Skin Cancer Overview Flashcards

1
Q

what are the 2 main types of skin cancer?

A

non-melanomatous (from keratinocytes)
- BCC
- SCC
Melanoma (from melanocytes)

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2
Q

what is BCC?

A

arises from basal layer

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3
Q

what is SCC?

A

arises from suprabasal layer

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4
Q

how is skin cancer incidence changing?

A

increasing worldwide in fair skin populations

SCC increased 334% from 1990-2011

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5
Q

what is responsible for increase in skin cancer?

A
ageing population (mainly SCC)
behavioural change
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6
Q

how common is melanoma?

A

only 6% of all skin cancers but 75% of skin cancer death
most common type in 16-24 year olds
but sees the same increase in incidence

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7
Q

why are melanomas dangerous?

A

melanocytes are mobile cells as they move to skin from neural crest so can therefore quickly metastasise (e.g via lymphatics)

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8
Q

what is Breslow thickness?

A

depth of tumour

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9
Q

how does Breslow thickness effect survival?

A
<1mm = 95-100% 5 year survival
>4mm = 50%
metastases = 5%
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10
Q

ABCDE of melanoma diagnoses?

A
Asymmetry
Border
Colour
Diameter (>6mm)
Evolution (changes over weeks/months)
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11
Q

how do you measure a mole?

A

take 2 measurements and then take same measurements again 6-8 weeks later

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12
Q

what is the ugly duckling sign?

A

one mole in a collection of many moles looks different

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13
Q

what colour are melanomas?

A

can be black, red, brown or colourless

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14
Q

what causes a halo (pale area) around a melanoma?

A

immune system attacking the cancer

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15
Q

are people with many moles at an increased risk of melanoma?

A

yes

even higher risk if anyone in family has had a melanoma

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16
Q

what is the most common skin cancer?

A

basal cell (75%)

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17
Q

what are the features of a BCC?

A
slow growing lump or non-healing ulcer
painless
locally invasive but doesn't metastasise
usually can be cured with skin surgery
pearly appearance
central ulcer
arborizing blood vessels
18
Q

what are the features of squamous cell carcinoma?

A
warty, crusted lump or ulcer
arises on sun damaged skin
faster growth
can be painful or bleed
more potential to spread
19
Q

what can a superficial BCC be misdiagnosed as?

A

eczema
psoriasis
looks like a scaly plaque

20
Q

how do morphoeic (infiltrative) BCCs present?

A

like a scar
poorly defined
more difficult to define and remove

21
Q

what are 4 types of BCC?

A

superficial
nodular/nodulocystic
morphoeic
pigmented

22
Q

which is more aggressive BCC or SCC?

A

SCC

causes most non-melanoma deaths

23
Q

how does SCC present?

A
hyperkeratotic lump/ulcer on sun damaged skin
usually well differentiated
can metastasise but not many
grows fast
can be painful or bleed
24
Q

what is a cutenous horn?

A

crusty growth
type of SCC
can often just be scraped off

25
how common is developing another non-melanoma cancer after having one?
50% of people get more
26
what are some high risk sites for SCC?
ear lip scalp
27
where do high risk SCCs often spread?
bone | lymphatics
28
where else can SCCs arise apart from sun damaged sites?
chronic wounds/ulcers
29
what are actinic keratoses?
precancerous skin lesions highly associated with SCC and BCC if theres many this indicates a field of abnormality
30
what is bowens disease?
very slow growing erythematous plaque which can be a site for SCCs to develop
31
what is the main risk factor for skin cancer?
sun exposure
32
what other factors affect skin cancer skin?
genetics (skin type) immunosuppression (eg HPV infection) environmental carcinogens
33
what genetic factors can increase skin cancer risk?
DNA repair syndromes (xeroderma pigmentosum) albinism naevoid BCC (gorlins) epidermolysis bullosa
34
what is XP?
xeroderma pigmentosum | genetic disorder where you cant repair sun damaged DNA (NER defect)
35
how does XP present?
photosensitivity photodamage increased skin cancer risk
36
what does gorlins syndrome increase risk of?
BCC
37
what is a hallmark of epidermolysis bullosa (RDEB)?
blistering of skin causing mitten deformity of skin | due to deficiency of type 7 collagen
38
what does epidermolysis bullosa increase the risk of?
SCC
39
what does immunosuppression increase risk of?
SCC
40
what is often seen in the hands of transplant patients?
field cancerisation AKs SCCs etc
41
what environmental carcinogens can increase skin cancer risk?
``` coal tar ionising radiation trauma chronic ulceration smoking ```