Skin Cancer Flashcards
what are malignant skin cancers?
melanoma, basal cell carcinoma, squamous cell carcinoma
epi of melanoma
most dangerous skin cancer, presenting more frequently in young
pathology of melanoma
mutation in serine protein kinase B-RAF (V600E gene), RAS or MAPK pathways
why are melanomas so dangerous?
melanocytes are motile so ca spread more easily
aetiology of melanoma
sun- intermittent exposure, exposure to UV, genetic predisposition
risk factors for melanoma
pale skin, >50 melanocytes naevi, sun sensitivity, atypical mole syndrome
what are some skin conditions that are risks for melanoma?
lentigo maligna: slow growing, macular area of pigmentation on elderly due to sun damage (face)
xeroderma pigmentosa: super photosensitive due to defective NER (nucleotide excision repair proteins)
albinism: no melanin
recessive dystrophic epidermolysis bullosa: type VII collagen deficiency
what are the types of melanomas?
. lentigo malignant melanoma- sun damage
. superficial spreading malignant melanoma- large, flat, irregular that grows laterally. trunk and limbs
. nodular malignant melanoma- most aggressive, rapidly growing pigmented nodule which bleeds
. acral lentiginous melanoma- palm or sole lesion
. familial melanoma- mutations to genes
VGP means…
local invasion of melanoma
what gene mutations cause familial melanoma
mutations to CDKN2A and CDK4
dx of melanoma
ugly duckling signs, dermatoscope Asymmetry Border Colour Diameter (>6mm) Evolution characteristics
red flags for melanoma?
bleeding, ulceration, de novo, nodule
what is mx for melanoma
surgery is only curative option, preventative (sun cream etc)
T/F: <1mm melanoma lead 3cm margin
F: <1mm= 1cm margin
>2mm= 3cm margin
metastatic mx of melanoma
remove regional LNs (if sentinel biopsy +ve), radio/chemo, biologics (MAP kinase inhibitor etc)
prognosis of melanoma/scoring systems
clark's level: depth if invasion Breslow's thickness - pTis= in situ so 100% survival - PT1= <1mm - pT2= 1-2mm - pT3= 2-4mm - pT4= >4mm (20% survival)
where do melanomas usually spread to
skin, heart, lungs, GI, liver, brain
if melanoma spread to lungs, what is this called
pulmonary metastatic melanoma
what is basal cell carcinoma
non-melanoma malignant skin cancer (not melanocytes that are defective)
T/F: basal cell carcinoma (BCC) is the most common type of skin cancer
T
pathophysiology of BCC
basal cell in epidermis invade dermis
aetiology of BCC
intermittent burning episodes, mutations to PTTCH1 genes, Gorlin’s syndrome
triad for Gorlin’s syndrome?
early onset, jaw cysts, palmar pits
types of BCC?
nodular superficial pigmented morphoeic basosquamous
