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Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

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Dermatology Board Prep flashcards
1
Q

what are malignant skin cancers?

A

melanoma, basal cell carcinoma, squamous cell carcinoma

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2
Q

epi of melanoma

A

most dangerous skin cancer, presenting more frequently in young

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3
Q

pathology of melanoma

A

mutation in serine protein kinase B-RAF (V600E gene), RAS or MAPK pathways

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4
Q

why are melanomas so dangerous?

A

melanocytes are motile so ca spread more easily

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5
Q

aetiology of melanoma

A

sun- intermittent exposure, exposure to UV, genetic predisposition

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6
Q

risk factors for melanoma

A

pale skin, >50 melanocytes naevi, sun sensitivity, atypical mole syndrome

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7
Q

what are some skin conditions that are risks for melanoma?

A

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

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8
Q

what are the types of melanomas?

A

. 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

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9
Q

VGP means…

A

local invasion of melanoma

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10
Q

what gene mutations cause familial melanoma

A

mutations to CDKN2A and CDK4

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11
Q

dx of melanoma

A 
ugly duckling signs, dermatoscope
Asymmetry 
Border
Colour
Diameter (>6mm)
Evolution 
characteristics
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12
Q

red flags for melanoma?

A

bleeding, ulceration, de novo, nodule

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13
Q

what is mx for melanoma

A

surgery is only curative option, preventative (sun cream etc)

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14
Q

T/F: <1mm melanoma lead 3cm margin

A

F: <1mm= 1cm margin

>2mm= 3cm margin

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15
Q

metastatic mx of melanoma

A

remove regional LNs (if sentinel biopsy +ve), radio/chemo, biologics (MAP kinase inhibitor etc)

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16
Q

prognosis of melanoma/scoring systems

A 
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)
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17
Q

where do melanomas usually spread to

A

skin, heart, lungs, GI, liver, brain

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18
Q

if melanoma spread to lungs, what is this called

A

pulmonary metastatic melanoma

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19
Q

what is basal cell carcinoma

A

non-melanoma malignant skin cancer (not melanocytes that are defective)

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20
Q

T/F: basal cell carcinoma (BCC) is the most common type of skin cancer

A

T

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21
Q

pathophysiology of BCC

A

basal cell in epidermis invade dermis

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22
Q

aetiology of BCC

A

intermittent burning episodes, mutations to PTTCH1 genes, Gorlin’s syndrome

23
Q

triad for Gorlin’s syndrome?

A

early onset, jaw cysts, palmar pits

24
Q

types of BCC?

A 
nodular 
superficial 
pigmented 
morphoeic 
basosquamous
25
Q

s/s of BCC

A

slow growing, non-healing ulcer/lump, painless, locally invasive
sites- face, neck

26
Q

what does a BCC lesion look like

A

pearly/ translucent/ shiny, telangiectasia, central ulceration, can be pigmented

27
Q

mx for BCC?

A

wide excision

28
Q

surgery for morphoeic BCC?

A

Mohs Micrographic surgery

29
Q

epi of squamous cell carcinoma (SCC)?

A

least common but grows faster

30
Q

aetiology of SCC?

A

sun damage or chronic cumulative UV exposure, acitinic keratosis (rough scaly erythematous patches and surrounding skin with lentigines), Bowen’s disease, HPV, trauma e.g. burn sites

31
Q

what is Bowen’s disease?

A

indolent form of SCC in situ, slowly enlarging red patch with irregular border and no dermal invasion

32
Q

lesion for of SCC?

A

warty/crusted painful nodule, may ulcerate, ill defined

33
Q

common SCC sites

A

earl, lip, scalp

34
Q

mx for SCC?

A

surgical excision + radio

35
Q

what are some benign skin lesions?

A

seborrheic keratosis, melanocytes naevi, dermatofibroma, dermatofibrosarcoma protrubens, angioma etc

36
Q

what is seborrheic keratosis

A

common harmless wart growth

37
Q

pathophysiology of seborrheic keratosis

A

overgrowth of basal keratinocytes

38
Q

histology of seborrheic keratosis

A

epidermal acathosis, hyperkeratosis, horn cysts

39
Q

s/s of seborrheic keratosis

A

flesh coloured to very dark brown, greasy stuck on appearance, rough warty surface

40
Q

sites of seborrheic keratosis

A

face, trunk, greasy hyperkeratotic surfaces

41
Q

mx of SK

A

removal via curettage, cryotherapy, electrodessication

42
Q

what are melanocytic naevi

A

benign proliferations of overgrowth of melanocytes

43
Q

epi of naevi?

A 
congenital- at birth 
acquired 
- children= junctional naevus
- adolescents= compound 
- adults= dermal
44
Q

types of naevi

A

dysplastic= >6mm, border asymmetry, sporadic or familial

halo naevi= peripheral halo of depigmentation due to lymphocytes

blue naevi= blue/gray due to pigment rich dendritic spindle cells, entirely dermal

spitz naevi= <20yo, consists of spindle or epithelial cells

45
Q

pathophysiology of naevi

A

keratinocyte ratio breaks down at cutaneous sites

  • junctional: proliferation fo melanocytes at DEJ
  • compound: proliferation of melanocytes into dermis
46
Q

s/s of naevi

A

even pigmentation and regular borders- larger lesions have inc risk of melanoma

47
Q

what is dermatofibroma

A

pink/beige firm nodule, may follow trauma/ bite, F legs

48
Q

what is dermatosarcoma protrubens

A

starts as bruise/ scar and as it grows lumps of tissue form

49
Q

what is an angioma

A

derived from cells of vascular/ lymphatic system, tiny red papules found on trunk

50
Q

fast growing painless flesh coloured/ bluish red nodule on sun-exposed sites is…

A

Merkel Cell Carcinoma

51
Q

t-cell lymphoma that causes lymphoproliferation is called….

A

mycosis fungoides

52
Q

s/s of mycosis fungoides

A

itchy scaly patches which start on buttock (asymmetric)

53
Q

ix and tx for mycosis fungoides

A

ix- biopsy shows invasion of epidermis by T-cells

tx- relapse/chronic course

Dermatology (14 decks)

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