Skin Cancer Flashcards
Describe the general clinical features of an skin SCC?
Non-pigmented
Tender on palpation
Rapid growth (over weeks or months)
Skin is freely movable over underlying skull
+/- Hyperkeratotic nodule, bleeding, ulceration
What is more common SCC or BCC skin lesions?
BCC
Where are SCC typically found?
Sun exposed sights
What are the group of disorder that result from keratinocyte dysplasia?
Actinic keratosis
SCC in situ (Bowen’s disease)
SCC
What is the time course of SCC development?
Weeks to months
How are SCC managed?
Surgery with borders of 5-10mm
Adjunct radiotherapy if required
Radiotherapy alone can be used if surgery is contraindicated
Describe the clinical features of a BCC?
Pearly nodules with telangectasia
Often centrally ulcerated
Indolent growth
In areas of high sun exposure
What are the histopathological features of BCC?
Pallisading
Basaloid cells with a pushing boarder invading into stroma
What type of BCC can mimic melanoma?
Nodular BCC
How do BCC spread?
Locally
Rarely metastasize
How are BCC Mx?
Surgical excision - particular nodular or infiltrative
Serial curettage
Topical imiquimod
Photodynamic therapy
At what rate to actinic keratosis overgo malignant transformation to SCCs?
1:1000 per year
What must you be way of when examining actinic keratosis?
Hyperkeratotic, tender nodules that might be transformation in SCC
How are actinic keratosis managed?
Cyrotherapy
Topical agent eg 5FU, imiquinod
Surgical excision
What are the clinical features of Bowen’s disease?
Scaly erythematous plaques with some surface erosions
May be itchy, painful and bleed
How is Bowen disease Mx?
Topical therapies - eg 5FU, imiquimod
Surgical excision
What is imiquimod?
Local immune stimulator used to treat superficial viral infections and tumours
Where is Bowen disease classically found?
Legs - shins
How can you divide naevi?
Congenital
Acquired
What are you worried about with congenital naevi?
Malignant transformation - larger ones more likely
Cosmetic
What are the characteristics of a benign junctional naevus?
Occurs of the epidermal side of the DEJ
Macular - Slightly raised
<1cm
Uniform colour
What are the characteristics of a compound benign naevus?
Cell in the both the epidermis and dermis
<1cm diameter
Papules or Nodules
Even colour and smooth border
What are the characteristics of a benign intradermal naevus?
All intradermal
Paler colour
Papular or nodule
Small, later onset
Smooth surface
What are lentigines?
Papules of increased pigmentation due to increased melanocytes
On sun exposured sites
Static with time
What are seborrheic keratosis? What do they look like?
Benign lesions of elderly people due to keratinocyte proliferation
Warty, macular appearance
Can be pigmented and increase in size
What are the clinical features of dysplastic naevi?
Larger >5mm lesions
Smudged border
More than 2 colours
Atypical pigment on dermatoscope
Generally still symmetrical
When should dysplastic naevi be removed?
If they are suspicious for transformation to melanoma
Not prophylactically
