Skin Cancer Flashcards
Types of Skin Cancer
-Basal Cell Carcinoma
- Cancer of the basal cell layer of the epidermis
- Can damage surrounding tissue and can advance to include underlying structures
- NOT usually metastatic
- Rate of recurrence is very high `
Types of Skin Cancer
-Squamous Cell Carcinoma
- Cancer of the epidermis that can be localized
- May metastasize to other tissue and organs
Types of Skin Cancer
-Malignant Melanoma
- Aggressive, metastatic cancer that originates in the melanin-producing cells of the epidermis
- 1/3 originate in existing nevi (moles)
Skin Cancer
-Risk Factors
- Age
- Sun Exposure and pre-pubescent sun burns
- Occupation / recreation
- Ethnicity & Family Hx
Basal & Squamous Cell Carcinoma
-Physical Assessment Findings
- Small, waxy nodule w/ small, superficial blood vessels
- Rough, scaly lesion that may bleed & has central area of ulceration or crusting (Squamous)
- Size varies
Melanoma
-ABCDEF of Suspicious Lesions
- A-symmetry (one side doesn’t match the other)
- B-orders (Ragged, notched, irregular or blurred)
- C-olor (lack of uniformity in pigmentation.. 2 toned)
- D-iameter (Width >6mm / size of pencil eraser)
- E-volution, elevation, erythema
- F-unny feeling, fast growing
Types of Skin Cancer
-Basal Cell Cancer
- Basal cell cancer is the most common but least aggressive type of skin cancer
- Rarely metastasizing
- Tend to recur
Melanoma
-Risk Factors
- High # of moles, or large moles
- Fair skin, freckling, blond hair or blue eyes
- Close relative w/ disease
- Men w/ gene changes from a fam hx of breast or ovarian CA
- Immune suppressant medications
- Age >50 and UV radiation exposure
Malignant Melanoma
-Lentigo Maligna Melanoma
- Occurs on skin that has had long-term sun exposure, such as the face, neck, and dorsal surface of the hands and lower extremities
- Affects women more than men (60’s -70’s)
- Lesion becomes malignant as soon as melanocytes invade dermis
Malignant Melanoma
-Superficial Spreading Melanoma
- Most common type of melanoma
- Arises from preexisting nevus
- Found on trunk and back of men and legs of women
- Radial growth phase 1-5 years // Vertical phase is rapid
- During Vertical phase the lesion changes color to red, white, and blue
- Lesion develops irregular borders and has raised nodules and ulcerations
Malignant Melanoma
-Acral Lentiginous Melanoma
- More common in people with dark skin
2. Nodules are found on palms of the hands and soles of the meet, mucous membranes, and nail beds
Malignant Melanoma
-Nodular Melanoma
- Lesions arise from unaffected skin rather than from preexisting lesion
- Only has vertical growth phase making it harder to detect
Types of Basal Cell Cancer
-Superficial Basal Cell Cancer
- Most often on the trunk and extremities
- Second most common basal cell after nodular
- Tumor is a flat papule w/ well defined borders
- May ulcerate and be covered w/ crusts or shallow erosions
Types of Basal Cell Cancer
-Nodular Basal Cell Cancer
- Most common type of basal cell cancer
- Most likely appears on face, neck and head
- Early stages, the tumor is a papule that looks like a smooth pimple
- It doubles in size every 6-12 months - Center or periphery may ulcerate and bleed easily
Types of Basal Cell Cancer
-Morpheaform Basal Cell Cancer
- Rarest form and tumor forms finger-like projections that extend in any direction along dermal tissue planes
- Flat ivory or flesh-colored scar
- More likely to extend into and destroy adjacent tissue, especially muscle, nerve, and bone
Types of Basal Cell Cancer
-Pigmented Basal Cell Cancer
- Found on head, neck, & face
- May appear dark brown, blue, or black
- Shiny well defined borders
Squamous Cell Cancer
- Occurs most often on areas of skin exposed to UV rays and weather
- forehead, ears, top of nose - Much more aggressive than basal cell w/ faster growth rate and much greater potential to metastasize if untreated
Types of Basal Cell Cancer
-Keratotic Basal Cell Cancer
- Found on preauricular and postauricular groove
- Appears much like a nodular basal cell cancer
- Tends to recur locally and also is the type most likely to METASTASIZE
Malignant Melanoma
-Where does it Present on men and women?
- Most often found on the trunk of men and on the lower extremities of women
- Change in color or size of nevus is reported in 70% of people dx w/ malignant melanoma
Squamous Cell Cancer
-Progression
- Begins as small, firm, red nodule
- May be crusted w/ keratin products
- As it grows it may ulcerate, bleed and become painful
- Area around nodule can become indurated (hardened)
Squamous Cell Cancer
-Actinic Keratosis
- Directly r/t chronic sun exposure and photo-damage
- May progress to squamous cell carcinoma
- Classified as pre-malignant
- Lesions are erythematous, rough, macules a few mm in diameter
- Often Shiny but may be scaly & if scale is removed it will bleed - Occur in multiple patches on face, hands, forearms
- Enlargement or ulceration suggests transformation to malignancy
Clarks Levels for Staging
-Level 1
- Into epidermis
Clarks Levels for Staging
-Level 2 & 3
- Into epidermis and papillary dermis
Clarks Levels for Staging
-Level 4
- Into epidermis, papillary dermis & reticular dermis
Clarks Levels for Staging
-Level 5
- Into the epidermis, papillary dermis, reticular dermis & subcutaneous tissue
- Most likely to metastasize
