Skin Cancers Flashcards
What are the risk factors of basal cell carcinoma?
Basal cell naeva X-ray exposure UV exposure Light skin type Xeroderma pigmentosa History of transplant Arsenic exposure
Describe the potential appearances of basal cell carcinomas?
Pearly plaques / papules Plaques or nodules with rolled edges Papules with associated teleangiectasias Non healing scabs Small crusts with non-healing wounds
What are the potential surgical options for treatment of basal cell carcinoma?
Standard surgical excision
Currage and cautterage
Moh’s micrographic surgery
Other than surgery, what treatment options can be considered for basal cell carcinoma?
Radiotherapy
In advanced disease hedgehog pathway inhibitors
What age group is mostly affected by squamous cell carcinoma?
> 40 years
What are the risk factors for squamous cell carcinoma?
Male sex Increasing age Sun (UV) / radiation exposure Fair skin Arsenic pr tar exposire HPV infection Hereditary skin conditions Immunosuppression Actinic keratotsis
Describe how squamous cell carcinomas can be differentiated from actinic keratosis?
Lesions are generally thicker, larger and more indurated
More likely to be symptomatic - itchy, bleeding, inflamed
Describe the appearance of a squamous cell carcinoma?
Skin coloured / yellowish or erythematous skin lesion which is ill-defined and irregular and may present as a small, scaly macule or plaque on sun exposed areas.
It is typically symptomatic (inflamed, bleeding, tender, itchy) and enlarging.
It may present as a non-healing lesion
Squamous cell carcinomas do not often metastasise, but when they do to which site do they most often metastasise?
Lymph nodes only
What is the first line management of squamous cell carcinoma in situ (Bowen’s disease)?
Destructive therapy - cryotherapy, electrodissection, photodynamic therapy
AND
Topical therapy - fluorouracil, Imiquimod
What is the second line management of squamous cell carcinoma in situ (Bowen’s disease)?
Conventional surgical excision +/- radiotherapy
What is the management of invasive squamous cell carcinoma?
Surgical excision / Mohns micrographic surgery
Radiotherapy second line
Biologic therapy third line
What is the management of metastatic squamous cell carcinoma?
Surgical excision
Radiotherapy
Chemotherapy
Biologic therapy
What is the A-E rule for the description of melanoma?
A - asymmetry B - border irregularity C - colour irregularity within the lesion D - diameter >6mm E - evolution of lesion
What are the risk factors of malignant melanoma?
Fhx melanoma PMHx skin cancer including melanoma Immunosupression Xeroderma pigmentosum Fair skin UV / radiation exposure Large congenital naevi Atypical nevi
