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DERMATOLOGY > 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 Carcinoma (BCC)

Squamous Cell Carcinoma (SCC)

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2
Q

What percentage increase has there been in Scotland for Squamous Cell Carcinoma between 1990 and 2011?

A

334%

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3
Q

What factors may be responsible for the increase in squamous cell carcinoma rates in Scotland?

A

Cheaper air travel
More leisure time
Sun seeking Behaviour
Ageing Population

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4
Q

Roughly how many skin cancers were diagnosed in the UK during 2015?

A

around 250,000

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5
Q

What percentage of skin cancers are melanomas?

A

6%

** BUT THEY ACCOUNT FOR 75% DEATHS**

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6
Q

What feature of melanocytes makes their cancers more likely to metastasize?

A

They are motile cells

unlike keratinocytes

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7
Q

What is the Breslow Thickness?

A

depth to which the tumour has invaded

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8
Q

What is the 5 year survival of a tumour of Breslow thickness <1mm?

A

95-100%

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9
Q

What is the 5 year survival of a tumour of Breslow thickness >4mm?

A

50%

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10
Q

What is the ABCDE to early diagnosis of skin cancer?

A 
A - Asymmetry
B - Border (irregular)
C - Colour (multiple)
D - Diameter (large)
E - Evolution (changing quickly over weeks/months)
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11
Q

What other features should you look out for when diagnosing skin cancer?

A

The “ugly duckling” sign
=> lesion is different from all others that patient has

Excision scars (particularly in same place as current mole)

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12
Q

What cancer is often confused with melanoma in younger people?

A

Pyogenic Granuloma

- type of vascular lesion

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13
Q

What piece of equipment is used to visualise lesions more closely?

A

Dermatoscope

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14
Q

How quickly do Basal Cell Carcinomas arise?

A

Slowly growing lump (OR non healing ulcer)

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15
Q

Are basal cell carcinomas painful?

A

No, therefore patients often ignore them

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16
Q

Do basal cell carcinomas normally metastasize?

A

No, they are locally invasive but don’t spread

17
Q

What treatment can be used for a Basal Cell Carcinoma?

A

Surgical Excision

18
Q

Describe the appearance of a Squamous Cell Carcinoma

A

warty or crusted lump or ulcer
arises on sun-damaged skin
grow faster, may be painful &/or bleed
if neglected may spread

19
Q

Describe the appearance of a basal cell carcinoma

A

‘pearly’ or translucent
visible, arborising blood vessels
central ulceration - “rodent ulcer”

20
Q

What other forms of Basal Cell Carcinoma exist?

A

may present as scaly plaque - ‘superficial’
nodular or nodulocystic
infiltrative - ‘morphoeic’
pigmented

21
Q

What is the risk of metastases in squamous cell carcinoma?

A

3 - 5%

22
Q

What precursor lesions can be responsible for the development of a squamous cell carcinoma?

A

actinic keratoses

Bowen’s disease (carcinoma-in-situ)

23
Q

What percentage of people with a squamous cell carcinoma with develop another keratinocyte cancer within 5 years?

A

50%

24
Q

Name 3 high risk sites fro squamous cell carcinomas

A

Ear
Lip
Scalp

25
Q

Where do squamous cell carcinomas commonly metastasize to?

A

Lymph nodes

Bone

26
Q

What percentage of patients with metastatic squamous cell carcinoma are still alive after 5 years?

A

25%

27
Q

What do multiple actinic keratosis lesions on an area of skin indicate?

A

The whole are of skin underneath the multiple lesions has been sun damaged

28
Q

Describe the appearance of Bowens disease

A

erythematous plaque

29
Q

What are the main risk factors for skin cancer?

A
  1. Sun exposure
  2. Genetic predisposition
  3. Immunosuppression
    (HPV infection)
  4. Other environmental carcinogens
30
Q

What genetic conditions increase the risk of skin cancer?

A
  • DNA repair syndromes, e.g. Xeroderma Pigmentosum
  • Albinism
  • Naevoid basal cell carcinoma (Gorlin’s) syndrome
  • Epidermolysis bullosa
31
Q

How do DNA Repair syndromes e.g. Xeroderma Pigmentosum cause an increased risk of skin cancer?

A

DNA damage by UV cant be repaired and cells replicate with this damage

32
Q

How does Gorlin’s) syndrome predispose to skin cancer?

A

autosomal dominant familial cancer syndrome

33
Q

How does epidermolysis bullosa predispose to skin cancer?

A
  • Abnormality of Collagen 7
  • This usually anchors epidermis and dermis together
  • Without it, the skin blisters and the epidermis is lost
  • SCC can develop on these chronically wounded sites
34
Q

Why does albinism increase skin cancer risk?

A

lack of melanin pigment => no natural sun protection

35
Q

What immunosuppressed patients are most at risk of skin cancer?

A 
organ transplant recipients
chronic inflammatory diseases:
    - arthritis
    - vasculitis
    - inflammatory bowel disease
36
Q

What environmental carcinogens can be respoinsible for an increase in skin cancer?

A
  • ionising radiation
  • arsenic, coal tar,
  • trauma, chronic wounding, scarring
37
Q

What symptoms are common in Xeroderma Pigmentosum

A

Photosensitivity
Photodamage
Neurological degeneration
Increased risk all skin cancers and other cancers

38
Q

What methods can be used to prevent skin cancer

A
  1. Behaviour
    • avoid sun at its height (11am-3pm)
    • use shade wherever possible
    • particular care of babies/children
    • avoid sunbeds
  2. Clothing
    • tightly woven, loose fitting clothing (dark)
    • long sleeves, trousers, skirts
  3. Sunscreens
    • broad spectrum (SPF25+) with UVA protection
    • application important – twice, sufficient
      quantities, re-apply after swimming/towelling
  4. Regular (self-) surveillance

DERMATOLOGY (18 decks)

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