Skin Cancer Flashcards
What is basal cell carcinoma?
Malignant tumour of epidermal keratinocytes
Locally invasive, rarely metastasises
Risk factors of BCC?
UV exposure Frequent sunburn in childhood Fair skin, skin type 1 Age Male Immunodeficiency Genetics
What types of BCC are there? Describe.
Nodular (most common)
Superficial (plaque like)
Cystic, pigmented, others
Describe nodular BCC. Where are they most commonly?
And superficial BCC?
Nodular:
- Small, skin coloured
- Papule or nodule
- Telangiectasia
- Pearly rolled edge
- Could have necrotic or ulcerated centre (rodent ulcer)
- Usually head and neck
Superficial: plaque-like
What is a rodent ulcer?
A BCC which has become ulcerated or necrotic in the centre
Management of BCC?
Surgical excision is gold standard
Micrographic surgery
Radiotherapy
Topical Aldara cream
How does Aldara cream work?
Makes the BCC a target for T cells, so the attack. Can cure the BCC
What is squamous cell carcinoma?
Malignant tumour of epidermal keratinocytes and appendages (so sebaceous glands, hair follicles etc.)
Locally invasive and has potential to metastasise
Risk factors for SCC?
UV exposure
Actinic keratosis: a pre-malignant skin condition
Chronic inflammation: leg ulcers, wound scars
Immunosupression
Genetics
What is actinic keratosis?
Pre-malignant skin condition
Potential to become SCC
What is Bowen’s disease?
An early form of SCC
The abnormal cells are only in the epidermis
Presentation of SCC?
Keratotic (crusty, scaly)
Ill-defined
Ulceration
Management of SCC?
Surgical excision (gold standard)
Micrographic surgery
Radiotherapy
What is malignant melanoma?
Malignant tumour of epidermal melanocytes
Locally invasive and likely to metastasise
Risk factors of MM?
UV exposure Fair skin, skin type 1 Lots of moles Atypical moles Family history Previous MM
Presentation of MM?
A suspicious mole: think ABCDE
Asymmetry Borders irregular Colour: different colours Diameter >6mm Evolution: changing shape, size, colour
Can itch and bleed
Often on legs in women and trunk in men
What is the ABCDE rule?
Signs that point to MM
Asymmetry Borders irregular Colour: different colours Diameter >6mm Evolution + elevation (raised): changing shape, size, colour
What types of MM are there? Which patients are commonly affected by each type?
Superficial spreading: flatter, lower limbs, young people, intermittent high intensity UV exposure
In-situ: only present in epidermis so no chance it could metastasise
Nodular: nodule, trunk, as above
Lentigo: face, elderly, long term exposure to UV
Acral lentigous: palms, soles, nail beds, elderly, no clear relation with UV
Management of MM?
Surgical excision (gold standard)
Radiotherapy
Chemotherapy for metastatic disease
Immunotherapy: B-Raf
Where does MM commonly metastasise to?
Liver
Lungs
Bones
Brain
Eyes
A patient has a changing pigmented lesion. What’s the differential diagnosis?
MM
Melanocytic naevi
Seborrhoeic wart
What is a melanocytic naevus?
- History
- Appearance
- Sites
- Management
Develop during infancy, childhood, adolescence
Asymptomatic
Can be anything: large, small, flat, raised, dark, hairy
Seen all over body
No management needed
What is a Seborrhoeic wart?
- History
- Appearance
- Sites
- Management
Arise in middle age or elderly
Often have many
Warty, greasy papule or nodule
‘Stuck on’
Well defined edges
Often on face or trunk
No management needed
What is skin type 1?
Always burns never tans
