Skin Cancer Flashcards
What is most common skin cancer?
- Basal cell carcinoma (BCC)
- Followed by squamous cell carcinoma (SCC)
- Then Malignant melanoma
What is the most deadly skin cancer?
malignant melanoma
What is the defintion for squamous cell carcinoma?
cancer of keratinocytes in epidermis
What does normal epidermis contain?
squamous cells, basal cells and melanocytes
what are RF for SCC?
- UV light
- FHx
- Lighter skin
- Actinic keratosis (pre-cancerous condition)
What are symptoms of SCC?
- hyperkeratotic
2. ulcerate
What is the invasion like in SCC?
- Local invasion (e.g. into dermis)
2. Can metastasise
What are common sites of metastasises for SCC?
- Lung
- Bone
- Brain
- Liver
What is the defintion of basal cell carcinoma?
cancer of keratinocytes in epidermis (in stratum basale)
What are RF for BCC?
- UV light
- FHx
- Lighter skin
What is the invasion like for BCC?
• Slow growing
• Local invasion
(e.g. into dermis)
• DOESN’T TYPICALLY METASTASISE
What is a lesion like in BCC?
- Nodule
- Pearly edges
- Rolled edges
- Central ulcer
(rodent ulcer) - Central fine
telangiectasia
What are subtypes of BCC?
- Nodular
- Morpheic
- Superficial
- Pigemented
Which is the most common subtype of BCC?
nodular
What is morpheic BCC?
- yellow waxy plaque
2. scar-like
What is superficial BCC?
flat shape
What is pigemented BCC?
- Dense colour
- Specks of colour
- harder to distinguish melanoma
What is the definition of malignant melanoma?
cancer of melanocytes in epidermis
What are RF for malignant melanoma?
- UV light
- FHx
- Lighter skin
What is the invasion like for malignant melanoma?
- Local invasion (e.g. into dermis)
* Can metastasise
Where are common sites of metastases for melaignant melanoma?
- Lung
- Bone
- Brain
- Liver
How is the lesion for malignant melanoma described?
- Asymmetry
- Border
(irregular) - Colour
(pigmented) - Diameter >6mm
- Evolution
(size/shape) - May bleed, itchy, ulcerate, crust over
- Border
What is the referral time for different skin cancers?
- Melanoma - urgent referral (2 weeks)
- SqCC – urgent referral (2 weeks)
- BCC – routine referral (6 weeks)
What are the bedside tests for skin cancer?
- Physical examination
- Basic observation
- Dermatoscope
What bloods are done for skin cancer?
- Calcium (bone mets or PTHrp)
- ALP (bone mets)
- LFTs (liver mets)
What imaging is done for skin cancer?
CT/MRI/PET (for staging)
What is the biopsy like in skin cancer?
- Skin biopsy
- Breslow Thickness
What is breslow thickness?
Breslow thickness for melanoma (measured in mm from surface of skin down to deepest point in tumour) -> used for prognosis and guiding surgical removal management – lower is better
How do you treat in situ SqCC?
cryotherapy
How do you treat invasive SqCC?
- Surgical excision
2. Radiotherapy
How do you treat non-cosmetrically challenging BCC?
Surgical excision
How do you treat cosmetrcally challenging BCC?
Mohs surgery
How do you treat early stage melanoma?
Surgical excision with lymph node biopsy
How do you treat resectable advanced melanoma?
Surgery and systemic therapy (nivolumab)
How do you treat advanced lesions?
Systemic therapy (nivolumab) and treat metastases
