age after puberty

On back in men, on legs in women

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5
Q

What is nodular melanoma

A

On chest, back, head, neck

Raised/domed

Spreads very quickly

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6
Q

What is lentigo maligna melanoma

A

On sun-damaged skin

On head and neck

Large, flat lesions that begin as freckles

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7
Q

What is acral lentiginous melanoma

A

On palms, under feet, under nails

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8
Q

What are the investigations for melanoma

A

Examination

Dermoscopy

Biopsy

Bloods (LDH)

Imaging (staging)

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9
Q

How are dermatological lesions examined

A

Asymmetry

Border

Colour variation

Diameter >6mm

Evolving

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10
Q

What are the different types of biopsy for dermatological lesions

A

Excisional (remove lesion and some surrounding tissue)

Incisional (remove lesion)

Punch (remove cone-shaped section of tissue, contains epidermis and full thickness of dermis)

Shave (removal of protruding lesion)

Sentinel node (for staging)

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11
Q

How are dermatological lesions staged

A

TNM staging

Breslow staging (based on thickness of lesion)

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12
Q

How is melanoma managed

A

Stage 0, 1, 2 - surgery (local excision)

Stage 3, 4 - lesion excision, local lymph node excision, adjuvant immunotherapy and targeted therapy

Unresectable disease - radiotherapy, immunotherapy

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13
Q

What are the most common types of non-melanoma skin cancer

A

Basal cell carcinoma

Cutaneous squamous cell carcinoma

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14
Q

What are the risk factors for non-melanoma skin cancer

A

UV light exposure

Chronic arsenic exposure

Chronic immunosuppression

HPV infection

Moles

Smoking

Genetic conditions (epidermolysis bullosa)

Family history

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15
Q

Give an overview of basal cell carcinoma

A

Cancer of non-keratinizing cells of basal lamina of epidermis

Subtypes: nodular, superficial, sclerosing

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16
Q

Give an overview of cutaneous squamous cell carcinoma

A

Cancer of keratinocytes of epidermis

Usually develop from actinic keratosis

Subtypes: cutaneous squamous cell carcinoma in situ, invasive squamous cell carcinoma

17
Q

How is non-melanoma skin cancer managed

A

Surgical excision

Radiotherapy

Curettage and electrodessication

Cryotherapy

Topical 5-FU