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Y2 - Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the keratinocyte skin cancers, and why are they classed as that?

A

Basal Cell Carcinomas (BCC)
Squamous Cell Carcinomas (SCC)
They arise from keratinocytes

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2
Q

What cells do melanomas arise from?

A

Melanocytes

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3
Q

What are melanocytes?

A

The pigment forming cells scattered along the basal layer of the epidermis

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4
Q

Where do melanocytes migrate from?

A

Migrate from the neural crest

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5
Q

Which are more likely to metastasise: melanoma or keratinocyte skin cancers?

A

Melanomas

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6
Q

What clinical features shows that a melanoma has metastasised?

A

Micronodules - little black dots around the main melanoma

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7
Q

What factor correlates with the prognosis of a melanoma, and how is this measured?

A

Tumour depth
Breslow thickness - AKA the measurement of depth of the melanoma from the surface of the skin to the deepest point of the tumour

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8
Q

What factors are used to evaluate whether a pigmented nodule is a melanoma?

A 
Asymmetry
Border
Colour
Diameter
Evolution
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9
Q

How do basal cell carcinomas present?

A 
Slow growing lump or ulcer
Painless
Shiny appearance
Telangectasia
Central ulceration
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10
Q

In what way can BCCs spread?

A

Locally - very rarely metastasise

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11
Q

What are the different types of BCC?

A

Superficial
Nodular or nodulocystic
Infiltrative or morphemic
Pigmented

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12
Q

What do superficial BCCs look like?

A

Scaly plaque resembling dermatitis

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13
Q

How do squamous cell carcinomas present?

A

Kyperkeratotic lump or ulcer
On sun-damaged skin
Fast growing
May be painful and/or bleed

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14
Q

What is a keratoacanthoma?

A

A self-resolving SCC

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15
Q

What are high risk sites for SCC?

A

Ear
Lip
Scalp

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16
Q

Where can SCCs commonly metastasise to?

A

Lymph nodes

Bone

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17
Q

What are the main risk factors for skin cancer?

A 
Sun exposure
Family history
Genetic susceptibility 
Immunosuppression
Environmental carcinogens (smoking, coal tar etc)
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18
Q

What are examples of genetic conditions that predispose to skin cancer?

A

Xeroderma pigmentosum

Albanism

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19
Q

What is a benign skin tumour?

A

Seborrheic keratosis

20
Q

What is seborrheic keratosis?

A

Benign proliferation of epidermal keratinocytes

21
Q

What is the clinical presentation of seborrheic keratosis?

A

‘Stuck-on’ appearance with a greasy keratitis surface

22
Q

What may an eruptive appearance of many keratotic lesions indicate?

A

Internal malignancy

23
Q

What are the precursors of squamous cell carcinoma?

A

Bowen’s disease
Actinic keratosis
Viral lesions

24
Q

What is Bowen’s disease?

A

Scaly patch/plaque
Especially on legs
Females mostly
Irregular border

25
Q

What is actinic keratosis?

A

Variable epidermal dysplasia
Very common
Sun exposed skin, especially head/neck, hands

26
Q

What are rare presentations of SCC?

A

Chronic leg ulcers
Sites of burns, sinuses
Chronic lupus vulgaris
Xeroderma pigmentosum

27
Q

What are adverse prognosis features of SCC?

A

Breslow thickness >4mm with poor differentiation
Lymphatic/vascular space invasion
Periurnal spread
Some sites - scalp, ear, nose

28
Q

What are the types of melanoma?

A

Superficial spreading
Acral or mucosal lentiginous
Lentigo maligna melanoma
Nodular

29
Q

What is different about nodular melanomas?

A

No rapid growth phase, only vertical growth phase

30
Q

What sites do melanomas metastasise to, and by which type of spread?

A 
Skin/soft tossue
Heart
Lungs
GI tract
Liver
Brain
Haematological spread
31
Q

What is the technical term for freckles?

A

Ephelides

32
Q

What are ephelides?

A

A patchy area of increase in melanin pigmentation after UV exposure

33
Q

What are actinic lentigenes better known as?

A

Age or liver spots

34
Q

What are actinic lentigines?

A

Areas of increase in melanin and basal melanocyte population related to UV exposure

35
Q

What are melanocytic naevi?

A

A broad range of benign pigmented lesions

36
Q

What are the different types of melanocytes naevi?

A 
Congenital
Usual type
Dysplastic
Spitz
Blue
37
Q

What are classed as small, medium and giant congenital naevi?

A

Small - <2cm
Medium - >2cm, <20cm
Giant - >20cm

38
Q

What is the risk of congenital naevi progressing to melanoma?

A

Larger lesions have 10-15% risk

39
Q

What are usual type naevi?

A

Naevi acquired during infancy when the melanocyte:keratinocyte ratio breaks down at a number of cutaneous sites

40
Q

What is the process of development of a usual type naevi?

A

Juntional phase - clusters of melanocytes form at the derma-epidermal junction, melanocytes proliferate
Compound phase - junctional clusters at the demo-epidermal junction and groups of cells in the dermis
Intradermal phase - all junctional activity has ceased, entirely dermal

41
Q

What do dysplastic naevi look like?

A

Generally >6mm in diameter
Variegated pigment
Border asymmetry

42
Q

What are sporadic dysplastic naevi?

A

Not inherited
One to several atypical naevi
Risk of malignant melanoma slightly raised

43
Q

What are familial dysplastic naevi?

A 
Strong family history of melanoma
Autosomal inheritance
High penetrance
Multiple atypical naevi
Lifetime risk of melanoma up to 100%
44
Q

How are dysplastic naevi diagnosed histologically?

A

Atypical architecture and cells
Host reaction - fibrosis and inflammation
Epidermis not affected

45
Q

What are halo naevi?

A

Have a peripheral help of depigmentation
Show inflammatory regression
Overrun by lymphocytes

46
Q

What are blue naevi?

A

Entirely dermal

Consist of pigment-rich dendritic spindle cells

47
Q

What are spitz naevi?

A

In people <20
Look like melanoma but most benign
Consist of large spindle and/or epithelioid cells
Pink appearance due to dilated capillaries

Y2 - Dermatology (12 decks)

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