Skin cancer

Question 1

What is the most aggressive subtype of malignant melanoma?

Answer 1

Nodular melanona - tend to grow rapidly downwards intot he deeper layers of skin increasing in thickness faster than in diameter

Question 2

What are the 4 main subtypes of melanoma and what do they present like?

Answer 2

1. Superficial spreading (moles)
2. Nodular (red or black lump which bleeds and oozes)
3. Lentigo maligna (a growing mole in chronically sun exposed older people)
4. Acral lentiginous (nails palms or soles, in african americas )

Question 3

What kind of cancers are transplant patients at risk of?

Answer 3

Non melanoma skin cancer (SCC)

Question 4

What are risk factors for Squamous cell cancer?

Answer 4

High sun exposure
Actinic keratosis/bolcers wens disease
Immunosupression
Smoking Long standing leg u

Question 5

What is the treatment of squamous cell carcinoma?

Answer 5

Surgical excision with 4mm margins if lesion less than 20mm.
Surgical exision with 6mm margins if more than 20mm

Question 6

What is the most common type of melanoma?

Answer 6

Superficical spreading

Question 7

What is lentigo maligna?

Answer 7

A precursos to lentigo malignan melanoma. It begins as a suspicous flat freckle which can grown over 5 - 20 years. Typically occurs in older people on chronically sun exposed sites.

Question 8

What is acral lentiginous melanoma?

Answer 8

The rarest form of melanoma but commonest in people with dark skin.

Not related to sun exposure

Presents as an enlarging discoloured patch on the palms, finger, soles or toes.

Hutchisons sign in an important sign to recognise and is pigmentation of the nail bed affecting the proximal nail fold

Question 9

How do you treat actinic keratosis?

Answer 9

1. Fluorouracul cream: typically a 2 - 3 week course. Initially the skin becomes red and inflamed at first
2. Topical imiquimob
3. Topical diclofenac
4. Cryotherapy

Question 10

What are the margins of excision in relation to breslow thickness?

Answer 10

Lesions less than 1mm thick: 1cm
1 - 2mm: 1 - 2cm
2-4mm: 2 - 3cm
>4mm: 3cm

Question 11

What is the most common malignancy skin tumour?

Answer 11

Basal cell carcinoma

Question 12

What is the treatment of basal cell carcinoma?

Answer 12

Surgical excision
Mohs surgery
Radiotherapy

Question 13

What is basal cell carcinoma a tumour of?

Answer 13

Epidermal keratinocytes

Question 14

What are the risk factors for BCC?

Answer 14

UV exposure
History of frequent sunburn
Skin type 1
Immunosupression

Question 15

What is SCC a cancer of?

Answer 15

Epidermal keratinocytes

Question 16

What are risk factors for SCC?

Answer 16

Excessive UV exposure

Pre malignant conditions such as actinic keratosis

Question 17

What is the treatment for SCC?

Answer 17

Surgical excision

Mohs surgery

Question 18

What is the ABCDE of malignant melanoma?

Answer 18

Asymmetrical shape 
Border ill defined
Colour irregularity
Diameter over 6mm 
Evolution of lesion 
Symptoms such as bleeding and itching

Question 19

What is the most common body site for melanoma?

Answer 19

Legs in women

Trunk in men