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Y2 - BRS - Derm > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

What are the possible differential diagnoses?

A

x

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2
Q

What are the investigations conducted to narrow down the differentials, and which are most important?

A

x

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3
Q

What is melanoma and where can it develop?

A

Malignant tumour arising from melanocytes

Leads to >75% of skin cancer deaths

Can
x

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4
Q

What are the genetic, environmental and phenotypic risk factors for developing melanoma?

A

x

Atypical moles (e.g. aymmetrical)

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5
Q

What is the pathogenesis of melanoma?

A

The MPK pathway in our body is responsible for cellular proliferation, growth and migration

x

Further downstream, CDK2NA (tumour suppressor) mutations can also lead to melanoma

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6
Q

What is the host response to melanoma?

A

Our CD8T cells can recognise melanoma

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7
Q

What is imoirtant about our host response to melanoma?

A

Immunotherapy - blocks x

also PD1 important in autoimmunity and so prevents melanocytes being killed - block this so abnormal melanocytes in melanoma are killed by host’s own immune system

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8
Q

x

A

x

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9
Q

x

A

x

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10
Q

What are the different subtypes of melanoma?

A

x

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11
Q

What is superficial spreading melanoma?

What is the growth pattern of superficial spreading and so how does it look clinically?

A

Majority of melanomas
x

Firstly, slow radial growth phase = horizontal growht restricted to dermis, shows up as assymetrical / atypical ‘mole’ with blurred edges and colour variation
Afterwards, vertical growth - nodule going deeper into the skin

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12
Q

What is nodular melanoma?

What is the growth pattern of nodular melanoma and so how does it look clinically?

A

2nd most common type of melanoma in fair skinned individuals
May be black, blue or pink

x
Skips radial / horizontal growth phase - lack of asymmetry, not much colour variation and no blurred edges
Goes straight to vertical growth

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13
Q

What is Lentigo Maligna?

What is the growth pattern of lentigo maligna and so how does it look clinically?

A

When is becomes invasion it is called lentigo maligma

x
Grey circles / rhomboid structures seen in lentigo maligna

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14
Q

What is acral lentiginous melanoma?

What is the growth pattern of acral lengtiginous and so how does it look clinically?

A

x

Vary variable in appearance, asmmetric, ulcerific, scaly, non-specific, often presents at late stage
Can also appear in the nail, longitudinal dark appearance on nails
Can lack pigment

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15
Q

What is the best way to catch melanoma early?

A

Self-detection - history in colour, shape or size of a pigmented skin lesion

ABCDE rule

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16
Q

What is the ABCDE rule?

A

A = asymmetry

B = border irregularity

C =

First ABCD = horizontal growth = not useful for nodular melanoma (so that is why E is also v important)

x

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17
Q

Which types of melanoma can you diagnose without doing a biopsy?

A

x

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18
Q

What are the features of melanoma with poorer prognoses?

A 
>1mm
Ulceration
Age
Male
Anatomical site

x

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19
Q

How is melanoma thickness measured?

A

x

20
Q

What are the different investigations conducted for suspected melanoma?

A
  1. Firstly, dermascopy
21
Q

What is Dermascopy?

A

look at the melanoma - look for

x
Helps diagnosis of melanoma by 50% - but cannot be used in isolation as it needs to consider history, risk factors etc.

22
Q

What is essential lymph node biopsy?

A

The most likely node that area of skin drains to - looking for malignancy at lymph node - has the cancer spread?

23
Q

x

A

x

24
Q

x

A

x

25
Q

What is the primary management for melanoma?

A

Primary exision down to subcutaneous fat - 2mm peripheral margin

Wide exicision…

26
Q

How do we conduct TNM staging?

A

Use imaging for stages II, IV
Use bloods for prognostic factor in metastatic

x

27
Q

What is the management for unresectable or metastatic melanoma?

A

Immunotherapy - use the hosts immune system
x
Mutated oncogene targeted therapy

28
Q

What is Kertinocyte Dysplasia / Carcinoma?

What are the different subtypes within this?

A

x

Actinic keratoses =

Bowen’s disease =

x

29
Q

What is the risk factor for basal cell carcinoma?

A

UV radiation

30
Q

What is the pathogenesis of basal cell carcinoma?

A

Invasion of tumour is supported by mellatoproteinases and collagenases

p53 mutations are important

31
Q

What is the pathogenesis of squamous cell carcinoma?

A

UV radiation causes genetic alterations - commonly in p53, but also CDKN2A

32
Q

What is the epidemiology of keraintocyte carcinomas?

A

x

33
Q

What are the risk factors of keratinocyte carcinomas?

A

x

34
Q

What is actinic keratoses?

A

x

Can be difficult to distinguish

35
Q

x

A

x

36
Q

x

A

x

37
Q

x

A

x

38
Q

x

A

x

39
Q

x

A

x

40
Q

What does a keratoacanthoma look like?

A

Pseudomalignancy?

41
Q

x

A

x

42
Q

x

A

x

43
Q

What is the treatment / management for squamous cell carcinoma?

A

Primarily = resection

Metastatis = traditional chemotherapy or Cemiplimab = check cell inhibitor

44
Q

What are the main subtypes of basal cell carcinoma?

A

Nodular = most ocmmon, presents as shiny papule / nodule, accounts for half of BCCs

Morphoeic = more locally invasive and destructive, but almost never metastatis

Basisquamous = scalyness on top of papules

Micronodular = resembles nodular but more destructive (spreads locally quicker)

45
Q

What are the appropriate investigations for suspected basal cell carcinoma?

A

Clinical diagnosis

Can take biopsy

46
Q

What is the treatment for basal cell carcinoma?

A

x

Y2 - BRS - Derm (8 decks)

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