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Cancer Care > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

What are the 4 types of malignant melanoma?

A

Superficial spreading
Nodula
Lentigo maligna
Acral lentiginous

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2
Q

What is a superficial spreading melanoma?

A

A large flat lesion that grows laterally before invading vertically. i.e. a growing mole

It is the most common

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3
Q

What is a nodular melanoma?

A

Rapidly growing aggressive pigmented (red or black) nodule that bleeds and ulcerates

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4
Q

What is a lentigo maligna melanoma?

Who is it often seen in?

A

A patch of lentigo maligna grows a papule or nodule. i.e. a growing mole

Elderly people with chronic sun exposure

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5
Q

What is a lentigo maligna?

A

It is an area of “sun damaged skin” that is a melanoma in situ

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6
Q

What is an acral lentiginous melanoma?

Who is it often seen in?

A

Lesion under the nail (black patch on nail) , on the sole of the foot or palm of the hand. It is the most common type for dark skinned people

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7
Q

What are the risk factors for developing skin cancer?

A 
Naevi > 100 (>5x increased risk)
Bursts of sun exposure
Severe sunburn
Sun bed use <30y/o
Family history
Immunosuppression
Fitzpatrick skin type 1 or 2
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8
Q

What is the system used to describe a skin lesion?

A 
A - asymmetry
B - border irregularity
C - colour (varies)
D - diameter (greater than 6mm)
E - evolving (change in shape, size or shade)
F - funny looking
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9
Q

What are the major and minor criteria of signs and symptoms for malignant melanoma?

A

2 points each for:
change in colour
change in size
change in shape

1 point each for:
>7mm
Inflamed
Sensation change
Oozing
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10
Q

What is the criteria for referring a suspected skin cancer?

A

3 points or more - refer

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11
Q

Where do malignant melanomas metastasise?

A

Bone, brain, lung, liver

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12
Q

Describe the parts of TNM Staging for malignant melanomas

A

0 - confined to epidermis
1a - <1mm non ulcerating
1b - <1mm ulcerating OR 1-2mm non ulcerating
2a - 1-2mm ulcerating OR 2-4mm non ulcerating
2b - 2-4mm ulcerating OR >4mm non ulcerating
2c - >4mm ulcerating
3 - Lymph Node Involvement
4 - Metastatic melanoma

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13
Q

What investigations are carried out for malignant melanomas?

A

Full thickness excision biopsy with 2mm margins

+/- SLNB with blue dye

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14
Q

What are some poor prognostic indicators for malignant melanoma?

A

High Breslow thickness
Ulcerated
Node involvement
Location of head, neck, back of arms

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15
Q

What is the breslow thickness?

A

Depth from epidermal granular layer to the base of the tumour at thickest point

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16
Q

What is first line management for malignant melanomas?

A

Wide Local Excision with margins dependant on Breslow thickness

17
Q

Describe how BCC grow

A

Slow growing
Locally Invading
Very rarely metastasis

18
Q

What cells do BCC’s arise from?

A

epidermal tumours arising from hair follicles

19
Q

What areas are predominantly affected by BCC?

A

areas of UV radiation - head and neck but not ear

20
Q

How do BCC’s appear?

A

Pearly and translucent nodule
Telangiectasia
Indurated/ rolled edge
Ulcerated centre

21
Q

How do SCC’s appear?

A 
nodules on head and neck
ulcerated lesion
hard raised edges
bleeding
rapidly growing
22
Q

How are SCC’s investigated?

A

excision biopsy first

then MRI/CT to assess spread

FNA can be done to assess enlarged lymph nodes

23
Q

How are BCC’s and SCC’s managed?

A 
Surgical excision - gold standard
Mohs micrographic surgery
Cryotherapy
Topical imiquimod and flourouracil 
Radiotherapy
Active surveillance
24
Q

What is Mohs micrographic surgery?

A

Individual layers of cancer tissue are removed and examined under a microscope one at a time until all cancer tissue has been removed

25
Q

What chemotherapy agents are used for BCC’s?

A

topical imiquimod or fluorouracil

26
Q

What are the risk factors for SCC?

A 
Immunosuppression (renal transplant patients) 
Smoking
Solar keratosis 
Bowens disease
Long-standing leg ulcers (Marjolijn's)
27
Q

What are the complications of surgery for SCC and BCC?

A

Scarring and contractures can distort the face

Facial numbness

Cancer Care (25 decks)

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