Skin Cancer

Question 1

What are the 2 main groups of skin cancers?

Answer 1

Melanoma

Non-melanoma

Question 2

What are the 2 main non-melanoma skin cancers?

Answer 2

Basal cell carcinoma

Squamous cell carcinoma

Question 3

Non-melanoma skin cancers arise from which skin cells?

Answer 3

Keratinocytes

Question 4

Melanoma skin cancers arise from keratinocytes. True/False?

Answer 4

False

Arise from melanocytes

Question 5

Melanoma is the fastest increasing cancer in Scotland. True/False?

Answer 5

True

Question 6

Squamous cell carcinoma is more common than basal cell carcinoma. True/False?

Answer 6

False

Question 7

Melanoma is the most common cancer in 15-24 yr olds. True/False?

Answer 7

True

Question 8

Melanoma is 2x more common in which sex?

Answer 8

Females

Question 9

What determines prognosis in melanoma?

Answer 9

Depth of the melanoma

Question 10

What is the % survival for melanoma lesions less than 1mm over 5 years?

Answer 10

95-100%

Question 11

Thinner melanomas have better prognosis than thicker ones. True/False?

Answer 11

True

Question 12

What is the ABCDE approach to diagnosing melanoma?

Answer 12

Asymmetry
Borders
Colour
Diameter
Evolution

Question 13

If a mole is fast-growing and very dark black, it is not worrying. True/False?

Answer 13

False

Question 14

Basal cell carcinomas are fast-growing. True/False?

Answer 14

False

Slow-growing due to poor blood supply

Question 15

Are basal cell carcinomas usually painful?

Answer 15

No

Question 16

Describe the appearance of basal cell carcinoma

Answer 16

Pearly/translucent lump
Aborising blood vessels
Central ulceration

Question 17

What is the most common cause of squamous cell carcinoma?

Answer 17

Sun-damaged skin

Question 18

Squamous cell carcinoma is fast-growing. True/False?

Answer 18

True

Relatively fast compared to BCC

Question 19

Both basal and squamous cell carcinomas are likely to metastasise. True/False?

Answer 19

False

Basal cell carcinoma is localised

Question 20

Describe the appearance of squamous cell carcinoma

Answer 20

Hyperkeratotic lump/ulcer

May be painful/bleed

Question 21

Name 2 precursor lesions that can lead to squamous cell carcinoma

Answer 21

Bowen’s disease

Actinic keratosis

Question 22

How do actinic keratoses arise?

Answer 22

Sun damage

High risk of developing squamous cell carcinoma

Question 23

Describe Bowen’s disease

Answer 23

Erythematous plaque - very early form of squamous cell carcinoma that is easily treated

Question 24

List risk factors for skin cancer

Answer 24

Sun exposure
Genetics
Immunosuppression
Environmental carcinogens

Question 25

Describe skin type I

Answer 25

Always burns, never tans

Question 26

Describe skin type II

Answer 26

Usually burns, can tan

Question 27

Describe skin type III

Answer 27

Usually tans, can burn

Question 28

Describe skin type IV

Answer 28

Always tans, never burns

Question 29

Describe skin type V

Answer 29

Brown skin

Question 30

Describe skin type VI

Answer 30

Black skin

Question 31

List 3 genetic diseases that increase risk of skin cancer

Answer 31

Xeroderma pigmentosum Albinism Naevoid basal cell carcinoma (Gorlin's syndrome)

Question 32

What is xeroderma pigmentosum?

Answer 32

Photosensitivity disease where skin cancer can occur on UV-exposed sites Defect in NER genes

Question 33

What is Gorlin's syndrome?

Answer 33

Autosomal dominant disease featuring multiple basal cell carcinomas

Question 34

Which UV radiation is the most lethal - UVA, UVB or UVC?

Answer 34

UVC | Then UVB then UVA

Question 35

What blocks out UVC radiation so that we are never exposed to it?

Answer 35

Ozone layer

Question 36

What protects us from UVB radiation?

Answer 36

Window glass | Some sunscreen

Question 37

What is the effect of UV radiation upon DNA?

Answer 37

Damages DNA and causes mutations

Question 38

What is the signature DNA mutation of UV radiation?

Answer 38

Pyrimidine dimer mutation

Question 39

Skin type I individuals have which type of melanin instead of eumelanin which doesn't absorb UVR effectively?

Answer 39

Pheomelanin

Question 40

MC1R protein determines balance of pigment in skin and hair. What would 1 or 2 mutations in the MC1R gene cause respectively?

Answer 40

1 mutation causes freckling | 2 mutations causes freckling and red hair

Question 41

What is the scientific name for freckles?

Answer 41

Ephilides

Question 42

What do freckles represent?

Answer 42

Patchy increase in melanin pigmentation, usually due to UV exposure

Question 43

What are actinic lentigines?

Answer 43

"Age/liver spots" caused by UV exposure

Question 44

What is a naevus?

Answer 44

Birthmark/mole on the skin

Question 45

Naevi can develop into melanoma.. True/False?

Answer 45

True

Question 46

How do acquired naevi develop?

Answer 46

At infancy, melanocyte:keratinocyte ratio breaks down, allowing formation of simple benign naevi

Question 47

Where are melanocytes in a junctional naevus?

Answer 47

At the DEJ

Question 48

Where are melanocytes in a compound naevus?

Answer 48

DEJ + dermis

Question 49

Where are melanocytes in a intradermal naevus?

Answer 49

Dermis

Question 50

What size are dysplastic naevi?

Answer 50

Generally greater than 6mm

Question 51

List the 4 main types of melanoma

Answer 51

Superficial spreading Acral/mucosal lentiginous Lentigo maligna Nodular

Question 52

How do superficial spreading, acral/mucosal lentiginous and lentigo maligna melanoma differ from nodular melanoma, in terms of growth?

Answer 52

SSM, A/MLM and LMM grow as flat lesions in epidermis before vertically invading; NM vertically grows from the outset

Question 53

What is the most common subtype of melanoma? Where is it found?

Answer 53

Superficial spreading | Trunk or legs

Question 54

Describe seborrhoeic keratosis

Answer 54

Greasy, stuck-on appearance common on face and trunk | Hyperkeratotic