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dermatology > skin cancer > Flashcards

skin cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the majority of non melanoma skin cancers

A

basal cell cancer

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2
Q

What are the risk factors for skin cancer

A

UV radiation
photochemotherapy
chemical carcinogens
ionising radiation
Human papilloma virus
familial cancer syndromes
immunosuppression

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3
Q

Which cancer is human papilloma specifically linked to

A

squamous cell carcinoma

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4
Q

What is the presentation of a basal cell carcinoma

A

slow growing
locally invasive
rarely metastatic
The nodules have :
pearly rolled edges
telangiectasia
central ulceration

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5
Q

What are morphoeic basal cell carcinomas

A

basal cell carcinoma but with the appearance of a scar with no history of trauma

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6
Q

What is the treatment of basal cell carcinoma

A

gold standard is elliptical excision - draw around the carcinoma with a 4 mm of unaffected skin - then excise that - it will leave a large scar - curative treatment

Mohs surgery can also be done - cut into the tumour site and then biopsy in a lab there and then find the margins of the tumour

Vismodegib when the other treatments are not indicated - shrinks tumour but has large side effects

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7
Q

How do squamous cell carcinomas present

A

Sun exposed sites
16% metastasise

Has fast growing, tender, scaly/crusted or fleshy growths

They can ulcerate

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8
Q

What is the treatment of squamous cell carcinoma

A

Excision plus or minus radiotherapy

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9
Q

What is keratoacanthoma

A

Varient of squamous cell carcinoma which erupts from the hair follicles in sun damaged skin

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10
Q

how does keratoacanthoma present

A

rapidly growing and can shrink after a few months and resolve

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11
Q

What is the treatment of keratoancanthoma

A

surgical excision and treat as squamous cell carcinoma as hard to differentiate

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12
Q

What are the risk factors of melanoma

A

UV radiation

fair skin, red hair, blue eyes and tendency to burn easily

familial melanoma and melanoma susceptibility genes

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13
Q

What is the rule used for melanoma

A

A - asymmetry in shape and colour
B - border - nice clearly defined edge
C - colour - consistent colour - blue white veil is a significant feature of melanoma
D - diameter - greater than 7mm
E - evolution - is it changing - very important

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14
Q

What is a dermoscope used for

A

Improved clinical accuracy of what a mole looks like

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15
Q

what is Lentigo maligna melanoma

A

melanoma which Commonly appears on face

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16
Q

What are nodular melanomas

A

More aggressive melanomas that spread downwards immediately instead of out along the skin - diagnosed late usually

17
Q

What are acral lentiginous melanoma

A

Appear on the palms of the hands and the soles of the feet

18
Q

What is a subungal melanoma

A

Melanoma within the nail

19
Q

What is an ocular melanoma

A

Melanoma of the eye

20
Q

What is the treatment of melanoma

A

Urgent surgical excision

This gives the subtype of melanoma and the breslow thickness
Breslow thickness - the depth of the melanoma from the stratum granulosum

Wide local excision - going back to the excision and taking slightly larger excision to remove any remaining melanoma cells

chemotherapy and radiotherapy are rare

Immunotherapy can be used in metastasis or as adjuvant therapy

21
Q

What is the correlation between depth of melanoma and prognosis

A

The deeper the melanoma, the worse the prognosis (breslow depth)

22
Q

What is a cutaneous lymphoma

A

abnormal neoplastic proliferation of lympohocytes in the skin

T cell lymphomas are most common

23
Q

What is mycosis fungoides

A

Most common cutaneous T cell lymphoma

More common in older patients and in men

Patients normally live with the disease till they die

24
Q

What are the stages of mycosis fungoides

A

patch stage: flat, red, dry oval lesions
Usually in covered sites
may itch
hard to differentiate eczema and psoriasis

plaque stage - patches become thickened and itchy

Tumour stage - large irregular bumps that ulcerate - have chance of metastatic spread

metastatic stage - infiltration of neoplastic cells in lymph nodes, blood and solid organs

25
Q

What is sezary syndrome

A

cutaneous T cell lymphoma which affects all the skin in the body - skin becomes thickened, scaly and red - causes ERYTHRODERMA

There is node involvement and the cells are in the peripheral blood

Poor prognosis

26
Q

What is the treatment of cutaneous lymphoma

A

topical steroids
UVB
radiotherapy
interferon
Bexarotene
low dose methotrexate
chemotherapy
total skin electron beam therapy

27
Q

What is total skin electron beam therapy

A

radiotherapy consisting of very small electrically charged particles - delivers radiation to the superficial layers mainly

28
Q

What are the most common cutaneous metastases

A

breast, colon and lung

29
Q
A

dermatology (10 decks)

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