Skin Cancer Flashcards
Two main divisions of skin cancer
Non-melanoma (basal cell carcinoma and squamous call carcinoma)
Melanoma (malignant melanoma) (most life-threatening)
What is the most single preventable risk factor for skin cancer?
Sun exposure.
Basal Cell Carcinoma: Description
A slow-growing, locally invasive malignant tumour of the epidermal keratinocytes normally in older individuals, only rarely metastasises.
Basal cell carcinoma: Causes/Risk factors
UV exposure, history of frequent or severe sunburn in childhood, skin type I (always burns, never tans), increasing age, male sex, immunosuppression, previous history of skin cancer, and genetic predisposition.
Basal cell carcinoma: Presentation
Various morphological types:
Nodular (most common),
Superficial (plaque-like),
Cystic,
Morphoeic (sclerosing),
Keratotic and pigmented.
Basal cell carcinoma: Management
Surgical excision - treatment of choice as it allows histological examination of the tumour and margins.
Radiotherapy - when surgery is not appropriate.
Other e.g. cryotherapy, curettage and cautery - for small and low-risk lesions
Squamous cell carcinoma: Description
A locally invasive malignant tumour of the epidermal keratinocytes or its appendages, which has the potential to metastasise.
Squamous cell carcinoma: Causes/Risk factors
Excessive UV exposure, pre-malignant skin conditions (e.g. actinic keratoses), chronic inflammation (e.g. leg ulcers, wound scars), immunosuppression and genetic predisposition.
Squamous cell carcinoma: Presentation
Keratotic (e.g. scaly, crusty),
Ill-defined nodule which may ulcerate.
Squamous cell carcinoma: Management
Surgical excision - treatment of choice.
Radiotherapy - for large, non-resectable tumours.
Mohs micrographic surgery – may be necessary for ill-defined,
large, recurrent tumours
Malignant melanoma: Description
An invasive malignant tumour of the epidermal melanocytes, which has the potential to metastasise.
Malignant melanoma: Causes / Risk Factors
Excessive UV exposure, skin type I (always burns, never tans), history of multiple moles or atypical moles, and family history or previous history of melanoma.
Malignant melanoma: Presentation
The ‘ABCDE Symptoms’ rule (*major suspicious features):
Asymmetrical shape*
Border irregularity
Colour irregularity*
Diameter > 6mm
Evolution of lesion (e.g. change in size and/or shape)*
Symptoms (e.g. bleeding, itching)
Malignant melanoma: Types
Superficial spreading melanoma – common on the lower limbs; related to intermittent high-intensity UV exposure.
Nodular melanoma - common on the trunk; related to intermittent high-intensity UV exposure.
Lentigo maligna melanoma - common on the face; related to long-term cumulative UV exposure.
Malignant melanoma: Management
Surgical excision - definitive treatment.
Radiotherapy may sometimes be useful.
Chemotherapy for metastatic disease.
