Skin cancer two

Question 1

What is the prognosis of skin cancer related to and what is used to assess this (explain how this is done)

Answer 1

Thickness i.e. how far it’s invaded down from the epidermal granular layer (Breslow’s thickness)

Question 2

What does regression mean? Why is this a bad sign?

Answer 2

Immune response to the cancer causing loss of pigmentation -> bad because it means the cancer was thick enough there to alert the immune system, which means that it could have metastasised already

Question 3

Describe the distribution of acral lentiginous melanomas and who is this common in?

Answer 3

On palms and feet

Darker skin people

Question 4

Describe amelanotic melanomas

Answer 4

They’ve essentially lost their pigmentation

Question 5

List the main risk factors for skin cancer

Answer 5

Personal or FH history of melanoma
Skin burn in childhood
UV radiation
Skin type 1 and 2 (always burning, never/hardly tanning)
FH of abnormal moles
Larger than normal moles (dysplastic nevus syndrome)

Question 6

What name is given to larger than average moles?

Answer 6

Dysplastic nevi

Question 7

Name a type of squamous cell carcinoma and state what it is derived from

Answer 7

Keratoacanthoma

Derived from keratinocytes therefore can make keratin

Question 8

Describe keratoacanthomas and their metastasis profile

Answer 8

Oven involute and disappear themselves, but can be excised

Can metastasise but risk is lower than for melanomas

Question 9

What can cause squamous cell carcinomas?

Answer 9

UV exposure
HPV infection 
Immunosuppression 
Scarring 
Smoking

Question 10

What are the common sites of squamous cell carcinomas and how is this linked to gender)

Answer 10

Ears (men - ears more protuberant exposed to sun)
Legs (women)
Lips

Question 11

Which layer of the epidermis do basal cell carcinomas come from?

Answer 11

Basal layer…

Question 12

What is the prognosis for basal cell carcinomas?

Answer 12

Slow growing and doesn’t metastasise

Question 13

What causes BCC?

Answer 13

Sun exposure

Genetics - Gorlin’s syndrome

Question 14

Describe the appearance of a basal cell carcinoma

Answer 14

Pearly/glistening
Slightly crusty
Round edge
Arborizing telangiectasia (branching blood vessels visible)

Question 15

What are the common sites of basal cell carcinomas?

Answer 15

Face

Eyelids

Question 16

What is another name for mycosis fungoides?

Answer 16

T cell lymphoma of the skin

Question 17

Describe the appearance of mycosis fungoides and its prognosis

Answer 17

Plaque like lesion across the skin
Slowly progressive
Can be controlled well

Question 18

Kaposi’s sarcoma is derived from which cells?

Answer 18

Endothelial cells of lymphatics

Question 19

Which two viruses are implicated in Kaposi’s sarcoma?

Answer 19

HIV (not always)

HHP8 (almost always; in both HIV and non HIV patients)

Question 20

Describe the appearance of Kaposi’s sarcoma

Answer 20

Purplish nodules

Question 21

Which genetic condition predisposes to warts and SCCs?

Answer 21

Epidermodysplasia veruciformis

Question 22

What is the pattern of inheritance of epidermodysplasia veruciformis?

Answer 22

Rare autosomal recessive condition

Question 23

Which skin problems does this condition predispose to?

Answer 23

HPV induced warts and squamous cell carcinomas

Question 24

What is the main method of treatment for most skin cancers?

Answer 24

Surgery