skin

Question 1

how are skin lesions assessed

Answer 1

ABCD

asymmetry
border
colour
diameter

Question 2

what is malignant melanoma

Answer 2

tumour arising from melanocytes

occurs in skin, eyes, oral cavity

5th most common cancer in UK

2nd most common cancer in adults between 25-49

Question 3

risk factors for malignant melanoma

Answer 3

fair skin
sun exposure
sunbeds

Question 4

are malignant melanomas graded

Answer 4

no - all high grade

Question 5

how are melanomas staged

Answer 5

TNM

breslow thickness is the most important prognostic indicator

Question 6

do melanomas respond well to chemo and radio

Answer 6

NO - prevention is key

Question 7

what is acral melanoma

Answer 7

melanoma of palms, soles and under nails

not linked to sun expsoure

Question 8

which is the most common non-melanoma skin cancer

Answer 8

basal cell carcinoma

Question 9

clinical appearance of BCC

Answer 9

pearly appearance
nodule
central ulceration

Question 10

can BCC spread?

Answer 10

yes

aggressive local spread but distant metastasis is rare

Question 11

what is squamous cell carcinoma

Answer 11

the other main type of non-melanoma skin cancer

Question 12

what are the risk factors for squamous cell carcinoma

Answer 12

fair skin
UV exposure
immunosuppresion - post renal transplant
chronic skin ulcers

Question 13

clinical presentation of a SCC

Answer 13

irregular ketatotic tumour
ulcerates and crusts
grows faster than BCC

Question 14

what is actinic keratosis/solar keratosis

Answer 14

common in elderly

brow, dry, scaly lesions on sun exposed sites

Question 15

which non-melanoma is actinic keratosis related to any why

Answer 15

squamous cell carcinoma

actinic keratosis is pre-cancer/dysplasia

it is termed as carcinoma in situ as it is in one location and has the potential to spread

a small number of these cells can develop into SCC

Question 16

what is a pressure ulcer

Answer 16

localised area of skin that has underlying tissue injury caused by unrelieved pressure, friction and shearing forces

Question 17

where do pressure ulcers usually occur

Answer 17

bony prominences - sacrum and heel

Question 18

another name for pressure ulcer

Answer 18

bedsores

decubitus

Question 19

risk factors for pressure sores

Answer 19

malnourishment 
incontinence
reduced mobility
reduced perfusion - atherosclerosis. PVD, hypotension, smoking 
DM

Question 20

how are pressure ulcers assessed

Answer 20

by a grading system (1-4)

grade 1 = non-blanchable erythema of intact skin

grade 2 = partial thickness skin loss - involves epidermis or dermis, presents as abrasion or blister

grade 3 = full thickness skin loss, damage down to subcutaneous tissue (not down to fascia)

grade 4 = full thickness skin loss and tissue necrosis. down to muscle and bone