Skin Cancer Flashcards
Most common skin cancer
BCC
3 characteristics of BCC
Slow growing
Locally invasive
Rarely metastasise
Ix for BCC?
Shave/ punch biopsy for histology
4 characteristics of appearance of BCC
Pearly white/ pink papule-nodule or firm plaque
Rolled edge
Shiny
Associated telangiectasias
3 Tx options for BCC
Surgical excision
Curettage + cautery
Topical Imiquimod/ Fluorouracil 5%
Cells involved in SCC
Keratinocytes
Cells involved in BCC
Cells in epidermis + follicular epithelium
2nd most common skin cancer
SCC
List 4 characteristics of SCC
Non-healing ulcerated lesion with hard, raised edges.
Slow-growing ulcer or reddish skin plaque.
May bleed
Metastatic potential
Growth rate of SCC and BCC
SCC develop + grow over 3-6 months
BCC are slower
What are Actinic Keratoses?
Dry, rough, adherent scaly lesions
Pink/ skin coloured/ red
Non-malignant (low risk transformation to SCC)
AKA Solar keratoses
Ix for SCC
Biopsy
3 Tx options for SCC
Excisional biopsy
+/- Radiotherapy if metastatic/ invasive
Cryotherapy or Fluorouracil 5% (Bowens/ AK)
What is Bowens disease?
Red scaly patches
Intraepidermal (in situ SCC)
Arises in the outer layers of the epidermis
Pre-cancerous: 3% risk of progression to invasive SCC
HPV is a risk factor for which skin carcinoma
SCC
What are the 4 types of melanoma?
Lentigo maligna (Elderly)
Superficial (60%)
Nodular (>50s)
Acral lentiginous malignant (dark skinned)
Which skin cancer most commonly leads to death?
Malignant melanoma
Which melanoma is the most aggressive?
Nodular melanoma
Rapidly growing pigmented nodule which bleeds or ulcerates.
2 features of superficial melanoma
Large flat irregularly pigmented lesion which grows laterally before vertical invasion develops.
Arises in a pre-existing naevus
5 signs of malignant melanoma
A; asymmetrical B; irregular border C; >1 colour D; diameter >6mm E; Evolving/ elevating
6 risk factors for malignant melanoma
MMRISK Moles- atypical >5 Moles- common >50 Red hair Inability to tan Sunburn Kindred
Ix for melanoma
full-thickness excisional biopsy
What is used to stage melanoma?
Clark Scale + Breslow thickness
TNM
What is used to check for melanoma metastasis?
Sentinel lymph node biopsy
CXR
Liver US + LFTs (liver common site for mets)
CT head, abdo, pelvis
Tx for melanoma
Surgical excision
Nivolumab/ Pembrolizumab
Sentinel lymph node biopsy
What is a melanocytic naevus?
Mole
Benign proliferation of pigmented melanocytes
Ix for melanocytic naevus
Excision biopsy if suspicious
4 Tx options for melanocytic naevus
Excision biopsy: flat
Shave biopsy: protruding
Electrosurgical destruction
Laser: lessen pigment or remove coarse hair.
