skin cancer Flashcards by Abbie McGuire

2 types of non-melanoma skin cancer?

basal cell cancer (BCC)

Squamous cell cancer (SCC)

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most common NMSC?

BCCs

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4 risk factors for NMSC?

UV radiation
photochemotherapy (PUVA)
HPV
immunosuppression

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3 features of BCC?

slow growing
locally invasive
rarely metastatic

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presentation of nodular BCC - 3 features?

pearly rolled edge

telangiectasia

central ulceration

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telangiectasia?

widened venules (tiny blood vessels) cause threadlike red lines/patterns on the skin

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describe appearance of superficial BCC?

usually red,
sometimes raised,
can be crusty,
~1cm

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describe appearance of pigmented BCC?

looks like black spot

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describe appearance of morphoeic BCC?

looks like white burn/scar

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gold standard treatment of BCCs?

excision - ellipse with a rim of unaffected skin

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1 adv and 1 disadv to gold standard treatment of BCC?

adv - curative if fully excised

disadv - scarring

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2 other treatments of BCCs?

curettage

imiquimod

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what is Mohs surgery?

surgicaltechnique where thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains

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6 indications for Mohs?

size 
site
subtype
poor clinical margin definition 
recurrent 
perineurial/perivascular involvement

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indications for vismodegib?

local advanced BCC not suitable for surgery/radiotherapy
OR
metastatic

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action of vismodegib?

inhibits abnormal signalling in hedgehog pathway

side effects of vismodegib?

hair loss 
weight loss 
altered taste 
muscle spasms
nausea 
fatigue

derivation of squamous cell carcinoma?

keratinising squamous cells

where are SCCs usually found?

sun exposed sites

4 features of SCC?

faster growth
tender
crusty
ulceration

treatment for SCC?

excision +/- radiotherapy

when should follow-up be carried out with SCCs?

with high risk patients

describe high risk patients for SCCs?

immunosuppressed
>20mm diameter
>4mm depth
site of eyelid, ear, lip, nose

what is keratoacanthoma?

variant of SCC which originates in hair follicles in sun damaged skin

treatment for keratoacanthoma?

surgical excision

name 4 risk factors for melanoma?

UV radiation fair skin / red hair / blue eyes history of sunburn as a child / inability to tan familial melanoma / melanoma susceptibility genes

ABCDE for melanoma?

``` asymmetry border colour diameter evolution ```

7 point checklist?

change in size change in shape change in colour diameter >5mm inflammation oozing/bleeding itch/altered sensation

1 advantage of dermoscopy?

improved clinical accuracy compared to unaided eye

4 subtypes of melanoma?

lentigo maligna melanoma nodular melanoma acral lentiginous melanoma superficial spreading malignant melanoma

rarer subtype of melanoma?

ocular melanoma

treatments of melanoma?

surgical excision - wide local excision sentinel lymph node biopsy immunotherapy

rarer treatments for melanoma?

chemotherapy | radiotherapy

breslow thickness?

the distance between the upper layer of the epidermis and the deepest point of tumour

name 4 adjuvant therapies used for melanoma?

ipilimumab pembrolizumab nivolumab vemurafenib with dabrafenib

action of ipilimumab?

inhibits CTLA-4

action of pembrolizumab?

targets PD-1 receptor on tumour

metastatic melanoma - treatment?

adjuvent therapy