Skin Cancer Flashcards
What are the 2 main types of skin cancer?
Melanoma/non melanoma (BCC/SCC)
What is a key factor in melanoma survival?
Tumour depth
What are the Breslow Thickness’?
4mm=50%, Metastases = 5%
What do you look for in melanoma diagnosis?
Asymmetry, Border, Colour, Diameter, Evolution
What is a known sign of melanoma?
Ugly ducking sign
What is the clinical presentation of BCC?
Slow growing lump or non healing ulcer. Painless. Translucent/pearly. Visible arborising blood vessels. Central ulceration (rodent), scaly plaque if superficial. If infiltrative morphoeic. Locally invasive, usually >40 yo but can be younger
What is the clinical presentation of SCC?
Hyperkeratotic lump or ulcer, arises on sun damaged skin. Grows fast, can be painful &/or bleed. Majority-well differentiated low risk, minority opposite. Metastases : 5%, poor prognosis at this stage. Precursor lesions
What are the precursor lesions of SCC?
Actinic keratoses and Bowen’s disease (carcinoma-in-situ)
What is the self resolving skin lesion that can occur in SCC?
Keratoacanthoma
What is required for a finding of Actinic Keratoses?
Multiple lesions- evidence for a field of abnormality
What are high risk sites in SCC?
Ear, lip and scalp
What are some risk factors for Skin cancer?
Sun exposure, genetic predisposition, immunosuppression, HPV infection, other environmental carcinogen - coal tar, smoking etc
What are the 6 skin types?
Skin type I - always burns, never tans Skin type II - usually burns, can tan Skin type III - can burn, but usually tans Skin type IV - always tans, never burns Skin type V - ‘brown’ skin Skin type VI - ‘black’ skin
What sun exposure pattern is likely to be the cause of SCC?
Chronic, cumulative UV exposure
What sun exposure pattern is likely to be the cause of BCC and Melanoma?
Intermittent, intense sunburn episodes
What conditions can cause a genetic susceptibility to skin cancer?
DNA repair syndromes e.g. Xeroderma Pigmentosum, Albinism, Naevoid BCC (Gorlin’s) syndrome
What environmental carcinogens are risk factors for skin cancer?
Ionising radiation, arsenic, coal tar, trauma, chronic ulceration etc
What does Xeroderma Pigmentosum cause in relation to skin cancer?
photosensitivity skin cancers on UV-exposed sites neurological degeneration Increased risk of other cancers Defect in one of seven Nucleotide Excision Repair (NER) genes (XPA - G)
What is Naevoid BCC (Gorlin’s) Syndrome?
Autosomal dominant familial cancer syndrome
What are the major features of Gorlin’s?
Major features early onset/multiple BCCs palmar pits jaw cysts ectopic calcification falx
What are the minor features of Gorlin’s?
Minor features skeletal abnormality OFC >97th centile cardiac/ovarian fibroma medulloblastoma
What level of risk are Hereditary Type VII collagen deficiency (RDEB) of developing skin cancer ?
High risk
What are the hallmarks of cancer?
Autonomous growth signals Insensitivity to anti-growth signals Resist cell death (apoptosis) Limitless potential to divide Angiogenesis Invasion and metastasis
What are the emerging hallmarks and enabling characteristics of cancer?
Deregulating cellular energetics and avoiding immune destruction. Genome instability and mutation and tumour promoting inflammation
