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Dermatology > Skin cancer > Flashcards

Skin cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

From what cells in the skin do basal cell carcinomas arise?

A

Keratinocytes in the basal layer of skin

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2
Q

From what cells in the skin do squamous cell carcinomas arise?

A

Keratinocytes in the suprabasal layers

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3
Q

How do basal cell carcinomas usually present?

A

A translucent, slow-growing lump or a non-healing ulcer

Painless

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4
Q

Why is delay in treatment of basal cell carcinoma less important than in other cancers?

A

Although they invade locally, they don’t spread more widely

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5
Q

How do squamous cell carcinomas tend to present?

A

A warty or crusted growth or a non-healing ulcer

May be painful

Hyperkeratotic

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6
Q

Which tends to grow faster: basal cell or squamous cell carcinoma?

A

Squamous cell

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7
Q

What is the most common cancer in 15-24 year olds?

A

Malignant melanoma

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8
Q

What is used to determine prognosis from malignant melanoma?

A

Breslow thickness

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9
Q

What is the prognosis of a malignant melanoma with a Breslow thickness >4mm?

A

5 year survival rate 50%

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10
Q

What does ABCDE stand for in terms of assessing skin lesions?

A

Assymetry

Border

Colour

Diameter

Evolution

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11
Q

What is the name given to a lesion with central ulceration and what is the diagnosis most likely to be?

A

Rodent ulcer

Basal cell carcinoma

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12
Q

Which skin cancer tends to have visible blood vessels in it’s lesions?

A

Basal cell carcinoma

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13
Q

What are precursor lesions to SCC?

A

Actinic keratoses

Bowen’s disease (carcinoma-in-situ)

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14
Q

What are the predisposing factors to development of skin cancer?

A

UV light from sunlight and sunbeds

Skin type

Moles

Family history/genetics

Some drugs

Other cancer

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15
Q

What kind of UV light exposure predisposes to development of BCC?

A

Intermittent exposure

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16
Q

What kind of UV light exposure predisposes to development of SCC?

A

Chronic exposure

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17
Q

What kind of UV light exposure predisposes to development of malignant melanoma?

A

Intermittent exposure

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18
Q

Which type of UV damage is reflected by sunburn and solar lentigo?

A

UVB damage

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19
Q

What type of damage occurs to skin with UVA exposure?

A

Solar ageing is attributed to the deeper penetration and solar elastosis of UVA

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20
Q

What is sunburn?

A

A protective mechanism whereby badly UV-damaged keratinocytes undergo apoptosis or programmed cell death

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21
Q

What are some examples of phototoxic drugs?

A

Voriconazole

Thiazide diuretics

Anti-TNF

NSAIDs

BRAF inhibitors

22
Q

What are actinic/solar lentiges?

A

‘Age’ or ‘liver’ spots associated with UV exposure

23
Q

Where are actinic lentiges found?

A

Face, forearms and dorsal hands

24
Q

What is the risk of developing melanoma with a large congenital melanocytic naevi?

A

10-15%

25
Q

What are the characteristics of a dysplastic naevi?

A

Generally >6mm diameter

Variegated pigment

Border asymmetry

26
Q

What is this lesion?

A

Halo naevus

27
Q

What are halo naevus and what are they associated with?

A

A mole surrounded by an area of depigmentation

Associated with vitiligo

28
Q

What is seen on biopsy of halo naevus?

A

They show inflammatory regression and are overrun by lymphocytes

29
Q

What is this lesion and what does it consist of?

A

Blue naevus - collection of dendritic rich spindle cells in the dermis that may mimic melanoma

30
Q

What is this lesion?

A

Spitz naevus

31
Q

What is a spitz naevus?

A

‘benign juvenile melanoma’

Consist of large spindle and/or epithelioid cells and may closely mimic melanoma, however most are entirely benign

32
Q

In which gender are malignant melanomas most common?

A

Females 2:1

33
Q

What features might raise suspicion that a lesion is a malignant melanoma?

A

New lesion develops in adulthood

Satellite lesions

Bleeding

Change in shape

Ulceration

Irregular pigmentation

34
Q

What is the most common type of malignant melanoma?

A

Superficial spreading melanoma

35
Q

Where do acral lentiginous melanomas arise?

A

Palms

Soles

Beneath nails

36
Q

Which type of melanoma arises on sundamaged skin of the face, neck and scalp?

A

Lentigo maligna

37
Q

What is ‘VGP’ in relation to malignant melanoma?

A

Melanoma cells invade the dermis forming an expansile mass with mitoses

38
Q

Which type of melanoma are VGP only?

A

Nodular

39
Q

What is RGP in relation to malignant melanoma?

A

Grows as macules when either entirely in-situ or with dermal microinvasion

40
Q

What is the definition of Breslow thickness?

A

Depth of the deepest part of tumour from granular layer

41
Q

What are poor prognostic indicators in malignant melanoma?

A

Increasing Breslow thickness

Satellite lesion formation

Ulceration

High mitotic rate

Lymphovascular invasion

Sentinel lymph node involvement

42
Q

How does malignant melanoma spread?

A

Local dermal lymph nodes

Regional lymph nodes

Blood spread

43
Q

What are satellite nodules with malignant melanoma?

A

MM spreading to dermal lymph nodes

44
Q

Where do metastates from malignant melanoma spread?

A

Skin

Heart

Lungs

GI tract

Brain

Liver

45
Q

What size of margin should be left when doing an excision of a malignant melanoma in situ?

A

5mm

46
Q

What size of margin should be left when removing an invasive malignant melanoma <1mm thick?

A

1 cm

47
Q

What size of margin should be left in excision of an invasive malignant melanoma >1mm thick?

A

2cm

48
Q

When should a sentinel node biospy be performed with malignant melanoma?

A

>1mm thick or thinner with mitoses

49
Q

What are these lesions?

A

Seborrhoeic keratosis

50
Q

What are some of the precursors for squamous cell carcinoma and where are they commonly found?

A

Bowen’s disease: legs

Actinic keratosis: head/neck

Viral lesions: anogenital skin

51
Q

What are the characteristics of Bowen’s disease?

A

Normally on lower leg

Scaly patch/plaque

Irregular border

No dermal invasion

More common in females

Dermatology (8 decks)

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