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Year 2 - Dermatology > Skin cancer > Flashcards

Skin cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

Name the 3 types of skin cancer

A

basal cell carcinoma,
squamous cell carcinoma
malignant melanoma

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2
Q

Non melanoma skin cancer includes (2)

A

basal cell carcinoma

squamous cell carcinoma

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3
Q

Risk factors of non-melanoma skin cancer, i.e. basal cell and squamous cell carcinomas (6)

A 
UV radiation
Photochemotherapy - PUVA
Chemical carcinogens
X-ray and thermal radiation
Human papilloma virus
Familial cancer syndromes
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4
Q

Most common type of skin cancer

A

Basal cell carcinoma

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5
Q

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)
A

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

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6
Q

If BCCs are left untreated, they can eventually cause what

A

ulcer hence why BCCs aka rodent ulcer

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7
Q

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

A

bowen’s disease (SCC in situ)

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8
Q

Gold standard treatment of BCCs

+ other treatment options (2)

A

Surgical excision with 5mm margin

Mohs micrographic surgery
-used for complex BCCs

Chemotherapy - vismodegib
-for complex BCCs

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9
Q

Treatment of superficial BCCs (4)

A

Curettage + cautery
Cryotherapy
Topical immunotherapy
Photodynamic therapy

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10
Q

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

A

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

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11
Q

Vismodegib (chemotherapy agent)

is sometimes used to treat BCCs if simple surgical excision is not suitable; what are the indications for this

A

Locally advanced BCC not suitable for surgery or radiotherapy

Metastatic BCC

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12
Q

Characteristics of SQUAMOUS cell carcinoma

  • growth rate
  • invasion/metastasis
  • appearance/type of lesion (i.e. papule/plaque etc)
A

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

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13
Q

Treatment of squamous cell carcinomas (2)

A

Surgical excision

+/- radiotherapy if metastatic

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14
Q

What is a keratocanthoma + metastatic ability

A

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

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15
Q

Risk factors of malignant melanomas (5)

A 
UV radiation
Genetic susceptibility - fair skin
Family history of melanoma
Previous skin cancer
Atypical navei (mole) or >50 benign melanocytic naevi
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16
Q

What is bowen’s disease

A

SCC in situ - i.e. only in epidermis

commonly itchy

17
Q

Premalignant lesion of SCC

A

Actinic keratoses

18
Q

Characteristics of a malignant melanoma

  • ABCDE rule
  • other surrounding signs
A 
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

19
Q

Investigations of a malignant melanoma (2)

A

Dermatoscopy (using a dermatoscope) - to see if biopsy indicated

Skin biopsy

20
Q

Types of malignant melanoma (4)

A

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

21
Q

Treatment of localised malignant melanoma (3)

A

Surgical excision
+/- sentinel lymph node biopsy
+/- immunotherapy

22
Q

Treatment of metastatic malignant melanoma

A

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)

23
Q

What staging system is used for malignant melanomas

A

Breslow thickness

-<1mm is thin; best prognosis

24
Q

What is lymphoma

A

Malignancy of WBCs

25
Q

Commonest cutaneous lymphoma

A

cutaneous T cell lymphoma

26
Q

Name 2 forms of cutaneous T cell lymphomas

A

Mycosis fungoides

Sezary syndrome

27
Q

Mycosis fungoides clinical features (2)

A

May present with flat patches –> become raised plaques –> become tumours, or combination of all

Pruritus

28
Q

Clinical features of sezary syndrome (‘red man syndrome’) - a form of cutaneous T cell lymphoma (3)

A

Affects skin of entire body

Presents as ERYTHRODERMA (Affecting >90% skin)
PRURITUS
Skin thickened, scaly and red

29
Q

Treatment of cutaneous lymphoma (e.g. mycosis fungoides and sezary syndrome) depends on the stage but what are the options

A 
Topical steroids
UVA/UVB (phototherapy)
Localised radiotherapy
Interferon alpha - biologic
Bexarotene (retinoid) - slow cell growth
Methotrexate
Chemo
Total skin electron beam therapy - mainly to superficial skin layers
Extracorporeal photophoresis
30
Q

Extracorporeal photophoresis (Step 1
Patients blood is drawn and leucocytes collected
Step 2
Collected white cells mixed with psoralen which makes the T-Cells sensitive to UVA radiation
Step 3
Exposed to UVA radiation, damaging diseased cells
Step 4
Treated cells re-infused back to patient)

is used to treat what

A

Cutaneous lymphoma, esp sezary syndrome

31
Q

Cutaneous metastases are usually from what primaries (3)

A

Breast
Colon
Lung

32
Q

Principles of treatment of cutaneous metastases from a primary (4)

A

Treat the underlying malignancy
Local excision
Localised radiotherapy
Symptomatic relief

Year 2 - Dermatology (10 decks)

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