Skin Cancer Flashcards
What are the risk factors for non melanoma skin cancer?
UV radiation Photochemotherapy Chemical carcinogens X ray and thermal radiation Human papilloma virus Familial cancer syndromes Immunosuppression
What is the clinical appearance of basal cell carcinoma?
Slow growing Locally invasive Telangiectasia Central ulceration Pearly rolled edge
What is the treatment for basal cell carcinoma?
Excision
Curettage
Mohs surgery
Vismodegib
What are the indications for vismodegib?
Locally advanced BCC not suitable for surgery or radiotherapy
Metastatic BCC
What are the side effects of vismodegib?
Hair loss Weight loss Altered taste Muscle spasms Nausea Fatigue
What is the clinical appearance of squamous cell carcinoma?
Faster growing Tender Scaly/crusted Fleshy growths Can ulcerate
What is the treatment for squamous cell carcinoma?
Excision
Radiotherapy
What is the criteria for a high risk squamous cell carcinoma?
Immunosuppressed Diameter >20mm >4mm depth Ear, nose, lip, eyelid Perineural invasion Poorly differentiated
What is the origin of a keratoacanthoma?
Hair follicle in sun damaged skin
What is the treatment for keratoacanthoma?
Excision
What are the risk factors for melanoma skin cancer?
UV radiation
Fair skin, red hair, blue eyes
Tendency to burn easily
Familial melanoma and melanoma susceptibility genes
What is the ABCDE rule?
Asymmetry Border Colour Diameter Evolution
What are the major features of melanoma skin cancer?
Change in size
Change in shape
Change in colour
What are the minor features of melanoma skin cancer?
Diameter more than 5mm
Inflammation
Oozing or bleeding
Mild itch or altered sensation
What are some types of melanoma skin cancer?
Superficial spreading malignant melanoma Lentigo maligna melanoma Nodular melanoma Acral lentiginous melanoma Ocular melanoma Metastatic melanoma
What is the treatment for melanoma skin cancer?
Urgent wide margin surgical excision (Breslow thickness) Sentinel lymph node biopsy Chemotherapy/immunotherapy Regular follow up Primary and secondary prevention
What are the biologics used to treat metastatic melanoma?
Ipilimumab
Pembrolizumab
Vemurafenib
What cells are can be affected by cutaneous lymphoma?
Cutaneous T cell
Cutaneous B cell
What are the different stages of mycosis fungoides?
Patch
Plaque
Tumour
Metastatic
What is sezary syndrome also known as?
Red man syndrome
What is the treatment for cutaneous lymphoma?
Topical steroids PUVA or UVB Localised radiotherapy Interferon Bexarotene Low dose methotrexate Chemotherapy Total skin electron beam therapy Extracorporeal photophoresis Bone marrow transplantation
What are the steps of extracorporeal photophoresis?
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
What is the management for cutaneous metastases?
Treat underlying malignancy
Local excision
Localised radiotherapy
Symptomatic
