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BRS YEAR 2 > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

Melanocytic and non melanocytic pigmented lesions

A

Melanocytic:
Melanocytic naevi
Solar lentigo
Lentigo maligna
Malignant melanoma

Non Melanocytic
Seborrhoeic keratosis
Dermatofibroma
Skin tags

Melanocytic arise from melanocytes and non Melanocytic arise from other cells such as keratinocytes

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2
Q

Non pigmented lesions

A

Acitinic keratosis
Bowens
Squamous cell carcinoma
Basal cell carcinoma
Intradermal naevi
Clear cell acanthoma
Porokeratosis
Psoriasis

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3
Q

Epidermis layers superficial to deep

A

Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale
Dermis

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4
Q

Types of skin cancer

A

Squamous cell carcinoma(epidermis-stratum spinosum)
Basal cell carcinoma(epidermis and begins to enter dermis-stratum basale)
Melanoma (epidermis and enters dermis-melanocytes )

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5
Q

Malignant melanoma

A

Melanocytes become abnormal
They start proliferating
-atypical cells
-atypical architecture

Subtypes

superficial spreading (most common), nodular, lentigo maligna, acral lentiginous, unclassifiable

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6
Q

Lentigo maligna

A

Melanoma in situ
Proliferation of malignant melanocytes within the epidermis

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7
Q

How does lentigo maligna present

A

Irregular shape
Light and dark brown colors
Size usually >2cm
Usually on skull face or scalp

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8
Q

How does a malignant melanoma develop from a junctional naevus

A

Horizontal then vertical growth
(Melanoma is where it travels deeper into dermis)

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9
Q

Superficial spreading. MM

A

Lateral proliferation of malignant melanocytes

(Middle becomes skin color again-regression)

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10
Q

Diagnosis of superficial spreading melanoma

A

ABCD
A for asymmetry
B is for border (irregular scalloped or poorly defined border)
C is for color (varying colors from one area to the next eg shades of tan,brown,black or areas of white red or blue)
D js for diameter (white melanomas are greater than 6mm can be smaller when diagnosed
E it evolves

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11
Q

Nodular malignant melanoma

A

Vertical proliferation of malignant melanocytes within
No previous horizontal growth
Commonly found on head neck and trunk
Appear blue blah but can be pink or red

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12
Q

Nodular melanoma arising within a superficial spreading melanoma

A

Downward proliferation of malignant melanocytes following previous horizontal growth

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13
Q

Does the prognosis get better for Nodular melanoma arising within a superficial spreading melanoma

A

Prognosis becomes worse

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14
Q

Types of malignant melanomas

A

Lentigo malignant melanoma
Superficial spreading
Nodular
Acral lentiginous
Subungal
Amelanotic melanoma

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15
Q

Breslow thickness

A

Measurement from granular layer to bottom of tumour

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16
Q

Risk factors for developing melanoma’s

A

Genetic markers
Family history of dysplastic nevi or melanoma
Ultraviolet irradiation
Sunburns during childhood
Intermittent burning exposure in unacclimatized fair skin
Number>50 or size >5mm of Melanocytic nevi
Congenital nevi
Atypical/dysplastic nevus syndrome
Personal history of melanoma
High sociecinmic stays
Skin type I,II
equatorial latitudes
DNA repair defects
Immunosuppresion

17
Q

Melanoma management

A

1)Primary excision down to subcutaneous fat
2mm peripheral margin

2)Wide excision
-margin determined by breslow depth
-5mm for in situ (superficial)
Cut 10mm for melanoma less than <=1mm (deeper)
Prevents local recurrence of persistent disease

18
Q

Other management

A

Excision and wide local excision to all melanomas
Sentinel lymph node biopsy if breslow thickness >0.8mm
PET CT (if stage III,IV)
MRI BRAUN SCAN (if stage III,IV)
LDH major prognostic indicator

19
Q

Acintic keratosis

A

Progressed to scquamous cell carcinoma
It’s the precancerous stage
Primary invades epidermis

20
Q

Bowens disease

A

Squamous cell carcinoma in situ

erythematous scaly patch, possibly slightly elevated plaque

Non invasive skin cancer which involves the epidermis due to presence of atypical keratinocytes

21
Q

Treatment for AK and Bowens

A

5 fluorouracil cream
Cryotherapy
Imiquimod cream
Photodynamic therapy
Curretage and cautery
Excision

22
Q

Clinical appearance of squamous cell carcinoma

A

Arises within background of sun damaged disease
Erythematous to skin coloured
Papule
Plaque like
Exophytic
Hyperkeratotic
Ulcerated

Ill defined margins and localized on head and neck (1cm) trunk (2cm) and periorificial

Poorly differentiated invasion beyond subcutaneous fat/peruneural lymphatic vascular invasion possible

23
Q

Keratoacanthoma

A

rapidly enalarging papule that evolves j to a sharply circumscribed crateriform nodule with a keratotic core
Resolves slowly over months
Most occur in head or neck/sun exposed areas
Difficult to distinguish clinically and histologically from squamous cell carcinoma It’s

24
Q

Basal cell carcinoma

A

Superficial Well focused arborising vessels and occasional small blue globule
Typically presents as shiny pearl papule or nodule (Nodular)
Does not metastasis
Most common type of cancer

25
Q

Treatment for basal or squamous cell carcinoma

A

Surgery
MOHS surgery at high risk sites
Radiotherapy

26
Q

MOHS surgery

A
  1. First thin layer removed
    2.ankterh thin mater removed
    3.another then layer removed
    4.final layer of cancer removed
27
Q

What is a melanoma

A

Malignant tumour arising from melanocytes
Can occur on skin mucosal surfaces eg oral vaginal

28
Q

Acral lentiginous melanoma

A

Rare but aggressive melanoma that occurs on the palms soles and under the nails

29
Q

Longitudinal melonychia

A

Pigmented band forms in length of nail

30
Q

Subungual melanoma

A

Dark stripe on nail
Rare aggressive for

31
Q

Basiqumous cell carcinoma

A

Pearly or waxy bump with visible blood vessels
Combination of basal and squamous cell carcinoma

32
Q

Dermascopw

A

Tool used to help see clearly

33
Q

What is a major prognostic factor in melanoma

A

LDH
BRAF mutation status can also inform

34
Q

What can be used for unresectable bcc

A

Vismodegib

35
Q

What is indicated for unresectable scc

A

Cemiplimab

BRS YEAR 2 (61 decks)

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