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Dermatology AM > Skin cancer > Flashcards

Skin cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the types of non melanoma skin cancer?

A

Basal cell cancer

Squamous cell cancer

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2
Q

What are the risk factors for basal cell cancer?

A 
UV radiation
Photochemotherapy
Chemical carcinogens
Ionising radiation
HPV
Familial cancer syndromes
Immunosuppression
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3
Q

What is the appearance of basal cell cancer?

A 
P{early, rolled edge
Telangiectasia
Central ulceration
Aboring vessels on dermoscopy
Slow grwing
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4
Q

What is the progression of basal cell cancer?

A

Locally invasive but rarely metastacise

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5
Q

What are the surgical treatment options of basal cell cancer?

A

Excision
Curettage
Mohs surgery

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6
Q

How is a basal cell cancer excised?

A

Ellipse with rim of unaffected skin

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7
Q

What are the pros and cons of excision of basal cell cancer?

A

Curative if fully excised but will scar

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8
Q

What are the indications for Mohs surgery?

A 
Site
Size
Subtype
Poor clinical margin definition
Recurrent
Perineural or perivascular involvement
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9
Q

What are the non surgical treatment options of basal cell cancer?

A

Vismodegib

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10
Q

When is vismodegib used in BCC?

A

Locally advanced BCC not suitable for surgery of radiotherapy

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11
Q

How does vismodegib treat BCC?

A

Selectively inhibits signalling in molecular driver of BC

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12
Q

What are the side effects of vismodegib?

A

Hair loss, weight loss, altered taste

Muscle spasms, nausea, fatigue

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13
Q

What are the risk factors for squamous cell cancer?

A 
UV radiation
Photochemotherapy
Chemical carcinogens
Ionising radiation
HPV
Familial cancer syndromes
Immunosuppression
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14
Q

What are SCCs derived from?

A

Keratinising squamous cells

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15
Q

What are the clinical features of SCC?

A

Can metastasise
Faster growing
Tender, scaly/crusted or fleshy gorwht
Can ucerate

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16
Q

Where are SCCs most common?

A

Sun exposed sites

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17
Q

What is the treatment of SCC?

A

Excision +/- radiotherapy

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18
Q

When should SCC treatment be followed up?

A

If high risk

  • immuno suppressed
  • > 20mm diameter
  • > 4mm depth
  • eyelid, nose, ear or lip
  • perineural invasion
  • poorly differentiated
19
Q

What is a keratocanthoma?

A

Kind of SCC that erupts from hair follicles in sun damaged skin
Grows rapidly, may shrink after a few months and resolve but can be excised

20
Q

What are the risk factors for melanoma?

A

UV radiation
Genetic susceptibility
Familial melanoma and melanoma susceptibility genes

21
Q

What is the ABCDE rule?

A 
Diagnosing melanoma, look for
Asymmetry
Border
Colour
Diameter
Evolution
22
Q

What is the 7 point checklist in the diagnosis of melanoma?

A

Major features- change in size, shape and colour

Minor features- diameter >5mm, inflammation, oozing or bleeding, mild itch or altered sensation

23
Q

What are the types of melanoma?

A 
Superficial spreading malignant melanoma
Lentigo maligna melanoma
Nodular melanoma
ACral lentiginous melanoma/subungal melanoma
Ocular melanoma
24
Q

What is the treatment of melanoma?

A

Urgent surgical excision
Chemo/immunotherapy
Regular followup

25
Q

What are the requirements for excision of a melanoma?

A

Wide local excision

Sentinel lymph node biopsy

26
Q

What chemo is used for metastatic melanoma?

A

Ipilimumab
Pembrolixumab
Vemurafenib and dabrafenib for BRAF mutation

27
Q

What are the causes of cutaneous lymphoma?

A

Primary cutaneous disease

Secondary cutaneous disease

28
Q

What causes secondary cutaneous disease?

A

Systemic/nodular disease

29
Q

What causes primary cutaneous disease?

A

Abnormal neoplastic proliferation of lymphocytes in the skin

30
Q

What are the kinds of primary cutaneous disease?

A

Cutaneous T cell lymphoma

Cutaneous B cell lymphoma

31
Q

What are the types of cutaneous T cell lymphoma?

A

Mycosis fungoides

Sezary syndrome

32
Q

Who is mycosis fungoides most common in?

A

Older patients and men

33
Q

What are the stages of mycosis fungoides?

A

Patch
Plaque
Tumour
Metastatic

34
Q

What are the clinical features of patch mycosis fungoides?

A

Flat, red, dry oval lesions, usually on covered sites
May slowly enlarge or spontaneously resolve
May itch
Difficult to differentiate from eczema or psoriasis

35
Q

What are the clinical features of plaque mycosis fungoides?

A

Patches become thickened and are generally itchy

36
Q

What are the clinical stages of a tumour mycosis fungoides?

A

Large irregular lumps that can ulcerate that can arise from either existing plaques or normal skin

37
Q

What are the clinical features of metastatic mycosis fungoides?

A

Infiltration of neoplastic cells in lymph nodes, blood and solid organs

38
Q

What is Sezary syndrome?

A

Cutaneous T cell lymphoma affecting skin of entire body

39
Q

What are the clinical features of Sezary syndrome?

A

Skin thickened, scaly, red and itchy
Lymph node involvement
Atypical T cells in blood

40
Q

What is the treatment of cutaneous lymphoma?

A 
Topical steroids
UVA or UVB therapy
Localised radiotherapy
Interferon
Bexarotene
Low dose methotrexate
Chemo
Total skin electron beam therapy
Extracorporeal photophoresis
Bone marrow transplant
41
Q

What is total skin electron beam therapy?

A

Type of radiotherapy involving very small electrically charged particles
Delivers radiation primarily to superficial layers and spares deeper tissues

42
Q

What pacers most commonly metastasise to the skin?

A

Breast, colon or lung

43
Q

What is the treatment of cutaneous metastases?

A

Treat underlying malignancy’
Local excision
Localised radiotherapy
Symptomatic

Dermatology AM (9 decks)

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