Skin Flashcards
Where does melanoma usually start, where does it go to
Starts in epidermis (localised for many years)
Goes into dermis (deep invasion, vertical growth phase)
Where does melanoma commonly metastasise to
Brain
Bone
Liver
Lung
Adrenals
What are the risk factors for melanoma
UV radiation exposure
Naturally light skin
Nevi (moles)
Family history
Personal history of melanoma
Immunosuppression
What is superficial spreading melanoma
Most common type
At any age after puberty
On back in men, on legs in women
What is nodular melanoma
On chest, back, head, neck
Raised/domed
Spreads very quickly
What is lentigo maligna melanoma
On sun-damaged skin
On head and neck
Large, flat lesions that begin as freckles
What is acral lentiginous melanoma
On palms, under feet, under nails
What are the investigations for melanoma
Examination
Dermoscopy
Biopsy
Bloods (LDH)
Imaging (staging)
How are dermatological lesions examined
Asymmetry
Border
Colour variation
Diameter >6mm
Evolving
What are the different types of biopsy for dermatological lesions
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)
How are dermatological lesions staged
TNM staging
Breslow staging (based on thickness of lesion)
How is melanoma managed
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
What are the most common types of non-melanoma skin cancer
Basal cell carcinoma
Cutaneous squamous cell carcinoma
What are the risk factors for non-melanoma skin cancer
UV light exposure
Chronic arsenic exposure
Chronic immunosuppression
HPV infection
Moles
Smoking
Genetic conditions (epidermolysis bullosa)
Family history
Give an overview of basal cell carcinoma
Cancer of non-keratinizing cells of basal lamina of epidermis
Subtypes: nodular, superficial, sclerosing