Skin cancer

Question 1

What are the two main types of skin cancer?

Answer 1

Non-melanoma SC

Melanoma SC

Question 2

What are the types of non-melanoma skin cancer?

Answer 2

Basal cell carcinoma

Squamous cell carcinoma

Question 3

What is the commonest form of human cancer?

Answer 3

Skin cancer

Question 4

What % of skin cancers are non-melanoma?

Answer 4

90-95%

Question 5

Which skin cancer causes 75% of skin cancer deaths?

Answer 5

melanoma

Question 6

What cells do melanoma arise from?

Answer 6

Melanocytes

Question 7

Which skin cancers are more likely to spread, melanoma or non-melanoma?

Answer 7

Melanoma

Question 8

What is breslow thickness?

Answer 8

The distance between the upper layer of the epidermis and the deepest point of tumor penetration

Question 9

What is the 5 year survival for breslow thickness <1mm?

Answer 9

95-100%

Question 10

What is the 5 year survival for breslow thickness >4mm?

Answer 10

50%

Question 11

What is the 5 year survival for breslow with metastases?

Answer 11

5%

Question 12

What is the ABCDE of melanoma diagnosis?

Answer 12

Asymmetry
Border
Colour
Diameter
Evolution

Question 13

What cancers make up 75% of all skin cancers?

Answer 13

Basal cell carcinomas

Question 14

What do BCCs present as?

Answer 14

Slow growing lump or non-healing ulcer
Translucent
Painless
Telangectasia
Central ulceration

Question 15

Are BCCs painless?

Answer 15

Yes

Question 16

What are four types of BCC?

Answer 16

Superficial
Nodular
Morphoeic
Pigmented

Question 17

What can treat most BCCs?

Answer 17

Skin surgery

Question 18

What cancer makes up 20% of skin cancers?

Answer 18

Squamous cell carcinoma

Question 19

Can SCCs be metastatic?

Answer 19

Yes

Question 20

What is the presentation of SCCs?

Answer 20

Warty or crusted lumps or ulcers
Arise on sun-damaged skin
May be painful or bleed
Can spread if neglected

Question 21

What are precursors to SCC?

Answer 21

Actinic Keratosis

Bowen’s disease

Question 22

What is Keratocanthoma?

Answer 22

Self-resolving form of SCC

Question 23

What are the risk factors for skin cancer?

Answer 23

Sun exposure
Genetic predisposition
Immunosuppression
Environmental carcinogens

Question 24

What is Xeroderma pigmentosum?

Answer 24

DNA repair syndrome

Defect in one of seven nucleotide excision repair genes (NER A-G)

Question 25

What are the symptoms of Xeroderm pigmentosum?

Answer 25

Photosensitivity Skin cancers on sun exposed sites Neurological degeneration Increased risk of other cancers

Question 26

What is Naevoid basal cell carcinoma (Gorlin's syndrome)?

Answer 26

Autosomal dominant cancer syndrome

Question 27

What are the major features of Gorlin's syndrome?

Answer 27

Early onset BCCs Palmar pits Jaw cysts Ectopic calcification falx

Question 28

What are minor features of gorlin's syndrome?

Answer 28

Skeletal abnormality OFC>97th centile Cardiac/Ovarian fibroma Medulloblastoma

Question 29

What are examples of immunosuppression that can increase risk of skin cancer?

Answer 29

HPV infection Organ transplant Chronic inflammatory disease

Question 30

What are some environmental carcinogens that can increase risk of skin cancer?

Answer 30

``` Coal tar Smoking Radiation Trauma Chronic ulceration ```

Question 31

Which factors can help prevent skin cancers?

Answer 31

Behaviour Clothing Sunscreens Self-surveillance

Question 32

Which behavioural factors can prevent skin cancers?

Answer 32

Avoid sun at its height (11am-3pm) Use shade wherever possible Particular care of babies and children Avoid sunbeds

Question 33

Which clothing improvements can be made to prevent skin cancers?

Answer 33

Tightly woven, loose fitting dark clothing Long sleeves Trousers

Question 34

How should sunscreen be used to prevent skin cancers?

Answer 34

Broad spectrum with UVA protection SPF 25++ 2 applications Reapply after swimming