Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Derm > Skin cancer > Flashcards

Skin cancer Flashcards

1
Q

Most common modalities for examining skin cancers

A

Imaging and skin cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a melanoma?

A

Malignant tumour arising from melanocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where can melanomas form?

A

Skin
Mucosal surfaces e.g. vaginal, bowel, oral, conjunctiva
Due to abnormal migration of melanocyte precursors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Genetic risk factors of melanoma

A

Family history
DNA repair defects - xeroderma pigmentosum
Pale skin
Red hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Environmental risk factors of melanoma

A

Sun/UV exposure
Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phenotypic risk factors of melanoma

A

> 100 moles
atypical moles
nevi = moles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some specific genetic mutation that is a risk factor for melanoma?

A

CDKN2A Mutation - tumour suppressor
cyclin kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are four subtypes of melanoma?
LANS

A

Lentigo Maligna,
Acral Lentiginous,
Nodular,
Superficial Spreading

some are unclassifiable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common type of melanoma

A

Superficial spreading
Can arise de novo or from an old mole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do superficial spreading melanomas arise?

A

Trunk or Legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is depigmentation in melanoma tumours found?

A

Shows as grey or hypopigmented area
Where there has been an immune response against the tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the growth pattern of superficial spreading melanoma

A

First horizontal growth and then vertical growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the horizontal growth in superficial spreading melanomas characterised by

A

asymmetry
colour variation
border irregularity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where on the body do nodular melanomas occur

A

Trunk
head
neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the appearance of nodular melanomas?

A

Blue to black nodules (may also lack in colour), rapid development
more common in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the growth pattern of nodular melanomas?

A

Only vertical growth - therefore spherical shape
Deeper and more likely to metastasize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ABCDE of melanoma self detection
(nodular melanoma does not follow this rule)

A

Asymmetry
Border irregularity
Colour variation
Diameter >5/6mm
Evolution: change in size, shape, colour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who does Lentigo maligna mainly affect

A

> 60yrs
chronically sun damaged skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the appearance of lentigo maligna melanoma?

A

Slow growing, asymmetric brown/black macule with irregular border (not well defined)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lentigo maligna vs Lentigo maligna melanoma?

A

Lentigo Maligna - in situ
Lentigo Maligna Melanoma - invasive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What body parts are affected by acral lentiginous melanoma

A

palms/soles - ulceration and scarring
nail apparatus - lines called melanonychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who is most affected by acral lentiginous melanoma

A

Affects all skin types equally
Though darker skinned people are more likely to be diagnosed with this over other types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Amelanotic melanoma

A

No pigment
appears pink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are poor prognostic features for melanoma?

