Skin

Question 1

BCC low risk features?

Answer 1

< 2 cm on trunk and extremities
Primary
Superficial/nodular
No PNI
Well defined

Question 2

BCC high risk features?

Answer 2

Recurrent
Immunosuppression
Infiltrative, PNI
Poorly defined
> 2 cm on trunk and extremities
Any lesion on rest of body, including hands and feet
Prior RT

Question 3

BCC treatment options

Answer 3

Curettage (low risk, non hair bearing areas, < 6 mm)
Excision
Radiation
Cryotherapy
Topical treatments

Question 4

BCC systemic therapy?

Answer 4

Hedgehog inhibitors (Vismodegib, Sonidegib)
Nicotinamide prevents 20% in patients with actinic keratosis

Question 5

SCC low risk?

Answer 5

< 2 cm on Trunk and extremities
Primary
Well differentiated, no PNI, LVI
Not invading sub-cu fat

Question 6

SCC high risk?

Answer 6

> 2cm on trunk/ext, any lesions elsewhere
PNI, LVI
Invading subcu
Immunosuppresion
Post RT
Poorly diff

Question 7

SCC low risk treatment?

Answer 7

Excision (4-6 mm margin)
Curretage
Cryo
PDT (high recurrence)

Question 8

SCC high risk treatment?

Answer 8

Excision with SLN and LN dissection
Radiation
PD-1 treatment

Question 9

Merkel cell

Answer 9

Polyoma virus (check antibody titers)
AEIOU
PET in all patients
CK 20 pos, TTF 1 neg
WLE, SNLB, radiation
Adjuvant or neoadj immuno

Question 10

BCC margins?

Answer 10

Low risk 2-4 mm
High risk 4-6 mm

Question 11

SCC very high risk

Answer 11

> 4 cm
6mm thickness
Invasion beyond sub cu fat