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Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What are some risk factors in the development of skin cancer?

A

Age (>40)
Race/skin complexion
Sun exposure (especially with certain medications)
Tanning beds
Number of moles and freckles
Atypical nevi
Medical/family history
Smoking
immunosuppression

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2
Q

What are some red flags to think of when monitoring/screening for skin cancer?

A

Sore that does not heal

Spread of pigment from the border of a spot to surrounding skin

Redness or new swelling beyond the border

Change in sensation

Change in surface of a mole

Mole that looks different from other moles

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3
Q

What is the most common cancer in humans?

A

Basal Cell Carcinoma

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4
Q

What is the most common type of skin cancer?

A

Basal Cell Carcinoma

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5
Q

Which type of skin cancer is described below?

The most common type

Very limited capacity to metastasize (If it does metastasis, will go to bone)

Age of onset >40 years

Fair-skinned, younger presentation (20-40 y/o)

Males > females

A

Basal Cell Carcinoma

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6
Q

What are some predisposing factors in the development of basal cell carcinoma?

A

Skin phototypes I and II
Heavy sun exposure as youth
Xray therapy for facial acne
Ingestion of arsenic

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7
Q

Which type of basal cell carcinoma is described below?

Most common we’ll see

Papule or nodule

Translucent or “pearly” with telagiectasia

A

Nodular

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8
Q

Which type of basal cell carcinoma is described below?

Depressed or ulcerated center with a rolled border

Translucent or “pearly”

Smooth with telangiectasia

A

Ulcerating

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9
Q

Which type of basal cell carcinoma is described below?

Appears as a small patch of morphea or a superficial scar

Often ill defined

Skin colored, whitish but also with peppery pigmentation (fibrotic tissue)

A

Sclerosing

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10
Q

Which type of basal cell carcinoma is described below?

Appear as thin plaques

Pink or red

Characteristic fine threadlike border and telangiectasia

A

Superficial Multicentric

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11
Q

Which type of basal cell carcinoma is described below?

May be brown or black

Smooth, glistening surface (NOT greasy)

Hard and firm

A

Pigmented

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12
Q

What are some differential diagnoses to consider when evaluating for potential basal cell carcinoma?

A

Actinic keratosis

Squamous cell carcinoma

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13
Q

What is the treatment for basal cell carcinoma?

A

Excisional biopsy for diagnosis and management is preferred
If detected early- Excision
If detected late- Excise but referral

Can use cryosurgery or electrosurgery for small lesions not in danger
sites or on scalp

Radiation treatment

Topical 5-FU or imiquimod

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14
Q

Most often caused by UV radiation or HPV infection

Most often asymptomatic, but may bleed

Usually forms a patch or macule

Nodule formation = invasive

Diagnosis - biopsy

A

Squamous Cell Carcinoma

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15
Q

What are some patient characteristics who are diagnosed with squamous cell carcinoma?

A

Older patients (>55 y/o)

Sun-exposure (daily)

Carcinogen exposures

Immunosuppression

HPV

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16
Q

Appears as a sharply demarcated, scaling, or hyperkeratotic macule, papule, or plaque

Solitary or multiple lesions are pink or red in color and have a slightly scaling surface, small erosions, and can be crusted (Bowen’s disease)

Slowly evolving, isolated, keratotic

Eroded plaque/papule

Erythematous, pink, yellow/tan

A

Squamous Cell Carcinoma

17
Q

Red, sharply demarcated, glistening macular or plaque-like SCC’s on the glans penis or labia minora are called what?

A

erythroplasia of Queyrat

18
Q

What are some differential diagnoses to consider when evaluating for potential squamous cell carcinoma?

A

Basal cell carcinoma

Actinic keratosis (May arise from actinic keratosis)

19
Q

Squamous cell carcinoma may arise from what precancerous lesion?

A

Actinic keratosis

20
Q

What is the treatment for squamous cell carcinoma?

