Skin Cancer Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Why is early diagnosis essential in MM?
What % of skin cancers does it make up?
What % of skin cancer deaths does it make up?

A

It is a cancer that spreads at an early stage and once spread is very difficult to treat.
5% of skin cancers
75% of deaths?

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2
Q

What does MM survival generally depend on

A

Tumour depth

  • Less than 1mm, the 5 year survival is excellent
  • Greater than 4mm, only half of the patients will survive
  • Evidence of distant spread only 5% will survive 5 years
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3
Q

Which pnemonic should you use when diagnosing melanoma?

A

ABCDE rule

  • A – Asymmetry
  • B – Border
  • C – Colour
  • D – Diameter
  • E – Evolution
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4
Q

What is the most common skin cancer?

  • How does it present?
  • Does it metastasize?
  • What age?
A

Basal cell carcinoma

  • Slow growing lump or non-healing ulcer; painless and often ignored
  • ‘Pearly’ or translucent
  • Visible, arborising blood vessels
  • Central ulceration - “rodent ulcer”
  • Can present as scaly plaque - ‘superficial’
  • Can be infiltrative - ‘morphoeic’
  • Locally invasive, but rarely metastasize
  • > 40 yrs, but can be 3rd or 4th decade
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5
Q

How does squamous cell carcinoma tend to present?

Risk of metastasis?

A

SCCs can present in a number of ways including a warty or crusted growth or a non-healing ulcer. They usually arise on sun-damaged skin and tend to grow faster and may be painful.

  • Hyperkeratotic (crusted) lump or ulcer
  • Arises on sun-damaged skin
  • Grow relatively fast, may be painful &/or bleed
  • Majority - well differentiated low risk SCC
  • Minority - poorly differentiated high risk SCC
  • Risk of metastasis about 5%
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6
Q

What are two precursors to squamous cell carcinoma?

A

Actinic keratoses

Bowen’s disease

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7
Q

Where does SCC tend to metastasize to?

A

Lymph nodes & bone

Once it has metastasized, 5 year survival is 25%

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8
Q

Name some risk factors for skin cancer

A
  • Sun exposure
  • Genetic predisposition
  • Immunosuppression
  • (HPV infection)
  • Other environmental carcinogens e.g. coal tar, smoking, ionising radiation, arsenic, trauma, chronic ulceration
  • Genetic susceptibility
    e. g. Xeroderma Pigmentosum, Albinism, Naevoid basal cell carcinoma (Gorlin’s) syndrome
  • Other environmental carcinogens e.g. ionising radiation, arsenic, chronic ulceration etc
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9
Q

What is xeroderma pigmentosum characterized by?

A
  • 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)
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10
Q

What is Naevoid basal cell carcinoma (Gorlin’s) syndrome?
Major features?
Minor features?

A
This is an autosomal dominant familial cancer syndrome (1 in 57,000). 
Major features
- Early onset/multiple BCCs
- Palmar pits
- Jaw cysts
- Ectopic calcification falx
Minor features
- Skeletal abnormality
- OFC >97th centile
- Cardiac/ovarian fibroma
- Medulloblastoma
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11
Q

Give some treatment options for non-melanoma skin cancer

A
  • Surgery
  • Photodynamic therapy
  • Cryotherapy
  • Chemo/radiotherapy
  • 5-fluroucacil
  • Solaraze
  • Imiquimoid - an immune modifier; non-surgical; can be used on pre-cancer
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12
Q

What is the treatment for actinic keratosis?

A

ALA PDT (photodynamic light therapy) – aminolevulinic acid is put directly onto lesions of actinic keratosis, then blue light is used. It can show good results and is non-surgical.

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13
Q

How does imiquimoid cream work?

A

Immune modifier

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14
Q

Give three treatment options for pre-cancers e.g. sun aged skin

A
  • Solaraze
  • 5 FU
  • Resurfacing
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15
Q

Give four methods of local anaesthesia

A

Topical – e.g. numbing gel at the dentist so you don’t feel the injection.
Local infiltration – local anaesthesia injected at site for minor procedures.
Nerve block – local anaesthetic is deposited within close proximity to the larger nerve branches e.g. at the dentist.
Field block – local anaesthetic is deposited toward larger nerve terminal branches; treatment is done away from the site of local anaesthetic.

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16
Q

What does adrenaline do in anaesthetics?

Where should you not use it?

A

Adrenaline reduces bleeding, prolongs action of anaesthesia; avoid in fingers and toes; avoid in patients with cardiac disease and those on psychotropic drugs.