Skin Cancer Flashcards
Basal cell carcinoma risk factors
increasing age
previous BCC / skin cancers
chronic sun exposure
repeated episodes of sunburn
skin type (fair, fitzpatrick 1)
inherited conditions
BCC clinical features
slow growing plaque / nodule
skin coloured- pink, brown, pigmented
spontaenous bleeding or ulcerated
*non melanoma skin cancer
*most common cancer worldwide
types of BCC
- nodular BCC
- superficial BCC
- morphoeic BCC
- basosquamous BCC
nodular BCC
most common facial type
shiny/pearly nodule with a smooth surface and central depression / ulceration
blood vessels across the surface
can have variants
superficial BCC
common in younger adults
upper trunk / shoulders
slightly scaly, irregular plaque
thin, translucent rolled border
multiple microerosions
morphoeic BCC
mild facial sites
waxy, scar like plaque
indsitinct burers
can infliatrate cutaenous nerves
Basosqumous BCC
mixed basal and squamous cell carcinoma
infilatrative growth pattern
layers of the skin
- epidermis
- dermis
- hypodermis
layers of the epidermis
1. stratum corneum
2. stratum lucideum
3. stratum granulosum
4. stratum spinosum (SCC)
5. stratum basale (BCC)
investigations of BCC
- biopsy
- histopathological examination
management of BCC
complete removal of the tumor
topical flurouracil (5-FU), cryotherapy, photodynamic therapy
SCC (squamous cell carcinoma) pathophysiology
second most common skin cancer (after BCC)
malignant transformation of the stratum spinosum of the epidermis
SCC risk factors
exposure to sunlight
chemical carcinogens
precancerous lesions- actinic keratosis
skin damage- scars, burns, ulcers
SCC presentation
painless
non-healign
bleeding ulcers
crusting, itching
everted edges
*can also present as plaques, nodules, warty lesions
*all forms eventually ulcerate
most commonly on face, neck, lower lip, ears, hands
RED FLAGS- malaise, weight loss, lympadenopathy
investigations / diagnosis of SCC
- biopsy (punch biopsy / wedge / excisional)
- urther imaging- CT, MRI
- lymph node biopsies, FNAC
morphology of SCC lesions
firm to palpate (nodular/plaque)
ulcerate , bleed
tender / painful
crusty keratotic top with a nodular base
variable size
melanoma
highly malignant tumor arising from melanocytes
risk factors- UV radiation exposure, sunburn, age, fhx, immunosupression
melanoma clinical features
itchy (pruritic)
persistently bleeding skin lesion
assymetry
irregular border
color
diameter >6mm
evolving
diagnosis / investigation for melanoma
full thickness excisional biopsy
staging test (USS, MRI)
melanoma vs SCC vs BCC
melanoma: brown/black, irregular macule/nodule, commonly on trunk or extremitis, slow gorwth
SCC: red, scaly plaque like, rough texture, all eventually ulcerate
BCC: pink, pearly nodular lesion, superficial veins, central dimpling, slow growth
melanoma treatment
surgical excision
medical therapy - BRAF kinase inhibitor
