Skin Cancer

Question 1

What are the risk factors for non melanoma skin cancer?

Answer 1

UV radiation 
Photochemotherapy 
Chemical carcinogens 
X ray and thermal radiation 
Human papilloma virus 
Familial cancer syndromes 
Immunosuppression

Question 2

What is the clinical appearance of basal cell carcinoma?

Answer 2

Slow growing 
Locally invasive 
Telangiectasia 
Central ulceration 
Pearly rolled edge

Question 3

What is the treatment for basal cell carcinoma?

Answer 3

Excision
Curettage
Mohs surgery
Vismodegib

Question 4

What are the indications for vismodegib?

Answer 4

Locally advanced BCC not suitable for surgery or radiotherapy
Metastatic BCC

Question 5

What are the side effects of vismodegib?

Answer 5

Hair loss 
Weight loss 
Altered taste 
Muscle spasms 
Nausea 
Fatigue

Question 6

What is the clinical appearance of squamous cell carcinoma?

Answer 6

Faster growing 
Tender 
Scaly/crusted 
Fleshy growths 
Can ulcerate

Question 7

What is the treatment for squamous cell carcinoma?

Answer 7

Excision

Radiotherapy

Question 8

What is the criteria for a high risk squamous cell carcinoma?

Answer 8

Immunosuppressed 
Diameter >20mm 
>4mm depth 
Ear, nose, lip, eyelid 
Perineural invasion 
Poorly differentiated

Question 9

What is the origin of a keratoacanthoma?

Answer 9

Hair follicle in sun damaged skin

Question 10

What is the treatment for keratoacanthoma?

Answer 10

Excision

Question 11

What are the risk factors for melanoma skin cancer?

Answer 11

UV radiation
Fair skin, red hair, blue eyes
Tendency to burn easily
Familial melanoma and melanoma susceptibility genes

Question 12

What is the ABCDE rule?

Answer 12

Asymmetry 
Border 
Colour 
Diameter 
Evolution

Question 13

What are the major features of melanoma skin cancer?

Answer 13

Change in size
Change in shape
Change in colour

Question 14

What are the minor features of melanoma skin cancer?

Answer 14

Diameter more than 5mm
Inflammation
Oozing or bleeding
Mild itch or altered sensation

Question 15

What are some types of melanoma skin cancer?

Answer 15

Superficial spreading malignant melanoma 
Lentigo maligna melanoma 
Nodular melanoma 
Acral lentiginous melanoma 
Ocular melanoma 
Metastatic melanoma

Question 16

What is the treatment for melanoma skin cancer?

Answer 16

Urgent wide margin surgical excision (Breslow thickness) 
Sentinel lymph node biopsy 
Chemotherapy/immunotherapy 
Regular follow up 
Primary and secondary prevention

Question 17

What are the biologics used to treat metastatic melanoma?

Answer 17

Ipilimumab
Pembrolizumab
Vemurafenib

Question 18

What cells are can be affected by cutaneous lymphoma?

Answer 18

Cutaneous T cell

Cutaneous B cell

Question 19

What are the different stages of mycosis fungoides?

Answer 19

Patch
Plaque
Tumour
Metastatic

Question 20

What is sezary syndrome also known as?

Answer 20

Red man syndrome

Question 21

What is the treatment for cutaneous lymphoma?

Answer 21

Topical steroids 
PUVA or UVB 
Localised radiotherapy 
Interferon 
Bexarotene 
Low dose methotrexate 
Chemotherapy 
Total skin electron beam therapy 
Extracorporeal photophoresis 
Bone marrow transplantation

Question 22

What are the steps of extracorporeal photophoresis?

Answer 22

Patients blood drawn and leucocytes collected
WBC mixed with psoralen, makes T cells sensitive to UVA radiation
Exposed to UVA radiation, damges diseased cells
Treated cells re infused back to patient

Question 23

What is the management for cutaneous metastases?

Answer 23

Treat underlying malignancy
Local excision
Localised radiotherapy
Symptomatic