Skin Cancer Flashcards

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1
Q

What are the 2 types of non-melanoma skin cancers?

A

Basal cell and squamous cell cancer

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2
Q

What are the risk factors for non-melanoma skin cancers?

A
Causation skin types 
UV radiation
Photo chemotherapy - PUVA 
Chemical carcinogens
X-ray and thermal radiation
Human papilloma virus 
Familial cancer syndromes
Immunosuppression
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3
Q

What type of non -melanoma skin cancer is slow growing ?

A

Basal cell

Squamous cell is faster growing

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4
Q

What does basal cell carcinoma look like?

A

Nodular with pearly rolled edge
Telangiectasis
Central ulceration
Arborising vessels on dermoscopy (telangiectasias with tree branching appearance)

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5
Q

What is characteritic of basal cell carcinoma on dermatoscopy?

A

Arborising vessels

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6
Q

What are superifical basal cell carcinomas termed as?

A

Morphoeic

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7
Q

What is the treatment for basal cell carcinoma?

A

Excision
Curettage in some circumstances
Vismodegib (when surgery isnt an option)
Mohs surgery

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8
Q

How would you investigate would you carry out if you suspected skin cancerous lesion?

A

Dermatoscope

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9
Q

What is squamous cell carcinoma associated with?

A

Immunosppression and smoking

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10
Q

Where do you normally find suqmaous cell carcinomas?

A

Sun exposed areas of the skin

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11
Q

What does squamous cell carcinomas look like?

A

Tender / painful
Scaly / crusted
Fleshy
Can ulcerate

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12
Q

What is the treatment for squamous cell caricnoma?

A

Excision

+/- radiotherapy

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13
Q

What high risk patients will be followed up after 3 years of removal of squmaous cell carcinoma?

A
Immunosuppressed (transplant patients)
> 20 mm diameter
> 5mm depth
Ear, node, lip, eyelid
Perineural invasion (invading along nerves)
Poorly differentiated
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14
Q

What is keratokanthoma and what it is presentation?

A

Variant of squamous cell carcinoma
erupts from hair follicles in sun damaged skin
Grows rapidly (may resolve itself or need excision)

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15
Q

What are the risk factors for melanoma skin cancer?

A

UV radiation
Genetic suseptibility - fair skin, red hair, blue eyes, burn easily
Familial melanoma and melanoma susceptible genes

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16
Q

What is the ABCDE rule for identifying melanoma?

A
Asymmetry 
Border (il-defined) 
Colour (different colours)
Diameter ( > 6MM)
Evolution (is it changing)
17
Q

What are common sites of metastatsis of melanoma?

A

Lung, liver and brain

18
Q

What criteria is used to stage melanoma ?

A

Breslow thickness

19
Q

What are the tretaments for melanoma?

A

Surgical excision
Sentinel lymph node biopsy
Chemotherapy
Primary and secondary prevention

20
Q

If there is positive lymph node involvement what stage is the melanoma?

A

Stage 3

21
Q

If there is mets what stage is the melanoma?

A

Stage 4

22
Q

What is the tretament for metastatic melanoma?

A

Immunotherapy + excision

23
Q

What is cutaneous lymphoma?

A

Abnormal neoplastic proliferation of lymphocytes in the skin
- cutaneous B or T cell lymphoma
Can be primary or secondary to systemic lymphoma

24
Q

What is the most common type of cutaneous T cell lymphoma?

A

Mycosis fungoides

25
Q

What are the 4 stages of progression of mycosis fungoides ?

A

Patch
Plaque
Tumour
Metastasis

26
Q

What is the presntation of an early stage mycocis fungoides patch?

A

Flat, red, dry oval lesions
May slowly enlarge
May itch
Difficult to differentiate between eczema and psorias

27
Q

Why is mycosis fungoides difficult to differentiate between eczema and psoriasis and how would you determine between the two?

A

Due to the red, dry oval patches

They wouldnt respond to eczema/psoriasis treatment

28
Q

What investigations would you carry out if you suspected mycosis fungoides?

A

Blood for sezary cells

CT scan for staging

29
Q

What is sezary syndorme?

A

An aggressive form of cutaneous t cell lymphoma that affects the skin of the entire body

30
Q

What is the presentation of sezary syndrome?

A

Red man syndrome
Patient is erythrodermic affecting skin of entire body
Skin is thickened, scaly and red
Very itchy

31
Q

What is the prognosis of sezary syndrome with lymph node involvement?

A

2-4 years

32
Q

What is the treatment for cutaneous lymphoma?

A
Topical steroids
PUVA or UVB
Localised radiotherapy
Interferon
Bexarotene
Low dose methotrexate 
Chemotherapy
Total skin electron beam therapy 
Extracorporeal photohoresis
33
Q

From what cancers do cutaneous metastasis commonly arise?

A

Breast
Colon
Lung

34
Q

What is the indication of the use of Vismodegib?

A

Vismodegib used to treat basal cell carcinoma that cannot be cured with excision

35
Q

What is the indication of mohs surgery?

A

Used to treat basal cell carcinoma and at the same time biopsy to make sure all margins are excised

36
Q

what is the term used to describe pigmented and superficial basal cell carcinomas?

A
Superficial = morphoeic
Pigmented = monomorphic
37
Q

What does squamous cell carcinoma develop from?

A

Keratinizing squamous cells