Skin cancer Flashcards
(32 cards)
Name the 3 types of skin cancer
basal cell carcinoma,
squamous cell carcinoma
malignant melanoma
Non melanoma skin cancer includes (2)
basal cell carcinoma
squamous cell carcinoma
Risk factors of non-melanoma skin cancer, i.e. basal cell and squamous cell carcinomas (6)
UV radiation Photochemotherapy - PUVA Chemical carcinogens X-ray and thermal radiation Human papilloma virus Familial cancer syndromes
Most common type of skin cancer
Basal cell carcinoma
Characteristics of basal cell carcinoma
- growth rate
- invasion/metastasis
- initial appearance/type of lesion (i.e. papule/plaque etc)
- appearance when eroded (notice this more)
Slow growth
Local invasion/ rarely metastasise
Initially a pearly papule/ plaque
looks like a non-healing scab when eroded; tumour with rolled borders and central ulceration, maybe telangiectasia
If BCCs are left untreated, they can eventually cause what
ulcer hence why BCCs aka rodent ulcer
Some BCCs are superficial and look like a scaly red flat mark on the skin instead of the classic appearance of the rolled out edges with central ulceration; what might this scaly mark be confused with
bowen’s disease (SCC in situ)
Gold standard treatment of BCCs
+ other treatment options (2)
Surgical excision with 5mm margin
Mohs micrographic surgery
-used for complex BCCs
Chemotherapy - vismodegib
-for complex BCCs
Treatment of superficial BCCs (4)
Curettage + cautery
Cryotherapy
Topical immunotherapy
Photodynamic therapy
Mohs micrographic surgery is used for complex BCCs such as those present at DIFFICULT ANATOMICAL SITES/POOR CLINICAL MARGIN or RECURRENT BCCs if a simple surgical excision can’t be done; what does the procedure involve
excision of the affected skin and examination of the skin removed under the microscope straight away to see if all of the BCC has been removed. If any residual BCC is left at the edge of the excision further skin is excised from that area and examined under the microscope and this process is continued until all of the BCC is removed
Vismodegib (chemotherapy agent)
is sometimes used to treat BCCs if simple surgical excision is not suitable; what are the indications for this
Locally advanced BCC not suitable for surgery or radiotherapy
Metastatic BCC
Characteristics of SQUAMOUS cell carcinoma
- growth rate
- invasion/metastasis
- appearance/type of lesion (i.e. papule/plaque etc)
Faster growing than BCCs
Can metastasise to lymph nodes and distant?
Scaly or crusty raised area of skin with a red, fleshy inflamed base
Sore or tender and can BLEED easily
Treatment of squamous cell carcinomas (2)
Surgical excision
+/- radiotherapy if metastatic
What is a keratocanthoma + metastatic ability
Rapidly evolving tumour of the skin, composed of keratinising squamous cells originating in pilosebaceous follicles (hair follicles)
Low grade; unlikely to invade or metastasise
Resembles SCC
Risk factors of malignant melanomas (5)
UV radiation Genetic susceptibility - fair skin Family history of melanoma Previous skin cancer Atypical navei (mole) or >50 benign melanocytic naevi
What is bowen’s disease
SCC in situ - i.e. only in epidermis
commonly itchy
Premalignant lesion of SCC
Actinic keratoses
Characteristics of a malignant melanoma
- ABCDE rule
- other surrounding signs
Asymmetry B - borders irregular C- colour variability D - diameter >6mm E - evolution of cells
> 50 benign melanocytic navei (moles)
a melanocytic lesion that doesn’t look like the surrounding melanocytic navei
Investigations of a malignant melanoma (2)
Dermatoscopy (using a dermatoscope) - to see if biopsy indicated
Skin biopsy
Types of malignant melanoma (4)
Superficial spreading - most common
Nodular - most likely to metastasise, 2nd commonest
Lentigo maligna melanoma - primarily face
Acral lentinigous - prone in DARK SKINNED PEOPLE; on palms, soles and nails
Treatment of localised malignant melanoma (3)
Surgical excision
+/- sentinel lymph node biopsy
+/- immunotherapy
Treatment of metastatic malignant melanoma
Surgical excision of the primary and metastases if possible
Systemic immunotherapy
-ipilimumab
If it’s a BRAF mutated tumour then targeted therapy is
-vemurafenib/ dabrafenib (BRAF inhibitors)
What staging system is used for malignant melanomas
Breslow thickness
-<1mm is thin; best prognosis
What is lymphoma
Malignancy of WBCs
