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GI cancers > skin cancer > Flashcards

skin cancer Flashcards

1
Q

what gene mutations increase risk of melanoma?

A

CNKN2A

MC1R

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2
Q

risk factors for melanoma?

A

light skin
red hair
DNA repair defects

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3
Q

what phenotypes increase risk?

A

over 100 melanocytic nevi

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4
Q

what, in melanoma, is a natural inhibitor of t cell activation

A

CTLA-4

it removes the costimultory signal

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5
Q

what type of growth is seen in superficial spreading melanoma?

A

first hotizontal then vertical growth

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6
Q

where is superficial spreading melanoma seen?

A

trunk of men

legs of women

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7
Q

where are nodular melanomas found?

A

trunk

head and neck

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8
Q

what type of growth is seen in nodular melanoma?

A

no horizontal just vertical

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9
Q

what does lentigo maligna present as

A

slow growing assymetric brown macula with an irrecular border ad colour variation

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10
Q

where does acral lentiginous melanoma occur?

A

palms and soles

around nails

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11
Q

what is the abcde of melanoma?

A 
assymetry 
border irregularity 
colour variation 
diameterr over 5mm 
evolving
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12
Q

3 differentials of melanoma?

A

bcc
seborrhoeic keratosis
dermatofibroma

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13
Q

what are poor prognistic factors for melanoma?

A 
increased breslow thickness
ulceration 
increased age 
male 
trunk, head, neck
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14
Q

how is melanoma investigated?

A

dermoscopy (not in isolation)

history and cinical exam

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15
Q

management of melanoma?

A

primary excision to subcutaneous fat then biopsy

then wide excision if cancer

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16
Q

when is sentinel lymph node biopsy offered?

A

Pt1B+

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17
Q

when is imaging offered in melanoma?

A

stage 3+

or 2c without sentinel biopsy

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18
Q

what is given for metastatic melanoma?

A

ctla4 inhibition
braf ingibitor
chemo

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19
Q

what is the spectrum of kerotinocyte disorders?

A

actinic keratosis
bowens
invasive scc

20
Q

what is bowens?

A

squamous cell carcinoma in situ

21
Q

what is a significant risk factor of bcc?

A

uv radiation

22
Q

how does bcc spread?

A

proteolytic activity - metalloproteinases and collegenases

23
Q

what mutation is seen in bcc

A

loss of function in ptch gene in chromosome 8q

24
Q

4 genetic syndromes which increase risk of keratinocyte carcinomas?

A

xeroderma pigmentosum (sensitivity to sunlight)
OCULOCUTANEOUS ALBINISM
muir torre syndrome
nevoid basal cell carcinoma

25
Q

what is seen in actinic keratosis?

A

atypical keratinocytes confined to epidermis

26
Q

how is actinic keratoses diagnosed?

A

punch biopsy

27
Q

what is seen in bowens disease?

A

lesion is an erythmatous scaly patch or slighly elevated patch

28
Q

treatments for actinic keratoses and bowens?

A

5 fluorouacil cream
cryotherapy
imiquimod cream
excision

29
Q

what does scc look like?

A

erythmatois - skin colooured
papule
exophytic
eulceration

30
Q

what looks similar clinically and histologically to scc?

A

keratoacanthoma

31
Q

how is scc investigated?

A

clinical dianosis enough
biopsy
uss of regional lymph nodes

32
Q

how is scc treated?

A

excision

radiotherapy

33
Q

how does nodular bcc present?

A

shint pearly papule

34
Q

how is bcc investigated

A

clinical dianosis often sufficient

maybe biopsy

35
Q

differentials of bxx

A

squamous cell carcinoma
sebaceous carcinoma
merkel cell carcinoma

36
Q

how is bcc treated?

A

surgical excision

if recurrent etc then microhraphic surgery

37
Q

what is ctcl

A

groups of neoplasms of skin homing t cells

38
Q

3 stages of mycosis fungoides

A

patch stage
plaque stage
tumour stage

39
Q

how is mycosis fungoides diagnosed?

A

biopsy
clinincal
bloods
lymph node palaption

40
Q

how is the plaque/patch stage treated

A

steriods, phototherapy, radiotherapy

41
Q

if mycosis has spread what is the treatment?

A

systemic chemo

42
Q

what is the triad of symptoms in sezary syndrome?

A

erythroderma
generalised lymphadenopathy
presence of neoplastic t cells

43
Q

what are the criteria for szary diagnossis?

A

t cell clone in blood

expanded t cell population and CD4/CD8 ratio above 10

sezary cell ocunt of at least 1000 cells per microlitre

44
Q

how is sezary treated?

A

systemic treatment
extracoroporal photophoresis
puva
steroids

45
Q

what is merkel cell carcinoma?

A

malignant proliferation of anaplastic cells

associated with polyomavirus

red, rapid growing nodule

GI cancers (18 decks)

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