Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

239B > skin CA > Flashcards

skin CA Flashcards

1
Q

EPidermis layers

A

stratum corneum - dead layer
stratum granulosum - epi
stratum spinosum -epi
stratum basalis- above basement membrane then dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

UV rays spectrum

A

UVC- 100-290- blocked by ozone layer- not earth surface
UVB- 290-315- “ directly damage skin
UVA- 315-400 sun that reaches us! indirectly damages skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

non-melanosma skin ca

A 
BCC (most common ca in whites and rarely mets)
 or SCC (2nd most common ca, more common elderly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

SCC risk factors

A

elderly, caucasians, UV exposure, fair skin, male, >50YO, inflammatory skin conditions, smoking, arsenic , HPV infection, immunosuprresion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

actinic keratosis

A 
pre-cursor lesion of SCC
d/t chronic uv exposure
rough scaly plaques on sun-exposed skin
focal keratinocyte atypia and disorganization in epidermis and upper epi intact, <1% progress to SCC
tx- cryotherapy or topical chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

bowens disease

A

pre-cursor lesion of SCC
d/t chronic sun exposure or viral infection (HPV 16 or 18)
red or brown plaque wiht crusted scale
25% lead to SCC into dermis, full thickness epidermal atypia and disorganization no dermal invasion
tx chemo cryo or sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SCC tx

A

surgical excision **GOLD STD
Mohs micrographic sx
radiation (except verrucous carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Keratoacanthoma

A

variant of SCC- nodules with crater like center with keratin plug on sun exposed area, tx with sx, grows quickly, resomebles SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

verrucous carcinoma

A

SCC variant- resembles giant wart, caused by HPV 16 and18 tx with surgery NOT radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

marjolins ucler

A

SCC variant- develop from chronic ulcer or would or trauma, aggressive to mets (35%), tx with sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mucosal SCC

A

SCC variant- smokers, aggressive than traditional SCC, mets 20-70%, tx sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BCC risk factors

A 
high dose UVB exposure (sunburn)
 ionizing radiation  (xray)
carcinogenic chemicals ( arsenic)
genetic syndromes (BC nevus syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BCC differential dx

A

actinic keratosis, bcc, scc, mmm, dysplastic nevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BCC s&s

A

sun exposed areas, pearly nodular iwth telangiectasis, central ucler possible with occ bld, as new? bleed? scab? heal? previous skin ca? risk facotrs? painful?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SCC s&s

A

plaques, papules, nodules
red, scaly or ulcerated
full thickenss epidermal atypia wiht invasion into dermis
mets 2-6%
as new? hurt? growing? heal? risk facotrs? hx? painful?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SCC differential dx

A 
actinic keratosis
BCC
SCC
MM
dysplastic nevi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

BCC tx

A 
curettage and electrodesiccation (for superficial BCC <1cm, non-hair bearing skin cure 95% *
cryo- liq nitrogen, cure 90%, *
topcial chemo
radiation therpay
surgical exicison ** GOLD standard
mohs micrographic surgery
vismodegib
*leave hypopigmented and hypertrophic scars
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BCC referral

A

suspicious lesions refer to derm, definitive dx use biopsy either shave, punch or excisional
if not tx- will get worse on ear/muscle/neck not mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

curettage and electrodesiccation

A 
superficial BCC, <1 cm
non-hair bearing skin trunk/arms
cure 95%
leave hypopigmentation and scars
not morepheaform or infiltrated BCC
recurrence due to skill of person
20
Q

cryosurgery

A

liquid nitrogen, target tissue, cure 90%, lead to hypopigmentation and scars, recurrence due to skill of person

21
Q

topical chemotherpay

A

topical 5-flurouracil BID for 3-12 weekds
superficial BCC
cure 75-93%
SE pain, redness, scaring, crusty

22
Q

radiation therapy

A

poor surgical canidates (elderly, poor helalth, lg lesions)
daily tx for 6 weeks
80-93% cure rate
SE: rash, dry skin

23
Q

surgical exicsion

A

GOLD standard for BCC
decrease recurrences, margins of gd skin takne
95% cure
SE: bld, infeciton, nerve damage, scarring