A

Topical chemotherapy: 5-FU cream or Imiquimod

Cryosurgery - Highly effective

Photodynamic therapy

Surgical excision/excision biopsy - Has the highest cure rates but the
greatest chance of causing cosmetically disfiguring scars (Difficult to excise)

21
Q

Most malignant tumor of skin; most deadly form of skin cancer

Arises from transformation of melanocytes as dermal-epidermal junction, Dysplastic nevi, Congenital nevomelanocytic nevus gone invasive

Typically older patients

Affects men and women equally

Uncommon in blacks

Common sites: posterior trunk, lower extremities

A

Melanoma

22
Q

What is the most deadly form of skin cancer?

A

Melanoma

23
Q

What are the four major types of melanoma?

A

Lentigo maligna (5%)
Spreading superficial (70%)
Acral-lentiginous (5-10%)
Nodular (15%)

24
Q

Does horizontal growth or vertical growth in melanoma have the worst prognosis?

A

vertical growth

25
Q

What are some risk factors for melanoma?

A

Older age
Skin types I and II (Blonde or red hair, green/blue eyes)
UVR exposure
CDKN2a mutation (tumor suppressor protein)
Past history - severe sunburn in youth; chemical exposure
Family history - North European ancestry
Number (>50) and size (>5mm) of moles
Melanocytic nevi
Congenital nevi
immunosuppression

26
Q

List some precursor lesions to melanoma

A

Congenital nevi
Dysplastic nevi
Lentigo maligna

27
Q

Which type of melanoma is described below?

10-15%

Median age approximately 65

Sunlight pathogenic factor

Flat macule, border well defined, “geographic” shape

Tan to brown/black

Lateral growth phase lesion (irregular border)

5% risk of becoming invasive

A

Lentigo Maligna

28
Q

Which type of melanoma is described below?

Most common – 70%

Age 30-50

Upper back

Elevated plaque

Brown, dark brown, black, blue, and red

A

Superficial Spreading Melanoma

29
Q

Which type of melanoma is described below?

<10%

Very poor prognosis

Median age approximately 65

Most common in Asians and African Americans (most common form in blacks)

Soles and palms
Mucus membranes
Fingernail or toenail

A

Acral-Lentiginous

30
Q

Which type of melanoma is described below?

10%

Complete vertical growth phase (symmetric)

Can occur anywhere

Typically 40-60 y/o males

Uniformly elevated “blueberry-like” nodule or ulcerate or thick plaque

“thundercloud”

May not be pigmented – could resemble vascular, nevus

A

Nodular

31
Q

What is the most common type of melanoma?

A

Superficial Spreading Melanoma

32
Q

What is the most common type of melanoma in African Americans?

A

Acral-Lentiginous

33
Q

What is the treatment for melanoma?

A

Excision/excisional biopsy

Sentinel node mapping and biopsy

Malignant - Pallative treatment

Chemotherapy

Radiation

Aggressive skin exams

34
Q

Multifocal systemic tumor of endothelial cell origin

Linked with HHV-8

4 variants

Presentation – stage/variant dependent

Localized and/or generalized disease: patches, plaques, nodules

Course and prognosis based on type

A

Kaposi Sarcoma

35
Q

Risk is 20,000x greater than the general population

Currently 18% incidence in this risk group

Young males common (rare in females)

CD4 count < 500uL (17%)

A

HIV/AIDs Associated Kaposi Sarcoma

36
Q

What is the pathogenesis of Kaposi’s sarcoma?

A

Derived from endothelium of blood/lymphatic microvasculature

Widespread reactive polyclonal proliferation, then become monoclonal

Promotes own growth and growth of other cells - can reroute capillaries causing pooling of blood (makes it purpuracious)

37
Q

Widespread or localized

Almost always on hands, feet, and legs

Spreads centripetally

Trunk rare (except in HIV)

In HIV - Early in face, then spreads to trunk

A

Kaposi Sarcoma

38
Q

What are the treatment options for Kaposi’s sarcoma?

A

Important: control NOT cure

Limited Intervention: Radiation, Cryo/laser/excisional surgery, Vincristine injection

Aggressive intervention:
Single chemo - Adriamycin or Vinblastine
Combo chemo - Vincristine + Bleomycin + Adriamycin

Dermatology (17 decks)

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