Skin cancer Flashcards
what skin cancer makes up 75% of NMSDs
BCC
BCC risk factors?
previous skin cancer (any kind)
UV exposure: repeated acute sunburn
genetic susceptibility: skin type I and II, Gorlin syndrome, albinism, xeroderma pigmentosum
Immunosuppression
can BCC metastasise?
v rarely
why do BCCs need to be removed?
locally invasive
subtypes of BCC?
nodular (most common; ‘rodent ulcer’): raised pearly border with visible telangiectasia. Central ulceration can develop
Superficial: scaly plaque with raised ‘whipcord’ margin
Morphoeic (can be infiltrative; more difficult to manage): atrophic, scar-like
BCC
1) typical location?
2) rate of growth?
3) appearance?
4) colour?
5) pain?
1) areas of sun exposure (head and back), also back/ chest (areas of sunburn)
2) slow growing (months - years)
3) plaque, nodule or non-healing ulcer
4) skin, pink or pigmented
5) painless
type of biopsy for BCC diagnosis?
usually
excisional for nodular
punch for superficial
when is clinical diagnosis and management without biopsy appropriate in BCC?
superficial types at low risk sites (not head and neck)
Rx of BCC
1) nodular
2) superficial
3) difficult sites/ infiltrative types
1) surgical excision mainstay
2) imiquimod, liquid nitrogen, PDT, 5-FU
3) Mohs
BCC prognosis
treatment curative in most cases
increases risk of recurrence and other skin cancer types
risk factors for SCCs?
age and gender (elderly males) UV exposure (chronic sun exposure > photodamage)
SCC precursors differencce histologically?
Actinic keratosis: partial thickness keratinocyte dysplasia, no invasion
Bowen’s disease: full thickness keratinocyte dysplasia + invasion
histological definition of SCC?
unregulated proliferation of keratinocytes within the epidermis with invasion into the dermis
T/F: mets are common in SCC
false (5% risk) is locally invasive mets uncommon (occurs in larger and poorly differentiated tumours, immunosuppressed pts)
T/F: most SCCs are well differentiated
true (low risk)
histopathological subtypes of SCC?
cutaneous horn
Carcinoma cuniculatum.
presentation of SCCs?
fairly fast growing (weeks- months) hyperkeratotic lump, may be painful/ tender. Risk of bleeding.
diagnosis of SCC?
excisional biopsy
mainstay of treatment for SCC?
surgical excision
Rx metastatic SCC?
conventional surgery + radio/ chemo
MM precursor lesions?
benign melanocytic naevi
congenitcal melanocytic naevi
dysplastic (atypical) naevi
subtypes of MM?
superficial spreading
acral/ mucosal lentiginous
lentigo maligna
nodular
growth phases of MM?
significance of this
radial growth phase (within epidermis) vertical GP (dermal invasion)
only lesions with a VGP can metastasise
which of the subtypes of MM is in which growth phase?
lesions with RGP +/- VGP - superficial spreading - acral/ mucosal lentiginous - lentigo maligna lesions with VPG only - nodular