24
Q

mohs micrographic sxq

A 
tx for BCC aggressive or on face/scalp/neck
tissue sparing margin control
cure 95%
time consuming
cut horizontal edges
25
Q

vismodegib

A

app. jan 2012

local or advance or mets BCC

26
Q

melanoma risk factors

A 
intermittent high UV exposure
>50 melanocytic nevi
FH or dyplastic nevi
nevus>20cm
lighter skin
immuno-suppressant
lg congenital nevus
27
Q

melanoma differential dx

A 
actinic keratosis
BCC
SCC
MM
dysplastic nevi
28
Q

melanoma s&s

A

A-asymmetry
B- border irregular
C-color- variable from brown to black
DM- >6mm
E- elevation or evolution- raised, changing, evolving pigmented lesions
non-healing skin area >3 weeks, ulceration, bleed, weep, abnormal lesions of hands, nails, feet

29
Q

melanoma types

A 
melanoma in situ
lentigo melanoma
superficial spreading
nodular melanoma
acral lentiginous melanoma
subungual melanoma
30
Q

melanoma in situ

A

Irregularly pigmented macule or patch (often fulfills ABCDE)
Sun-exposed skin in elderly pts
Progresses to Lentigo Maligna-more invasive

31
Q

lentigo maligna

A

atrophic epidermis
loss of rete ridges
increases numbers of atypical basilar melanocytes
melanocytes vary in size, shape, hyperchromic nuclei
Solar elastotic changed in the dermis
No atypical melanocytes in dermis

32
Q

lentigo maligna melanoma

A

15% of melanomas
elderly pts
Sun damaged skin
Identical to lentigo maligna, but possesses a vertical growth (deeper, but not as wide)

33
Q

superficial spreading melanoma

A

Most common type (70%)
Frequently found on the back in men, on legs in women
May arise from a nevi
Fulfills ABCDE’s

34
Q

Nodular melanoma

A 
2nd most common type of melanoma (15-30%)
Rapidly developing nodule
Can be ulcerated and bleed
Mostly in the vertical growth phase
Can rarely be amelanotic (nonpigmented)
Sometimes neg ABCD, but possible E
35
Q

acral lentiginous melanoma

A 
Rarest type (5-10%), but most commonly seen in darkly pigmented pts (70%)
Occurs on palms and soles
36
Q

subungual melanoma

A

Variant of acral lentiginous melanoma
Can present as hyperpigmented streak on the nail plate (longitudinal melanonychia)
Hutchinson’s sign: pigmentation of the proximal nail fold

37
Q

seborrheic keratosis

A

not mole - benign growth

38
Q

dx of melanoma by..

A

biopsy (excisional (to get depth) 1st then shave or punch)

immunohistochemical stains can highlight melanocytes in difficult cases

39
Q

Breslow depth

A 
most important! depth in mm from top of granular layer
clarks levels:
1- within epidermis
2- into pap dermis
3- filing pap dermis
4 into reticular dermis
5 into SQ fat
40
Q

factors affecting prognosis in melanoma

A 
thickness- breslow depth - see clark levels
ulceration?
lymph nodes mets (5 yr survival 66%)
extra-nodal mets (5 yr survival 10%)
br
41
Q

clarks levels in melanoma prognosis

A 
I- within epidermis
II- into pap dermis 
III- filing papillary dermis 
IV- into reticular dermis
V- into SQ fat
42
Q

tx melanoma

A

1) surgical excision with app margins
2) sentinel lymph node biopsy.. only on tumors>1mm
3) elective lymph node dissection
4) adjutant or palliative chemotherapy

43
Q

surgical excision with appropriate margins

A

4mm thickness 2-3cm margins

44
Q

Primary skin ca prevention

A

Decrease sun exposure
Minimize exposure during peak UV hrs (10a-4p)
Wide brimmed hat,clothing etc. >15 min exposure req protection
min30 SPF, broad spectrum (including UVA coverage and zinc), reapply every 2 hours or after swimming
Start early in childhood
Educated pts to seek med attn for nonhealing sores (>4-6weeks) or changes to lesions/nevi.

45
Q

Secondary skin CA prevention

A

Early detection
Frequent skin ca screening in high risk pts
Biopsy of suspicious lesions-when in doubt, cut it out!!! or refer to derm:)

46
Q

breslow staging in melanoma prognosis

A

stage 1 thin 1mm
stage 3 involvement of lymph nodes
stage 4 involvement of internal organs

239B (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions