skin cancer Flashcards
what is the most aggressive skin cancer
melanoma
what is the ABCDE diagnosis of a melanoma
Asymmetry, Border, Colour (3+), diameter (o.7mm), Evolution (vertical growth, ulceration)
what mutations can occur in melanoma
vemurafenib. CDKN2A (tumour suppresor) CDK4 (permits cell cycle), ras/raf
who gets melanomas
more common in women, sunburn as a child with intermittent burning
what is a melanoma in situ called
RGP (radial growth phase)
what is a melanoma called that has extended to the dermis and can metastasis
VGP (vertical growth phase)
what are the growth phases of melanoma (4)
superficial spreading (SSM), mucosal lentiginous (MLM), lentigo malignant melanoma (LLM), nodular
what is a nodular melanoma
simple VGP tumour, very aggressive
what is used for prognosis of melanoma
breslow depth from granular layer
what is the treatment of melanoma (mild –> severe)
primary excision + margins, potential node biopsy, regional lymphadenectomy, chemo
what increases chances of basal cell carcinoma
sun expose sites and burning
what are the 3 types of BCC
nodular, superficial, infiltrative
describe infiltrative BBC
can infiltrate widely (esp morphemic) to brain, poorly defined margins, can travel along nerves
what is the metastatic potential of BCC
very low
how does BCC present
pearly, looks shiny, telangiectasia, slow growing lump/ non-healing ulcer
how do you treat BCC
superficial with cream (fluorouracil or imiquimod), excised elliptically
what is mutated in BCC and what drug can be used to counteract it
PTCH1 - hedgehog signalling that promotes cell division.
vismodegib blocks it
name 3 precursors for SCC
bowen’s disease, actinic keratosis, viral precursors
describe bowen’s disease
SCC in situ, scaly patch/ plaque with an irregular border, usually on leg. no dermal invasion
describe AKs
common from UV exposure, scaly patch, normally multiple, epidermal dysplasia
what viral precursors are there for SCC
HPV type 16
what increases risk of SCC
elderly in UV exposed sites, sun damage and outdoor workers, chronic leg ulcers, burns, lupus vulgaris, genetic syndromes
how metastitic is SCC
quite, more than BCC, less than melanoma
how does SSC present
hyperkeratotic lump/ ulcer, grows fast, can bleed, poorly differentiated, red border
