Skin Cancer Flashcards
Precursors of SCC
Actinic keratosis
Bowen’s disease
Viral lesions
Presentation of actinic keratosis
Sun exposed sites
Red and scaly
Presentation of Bowen’s disease
Scaly patch/plaque with irregular border
Treatment for actinic keratosis and Bowen’s disease
Cryotherapy, curettage, 5-fluorouracil, imiquimod, photodynamic therapy
What is the most common skin cancer?
BCC
BCC is associated with ______ of sun exposure
Intermittent burning episodes
In BCC there is abnormality in ______ signalling
Hedgehog
Presentation of BCC
Slow growing lump
Non-healing ulcer
Overlying telangiectasia
Central ulceration
Risk factors for BCC
UV exposure Smoking Genetic predisposition: xeroderma pigmentosum, albinism, epidermolysis bullosa, naevoid basal cell carcinoma (Gorlin's) syndrome Immunosuppression Ankylosing spondylitis Scalp ringworm Environmental carcinogens Previous skin cancer
Complications of BCC
Neglected invasive BCC
Metastasis (rarely)
Treatment of BCC
Surgical excision (4mm margin)
Superficial: cryotherapy,
Photodynamic therapy, fluorouracil, imiquimod
Vismodegib: (for advanced/inoperable BCC, inhibits hedgehog signalling pathway)
SCC is associated with ___ UV exposure
Chronic
Presentation of SCC
Warty/crusty lump or ulcer which is relatively fast growing
Risk factors for SCC
UV exposure Smoking Genetic predisposition: xeroderma pigmentosum, albinism, epidermolysis bullosa Immunosuppression: more common in immunosuppressed patients and transplant patients compared to other skin cancers Ankylosing spondylitis Scalp ringworm Environmental carcinogens Previous skin cancer
Which has a higher metastatic potential? BCC or SCC
SCC
Treatment of SCC
Surgical excision (6mm margin) Radiotherapy
Pathology of melanoma
Proliferation of atypical melanocytes with potential for dermal invasion and widespread metastases
Melanoma is associated with _____ episodes of sun exposure
Intermittent
ABCDE of melanoma
Asymmetry Border Colour Diameter Elevation
What is the “ugly duckling sign” in melanoma?
A mole that looks different from other moles
Risk factors for melanoma
UV exposure Smoking Genetic predisposition: xeroderma pigmentosum, albinism, epidermolysis bullosa Immunosuppression Ankylosing spondylitis Scalp ringworm Environmental carcinogens Previous skin cancer Pale skin Females
Definition of Breslow’s thickness
Depth from the granular layer of the epidermis to the deepest melanoma cell
Stage I (in situ) Breslow thickness 5-year survivial
90-100%
Stage IV (>4mm) Breslow thickness 5-year survival
50%