A

Increased Breslow thickness (>1mm) - main one!!!, Ulceration,
Age,
Lymph Nodes involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are some differential diagnoses for melanoma?
Basal cell carcinoma, Seborrhoeic keratosis, Dermatofibroma
26
What is dermoscopy?
Tool to microscopically examine skin Improves diagnosis
26
What is Breslow thickness?
Thickness of tumour from stratum granulosum
27
What is the primary management for melanoma?
Primary excision down to subcutaneous fat - wide border In larger melanomas you must also check the surrounding lymph nodes for metastasis
28
What is another biopsy done in melanoma management?
Sentinel lymphoma node biopsy - (sentinel lymph nodes are the initial nodes for skin drainage .: most likely for metastasis)
29
What imaging is done in melanoma management?
PET-CT, Brain MRI
30
What is a major prognostic factor in melanoma?
LDH - shows tissue damage Good for patients with proven metastases
31
What is the management of unresectable or metastatic melanoma?
Immunotherapy (CTLA-4 and PD-L1 inhibitors) Mutated oncogene targeted therapy (BRAF, MEK)
32
What is the main cause of keratinocyte dysplasia
UV damage
33
What is another term for keratinocyte dysplasia?
Keratinocyte carcinoma
34
What are the different conditions in keratinocyte dysplasia? ABBS
Actinic keratoses Bowen's disease (in situ SCC) Basal Cell Carcinoma Squamous Cell Carcinoma (including keratacanthoses)
35
What are actinic keratoses and where are they found?
Atypical keratinocytes confined to epidermis
36
What is the difference between macules and papules?
Macules - flat // Papules - raised
37
What is Bowen's disease?
Squamous Cell Carcinoma in situ
38
What is Squamous Cell Carcinoma
affects the Full thickness of the epidermis + invasive Can metastasise
39
What is Basal cell carcinoma
locally invasive, almost never metastasises Most common skin cancer
40
What are some other risk factors for keratinocyte carcinomas?
Pale Skin, Genetic syndromes (xeroderma pigmentosum), Organ transplantation, (immunosuppression) Ionising radiation Chemical exposure e.g. tar
41
Where do actinic keratoses usually develop?
Sun-damaged skin - head, neck, extremities
42
What are the features of actinic keratoses?
Erythematous Macules, some scaliness
43
What does Bowen's disease look like?
Erythematous scaly patch or elevated plaque
44
What other diseases can Bowen's disease replicate?
Actinic keratoses // Psoriasis
45
What is the treatment for actinic keratoses and Bowen's disease?
Topical chemotherapy, 5-fluorouracil Cryotherapy, Imiquimod cream, stimulates immunity Photodynamic therapy, apoptosis of atypical cells Excision no radiation therapy
46
Describe what a squamous cell carcinoma can look like
Erythematous or skin coloured // Papule // hyperkeratotic ulceration
47
What is a keratoacanthoma?
Rapidly enlarging papule that spontaneously resolves. Dome shaped nodule with keratotic core which resolves slowly by itself
48
What condition mimics SCC
keratoacanthoma often indistinguishable
49
Investigation of SCC
Diagnostic biopsy US of regional lymph nodes Fine needle aspiration if concerned about metastasis
50
What are the differential diagnoses for squamous cell carcinoma?
Basal cell carcinoma, Viral wart, Merkel cell carcinoma
51
What is the treatment for squamous cell carcinoma?
Excision, Radiotherapy (for unresectable/high risk features) Cemiplimab immunotherapy for metastases (block own inhibitors)
52
What are the different types of basal cell carcinoma? (Basal Never Metastasises, Mustn't Invade Systemically)
Basisquamous, Nodular (most common), Micronodular, Morpheic, Infiltrative, Superficial
53
How does nodular basal cell carcinoma present?
Shiny, pearly papule or nodule
54
How does superficial basal cell carcinoma present?
Well-circumscribed, erythematous, macule/thin papule
55
How does morphoeic basal cell carcinoma present?
Extensive Local destruction, light-pink to white (like a scar)
56
What histological features do basisquamous BCCs present with?
Features of both basal cell and squamous cell carcinoma High risk of metastasis
57
What is the difference between micronodular and nodular BCC?
Micronodular has more destructive behaviour and faster spread determined histologically
58
What are the differential diagnoses for basal cell carcinoma?
Squamous Cell Carcinoma, Sebaceous Carcinoma, Merkel Cell Carcinoma
59
What is the treatment for basal cell carcinoma?
Surgical excision, Mohs micrographic surgery, (for recurrent/aggressive BCC) Topical therapy (5-fluorouracil), radiotherapy photodynamic therapy
60
What is the treatment for unresectable BCC?
Radiotherapy, Vismodegib - selectively inhibits abnormal signalling
61
Mohs micrographic surgery
Remove individual layers of skin and examine until the cancer has all been taken out. Means you can retain the surrounding tissue Highly skilled technique which takes a long time
62
Describe the ideal excision process for basal cell carcinoma
Bread-loafing method - take thin slices at edges of tumour to find the whole size (usually 4-5mm extra) some areas such as the eyelids or nose do not have this extra space.
63
What cells are impacted by merkel cell carcinoma?
Anaplastic cells (not Merkel Cells!) share features with neuroendocrine cells (like Merkels)
64
What are the common causes of merkel cell carcinoma?
Polyomavirus, UV Exposure
65
How does Merkel Cell Carcinoma present?
Rapidly growing nodule -> pink-red dome shaped ulceration can occur
66
Merkel cell carcinoma
Most aggressive type of skin cancer 40% will metastasise
67
How should suspected melanoma be treated and diagnosed
Complete excision for diagnosis
68
High risk features of cutaneous SCC
localisation: head, neck, trunk, periorificial zones ill defined margins rapidly growing immunosuppression previous radiotherapy or chronic inflammation acantholysis on histology invasion beyond subcutaneous fat perineural, vascular, lymphatic invasion

Derm (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions