Skin Cancer Flashcards
Give examples of benign skin lesions?
Epithelial polyps (skin tags) Seborrhoeic warts
What are the three main types of skin cancer?
Basal cell carcinoma
Squamous cell. carcinoma
Malignant melanoma
What is the most common type of skin cancer?
Basal cell carcinoma
In which skin types is skin cancer most common?
Paler skin types 1 and 2
What mutation may, in rare cases, predispose to basal cell carcinoma?
PTCH gene mutation
At what sites are basal cell carcinomas normally found?
Head and neck or other sunlight exposure areas
Basal cell carcinoma has a good prognosis. T/F?
True
What are the different subtypes of basal cell carcinoma?
Nodular
Superficial
Pigmented
Morphoeic/sclerotic
Describe the appearance of a nodular basal cell carcinoma?
>0.5cm Raises lesion Shiny Telangiectasia (spider veins) Central ulceration
What is the gold standard treatment for basal cell carcinoma?
Surgical excision with a 3-4mm margin
Other than surgical excision, how can basal cell carcinoma?
Curettage and cauterise Cryotherapy Photodynamic therapy Topical imiquimod/5-fluorouracil cream Mohs micrographic surgery
From what cell type is basal cell carcinoma derived?
Keratinocytes
From what cell type is squamous cell carcinoma derived?
Keratinocytes
What are the high risk sites for metastasis in squamous cell carcinoma?
Lips
Ears
What are the pre-malignant variants of squamous cell carcinoma?
Actinic keratoses
Bowen’s disease
What is the gold standard treatment for squamous cell carcinoma?
Surgical excision with a 4mm margin
How can squamous cell carcinoma in situ be treated?
Topic imiquimod or 5-flurorouracil cream
Cryotherapy
Photodynamic therapy
From what cell type is melanoma derived?
Melanocytes
Which type of skin cancer has the worst prognosis?
Melanoma
Other than the skin, where can melanoma occur?
Bowel
Eye
How does melanoma spread?
Via lymphatics
What are the risk factors for the development of melanoma?
Genetic markers e.g. CDKN2A mutations Family history UV irradiation Sunburns during childhood Intermittent bruning exposure in unacclimatised fair skin Congenital nevi Number >50 and size >5mm of melanocytes nevi >5 atypical nevi Personal history of melanoma High socioeconomic status Skin types 1 and 2 Immunosuppression
What scale is used by pathologists to determine the prognosis of melanoma?
Breslow’s scale
What are the subtypes of melanoma?
Superficial spreading melanoma Nodular melanoma Aural melanoma Sublingual melanoma Melanotic melanoma Lentigo maligna Lentifo amiga melanoma
If a melanoma is <1mm in depth, then what surgical margin is required?
1cm
If a melanoma is >1mm in depth, then what surgical margin is required?
2cm
Other than surgery, how can melanoma be treated?
Immunotherapy - ipilimumab and nivolumab
Immune check points. / MEK inhibitors e.g. trametinib
Biologic antibodies e.g. debrafanib against BRAF genetic defects
How can melanoma be assessed for metastasis?
CT/MRI scans
Which melanoma patients would receive genetic testing?
Families where there are multiple primary melanomas
Young Individuals with several primary melanomas
What is Gorlin’s syndrome?
A predisposition to multiple basal cell carcinomas, Jae cysts and breast cancer
What is Brok Spiegler syndrome?
Predispositions to:
Multiple basal cell carcinomas and trichoepitheliomas
What is Gardner syndrome?
Predispositions to:
Soft tissue. tumours, polyps and bowel cancer
What is Cowden’s syndrome?
Predispositions to:
Multiple hamartomas
Thyroid and breast cancers.
