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2MB Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

What are the 2 main groups of skin cancers?

A

Melanoma

Non-melanoma

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2
Q

What are the 2 main non-melanoma skin cancers?

A

Basal cell carcinoma

Squamous cell carcinoma

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3
Q

Non-melanoma skin cancers arise from which skin cells?

A

Keratinocytes

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4
Q

Melanoma skin cancers arise from keratinocytes. True/False?

A

False

Arise from melanocytes

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5
Q

Melanoma is the fastest increasing cancer in Scotland. True/False?

A

True

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6
Q

Squamous cell carcinoma is more common than basal cell carcinoma. True/False?

A

False

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7
Q

Melanoma is the most common cancer in 15-24 yr olds. True/False?

A

True

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8
Q

Melanoma is 2x more common in which sex?

A

Females

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9
Q

What determines prognosis in melanoma?

A

Depth of the melanoma

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10
Q

What is the % survival for melanoma lesions less than 1mm over 5 years?

A

95-100%

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11
Q

Thinner melanomas have better prognosis than thicker ones. True/False?

A

True

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12
Q

What is the ABCDE approach to diagnosing melanoma?

A 
Asymmetry
Borders
Colour
Diameter
Evolution
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13
Q

If a mole is fast-growing and very dark black, it is not worrying. True/False?

A

False

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14
Q

Basal cell carcinomas are fast-growing. True/False?

A

False

Slow-growing due to poor blood supply

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15
Q

Are basal cell carcinomas usually painful?

A

No

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16
Q

Describe the appearance of basal cell carcinoma

A

Pearly/translucent lumps
Visible blood vessels
Central ulceration
ill defined

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17
Q

What is the most common cause of squamous cell carcinoma?

A

Sun-damaged skin

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18
Q

Squamous cell carcinoma is fast-growing. True/False?

A

True

Relatively fast compared to BCC

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19
Q

Both basal and squamous cell carcinomas are likely to metastasise. True/False?

A

False

Basal cell carcinoma is localised

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20
Q

Describe the appearance of squamous cell carcinoma

A

Hyperkeratotic lump/ulcer
May be painful/bleed
Red scaling plaques with sharp cut borders

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21
Q

Name 2 precursor lesions that can lead to squamous cell carcinoma

A

Bowen’s disease

Actinic keratosis

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22
Q

How do actinic keratoses arise?

A

Sun damage
High risk of developing squamous cell carcinoma

Scaly round brownish, erythematous macule
Common on scalp, face, hands

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23
Q

Describe Bowen’s disease

A

Erythematous, scaly plaque - very early form of squamous cell that has not yet broken through and invaded the dermis
Carcinoma that is easily treated
common on legs

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24
Q

List risk factors for skin cancer

A

Sun exposure
Genetics
Immunosuppression
Environmental carcinogens

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25
Q

Describe skin type I

A

Always burns, never tans

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26
Q

Describe skin type II

A

Usually burns, can tan

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27
Q

Describe skin type III

A

Usually tans, can burn

28
Q

Describe skin type IV

A

Always tans, never burns

29
Q

Describe skin type V

A

Brown skin

30
Q

Describe skin type VI

A

Black skin

31
Q

List 3 genetic diseases that increase risk of skin cancer

A

Xeroderma pigmentosum
Albinism
Gorlin’s syndrome

32
Q

What is xeroderma pigmentosum?

A

Photosensitivity disease where skin cancer can occur on UV-exposed sites
Defect in NER genes

33
Q

What is Gorlin’s syndrome?

A

Autosomal dominant disease featuring multiple basal cell carcinomas

34
Q

Which UV radiation is the most lethal - UVA, UVB or UVC?

A

UVC

Then UVB then UVA

35
Q

What blocks out UVC radiation so that we are never exposed to it?

A

Ozone layer

36
Q

What protects us from UVB radiation?

A

Window glass

Some sunscreen

37
Q

What is the effect of UV radiation upon DNA?

A

Damages DNA and causes mutations

38
Q

What is the signature DNA mutation of UV radiation?

A

Pyrimidine dimer mutation

39
Q

Skin type I individuals have which type of melanin instead of eumelanin which doesn’t absorb UVR effectively?

A

Pheomelanin

40
Q

MC1R protein determines balance of pigment in skin and hair. What would 1 or 2 mutations in the MC1R gene cause respectively?

A

1 mutation causes freckling

2 mutations causes freckling and red hair

41
Q

What is the scientific name for freckles?

42
Q

What do freckles represent?

A

Patchy increase in melanin pigmentation, usually due to UV exposure

43
Q

What are actinic lentigines?

A

“Age/liver spots” caused by UV exposure

wrists, backs of the hands, forearms, and face

44
Q

What is a melanocytic naevus?

A

Birthmark/mole on the skin

45
Q

Naevi can develop into melanoma.. True/False?

46
Q

How do acquired naevi develop?

A

At infancy, melanocyte:keratinocyte ratio breaks down, allowing formation of simple benign naevi

47
Q

Where are melanocytes in a junctional naevus?

A

At the DEJ

48
Q

Where are melanocytes in a compound naevus?

A

DEJ + dermis

49
Q

Where are melanocytes in a intradermal naevus?

50
Q

What size are dysplastic naevi?

A

Generally greater than 6mm

51
Q

List the 4 main types of melanoma

A

Superficial spreading
Acral/mucosal lentiginous
Lentigo maligna
Nodular

52
Q

How do superficial spreading, acral/mucosal lentiginous and lentigo maligna melanoma differ from nodular melanoma, in terms of growth?

A

SSM, A/MLM and LMM grow as flat lesions in epidermis before vertically invading; NM vertically grows from the outset

53
Q

What is the most common subtype of melanoma? Where is it found?

A

Superficial spreading

Trunk or legs

54
Q

Describe seborrhoeic keratosis

A

Greasy, stuck-on appearance common on face and trunk

Hyperkeratotic

55
Q

What is the management for BCC?

A

Surgical excision

Topical treatments if no risk of metastasis

56
Q

When are BCC common?

A

Common on sun exposed skin of 40+ years

57
Q

What is seborrheic keratosis?

A

Benign proliferation of epidermal keratinocytes
Presents: pigmented, well defined, brown growth with granular surface
Stuck on appearance

Can be excised but not needed and discouraged

58
Q

What does actinic keratosis look like?

A

Scalp round brownish

Common on scalp, face

59
Q

What is a blue naevus?

A

A naevus with a blue colour when deeper and black when more superficial

60
Q

Describe superficial spreading melanoma?

A

Irregular shaped and coloured flat

Slow growing

61
Q

What is a nodular melanoma?

A

Grows vertically- leads to metastasis

Rapidly growing pigmented nodule

62
Q

Describe lentigo maligna melanoma?

A

Small dark flat spot which becomes lumpy
Slow growing
Common in elderly with sun damage

63
Q

Describe acral lentiginous melanoma?

A

Palms soles and under nails

Most common in dark skinned patients

64
Q

What are the investigation for melanomas?

A

Biopsy- breslow thickness (>4mm)
Is there metastasis
Is there ulceration

65
Q

What is the management?

A

Excision with wide margins

66
Q

What is breslows thickness?

A

Prognostic factor in melanoma of the skin. It is a description of how deeply tumour cells have invaded

67
Q

What does Breslow thickness refer to?

A

The depth from the granular layer of the epidermis to the deepest melanoma cell

2MB Dermatology (13 decks)

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