Skin Cancer Flashcards
(25 cards)
What are th five layers of he epidermis?
Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale
What cancers make up 70% of non-melanomas?
BCCs
Which form of light, UVA or UVB, is more penetration to the skin?
UVA
What are some risk factors for skin cancer?
UV radiation Photochemotherapy Chemical carcinogens X- ray and thermal radiation Human papilloma virus Familial cancer syndromes Immunosupression
What are the characteristics of BCCs in relation to growth?
They are slow growing and rarely metastasise
What is the common appearance of BCCs?
Nodular with; pearly rolled edge Telangiectasia Central ulceration Arborising vessels on dermoscopy
What other forms of lesion my BCCs take?
Pigmented - dark
Morphemic - ver difficult to identify and resemble a shallow scar
Superficial
What surgical therapies are available for the treatment of BCCs?
Excision
- curative if fully excised
- will scar
Curettage and cautery
- lesion scraped off and heat applied to destroy residual cancer cells
Mohs
- expensive and time consuming surgery that involves taking of a small layer of skin at a time to fully excise the lesion - useful of the area involved has little excess tissue e.g. the nose
What is photo-dynamic therapy?
Photochemical reaction to selectively destroy cancer cells
- A topical photosensitising agent is applied which then concentrate in the cancerous cells and when red light is applied permits a photodynamic reaction aimed at destroying the cancer cells
What is crytotherapy?
Application of liquid nitrogen died at freezing and killing the lesion and its cells
It is cheap and easy to perform on the day but is not always fully effective
What is imiquimod therapy?
Application of aldara, an immune response modifier which stimulates cytokine release which cause inflammation and destruction of the lesion
This is useful where surgery is undesirable and there is usually a good cosmetic result
However the treatment takes 6 weeks and there is significant inflammation
Describe squamous cell carcinoma
Derived from keratinising squamous cells and are usually found on sun exposed sites
It may metastasise
The lesion is faster growing then a BCC and is likely to be tender, with scaly or crusted growths which my ulcerate
What is the treatment of SCC?
Excision and radiotherapy if indicated
If there are high risk factors such as immunosuppression or a large lesion the patient should be followed up
What is Bowen’s Disease?
Squamous cell carcinoma in situ
This lesion is not able to metastasise but will be able to if it is allowed to develop. Some describe these lesions as ‘pre-cancerous’ or an early stage of SCC
They appear as an erythematous scaly patch
What is the treatment for Bowen’s Disease?
Cryotherapy
Imiquimod
C&C - Curettage and cauterage
PDT - Photo-dynamic therapy
What is actinic keratoses?
Rough scaly patches on the skin that are a result of UV damage
What is the treatment for actinic keratoses?
Diclofenac gel
Cryotherapy
C&C
Imiquimod
What is keratoacanthanoma?
A variant of SCC which erupts fro the hair follicles in sun damaged skin
It grows rapidly and may shrink after a few months and resolve
Requires surgical excision
What are suborrhoeic keratoses?
Benign warty growths that look stuck-on
Patients often have multiple cherry angiomas
Generally left untreated but if troublesome consider cryotherapy or C&C
What are the risk factors for melanoma?
UV radiation
Genetic susceptibility - fair skin, red hair, slue eyes and tendency to burn easily
Familial susceptibility
What is the ABCDE rule for melanoma?
Asymmetry Border Colour Diameter Evolution
What is the 7 point checklist for melanoma?
Major features:
Change in size
Change in shape
Change in colour
Minor features: Diameter more than 5mm Inflammation Oozing or bleeding Mild itch or altered sensation
What are some different forms of melanoma?
Superficial spreading Lentigo maligna Nodular Acral lentiginous Subungal Ocular
What is the treatment for malignant melanoma?
Urgent surgical thickness - wide local Sentinel lymph node biopsy Chemotherapy Regular folk up Primary and secondary prevention
