Skin Cancer Flashcards
What are the 2 types of non-melanoma skin cancers?
Basal cell and squamous cell cancer
What are the risk factors for non-melanoma skin cancers?
Causation skin types UV radiation Photo chemotherapy - PUVA Chemical carcinogens X-ray and thermal radiation Human papilloma virus Familial cancer syndromes Immunosuppression
What type of non -melanoma skin cancer is slow growing ?
Basal cell
Squamous cell is faster growing
What does basal cell carcinoma look like?
Nodular with pearly rolled edge
Telangiectasis
Central ulceration
Arborising vessels on dermoscopy (telangiectasias with tree branching appearance)
What is characteritic of basal cell carcinoma on dermatoscopy?
Arborising vessels
What are superifical basal cell carcinomas termed as?
Morphoeic
What is the treatment for basal cell carcinoma?
Excision
Curettage in some circumstances
Vismodegib (when surgery isnt an option)
Mohs surgery
How would you investigate would you carry out if you suspected skin cancerous lesion?
Dermatoscope
What is squamous cell carcinoma associated with?
Immunosppression and smoking
Where do you normally find suqmaous cell carcinomas?
Sun exposed areas of the skin
What does squamous cell carcinomas look like?
Tender / painful
Scaly / crusted
Fleshy
Can ulcerate
What is the treatment for squamous cell caricnoma?
Excision
+/- radiotherapy
What high risk patients will be followed up after 3 years of removal of squmaous cell carcinoma?
Immunosuppressed (transplant patients) > 20 mm diameter > 5mm depth Ear, node, lip, eyelid Perineural invasion (invading along nerves) Poorly differentiated
What is keratokanthoma and what it is presentation?
Variant of squamous cell carcinoma
erupts from hair follicles in sun damaged skin
Grows rapidly (may resolve itself or need excision)
What are the risk factors for melanoma skin cancer?
UV radiation
Genetic suseptibility - fair skin, red hair, blue eyes, burn easily
Familial melanoma and melanoma susceptible genes
What is the ABCDE rule for identifying melanoma?
Asymmetry Border (il-defined) Colour (different colours) Diameter ( > 6MM) Evolution (is it changing)
What are common sites of metastatsis of melanoma?
Lung, liver and brain
What criteria is used to stage melanoma ?
Breslow thickness
What are the tretaments for melanoma?
Surgical excision
Sentinel lymph node biopsy
Chemotherapy
Primary and secondary prevention
If there is positive lymph node involvement what stage is the melanoma?
Stage 3
If there is mets what stage is the melanoma?
Stage 4
What is the tretament for metastatic melanoma?
Immunotherapy + excision
What is cutaneous lymphoma?
Abnormal neoplastic proliferation of lymphocytes in the skin
- cutaneous B or T cell lymphoma
Can be primary or secondary to systemic lymphoma
What is the most common type of cutaneous T cell lymphoma?
Mycosis fungoides
What are the 4 stages of progression of mycosis fungoides ?
Patch
Plaque
Tumour
Metastasis
What is the presntation of an early stage mycocis fungoides patch?
Flat, red, dry oval lesions
May slowly enlarge
May itch
Difficult to differentiate between eczema and psorias
Why is mycosis fungoides difficult to differentiate between eczema and psoriasis and how would you determine between the two?
Due to the red, dry oval patches
They wouldnt respond to eczema/psoriasis treatment
What investigations would you carry out if you suspected mycosis fungoides?
Blood for sezary cells
CT scan for staging
What is sezary syndorme?
An aggressive form of cutaneous t cell lymphoma that affects the skin of the entire body
What is the presentation of sezary syndrome?
Red man syndrome
Patient is erythrodermic affecting skin of entire body
Skin is thickened, scaly and red
Very itchy
What is the prognosis of sezary syndrome with lymph node involvement?
2-4 years
What is the treatment for cutaneous lymphoma?
Topical steroids PUVA or UVB Localised radiotherapy Interferon Bexarotene Low dose methotrexate Chemotherapy Total skin electron beam therapy Extracorporeal photohoresis
From what cancers do cutaneous metastasis commonly arise?
Breast
Colon
Lung
What is the indication of the use of Vismodegib?
Vismodegib used to treat basal cell carcinoma that cannot be cured with excision
What is the indication of mohs surgery?
Used to treat basal cell carcinoma and at the same time biopsy to make sure all margins are excised
what is the term used to describe pigmented and superficial basal cell carcinomas?
Superficial = morphoeic Pigmented = monomorphic
What does squamous cell carcinoma develop from?
Keratinizing squamous cells
