Skin cancer

Question 1

Types

Answer 1

Malignant melanoma
Squamous cell carcinoma
Basal cell carcinoma

Question 2

What is malignant melanoma

Answer 2

Cancer of melanocytes

Question 3

What is squamous cell carcinoma

Answer 3

Cancer of squamous cells

Question 4

What is Basal cell carcinoma

Answer 4

Cancer of the basal cells

Question 5

Malignant melanoma pathophysiology

Answer 5

Melanocytes in the basal layer of the epidermis.
Spread out within the epidermis (if within epidermis then melanoma in situ, if grown through the dermis then invasive).
Metastases can occur virtually anywhere.

Question 6

Aetiology of malignant melanoma

Answer 6

Strong association with sun exposure. Those with over 100 moles (or >2 atypical) have 5-20 fold increased risk

Question 7

*Clinical presentation of malignant melanoma

Answer 7

Distinguished from moles by 
Asymmetry 
Border irregularity 
Colour variation 
Diameter 
Elevation (Evolving?)

Question 8

Epidemiology of malignant melanoma

Answer 8

More common in caucasians

Question 9

Diagnostic tests of skin cancer

Answer 9

Clinical examination then biopsy

Question 10

Treatment of malignant melanoma

Answer 10

Wide local excision

Metastases are resistant to all treatments

Question 11

Complications of malignant melanoma

Answer 11

Metastasis

Question 12

Pathophysiology of squamous cell carcinoma

Answer 12

*Arises from the keratinising cells of the epidermis or its appendages.
Locally invasive, and has the potential to metastasise (rarely).

Question 13

Aetiology of squamous cell carcinoma

Answer 13

Strong association with sunlight.

Immunosuppression associated with multiple tumours.

Question 14

Epidemiology of squamous cell carcinoma

Answer 14

20% of non melanoma skin cancers

Question 15

*Clinical presentation of squamous cell carcinoma

Answer 15

ill defined nodules that ulcerate easily and grow rapidly.
Keratotic (hard raised edges).
Sun exposed sites.

Question 16

Treatment of squamous cell carcinoma

Answer 16

Local excision

Radiotherapy (occasionally)

Question 17

Complications of squamous cell carcinoma

Answer 17

Metastases are rare (5%) but very hard to treat

Question 18

Pathophysiology of basal cell carcinoma

Answer 18

Slow growing, locally invasive malignant epidermal tumour.
Thought to arise from hair follicles.
Infiltrates local tissues through slow irregular growth of fingerlike outgrowths

Question 19

Aetiology of basal cell carcinoma

Answer 19

Sun exposure.
Genetic predisposition.
Increasing age, male sex are RF.

Question 20

Epidemiology of basal cell carcinoma

Answer 20

80% of non-melanoma skin cancers

Question 21

*Clinical presentation of basal cell carcinoma

Answer 21

Sun exposed areas.
Early: Small, translucent or pearly and have raised areas with telangiectasia.
Later: Indurated edge and ulcerated centre.

Question 22

Treatment of basal cell carcinoma

Answer 22

Local excision
Radiotherapy
Cryotherapy
Photodynamic therapy

Question 23

Complications of basal cell carcinoma

Answer 23

Metastases are rare (5%) but very hard to treat.

Damage occurs if local spread reaches other structures.