Skin Cancers Flashcards
1
Q
What is BCC?
A
- A slow growing, locally invasive malignant tumour of the epidermal keratinocytes
- Normally in older individuals
- Rarely metastasises
- Most common malignant skin tumour
2
Q
What are the risk factors for BCC?
A
- Excessive sun exposure
- Hx of frequent sunburn in childhood
- Type 1 skin type (fair skin, red hair, blue eyes)
- Increasing age
- Male sex
- Immunosuppression
- Prev. Hx. of skin cancer
3
Q
What is the clinical presentation of BCC?
A
- Nodular (= most common type)
- Slow growing
- Small, skin-coloured papule or nodule
- Pearly-rolled edge
- Telangiectasia
- Central ulceration
- Arborising vessels on Dermoscopy
4
Q
What is the management of BCC?
A
- Surgical excision (= gold standard)
- Curettage
- Topical treatment (if superficial + low-risk)
- > Imiquimod
- Moh’s Micrographic Surgery (for high-risk, recurrent tumours)
- Chemo
- > Vismodegib
5
Q
What is Vismodegib used for?
A
- Chemo
- for locally-advanced BCC not suitable for surgery or radiotherapy
- Metastatic BCC
6
Q
What is SCC?
A
- Locally invasive malignant tumour of the epidermal keratinocytes
- Potential to metastasise
- In-situ = Bowen’s disease
7
Q
What are the risk factors for SCC?
A
- Excessive UV (sun) exposure
- HPV (genital SCC)
- Smoking (lip SCC)
- Outdoor occupation
- Caucasian ethnicity
- Increasing age
8
Q
What is the Clinical Presentation of SCC?
A
- Usually on sun-exposed sites
- Faster growing (than BCC)
- Tender
- Scaly/crusted (keratotic)
- Fleshy growths
- Can ulcerate
9
Q
What is the Management of SCC?
A
- Surgical excision
- +/- RT (large + non-resectable nodes)
- Follow-up if high-risk
10
Q
What are the risk factors for high-risk SCC lesions?
A
- Immunosuppressed
- > 20mm diameter
- > 4mm depth
- Ear, nose, lip, eyelid
- Perineural invasion
- Poorly differentiated -> tends to metastasise!
11
Q
What is Keratocanthoma?
A
- Varient of SCC
- Erupts from hair follicles in sun damaged skin
- Grows rapidly -> may shrink after a few months and resolve
- Surgical excision (tends to resolve itself by the time surgery-time comes)
12
Q
What is Malignant Melanoma?
A
- Malignant tumour of the Epidermal Melanocytes
- Potential to Metastasise
13
Q
What are the risk factors for Malignant Melanoma?
A
- Excessive UV (sun) exposure
- Type 1 skin type (fair skin, red hair, blue eyes)
- Hx. of multiple or atypical moles
- PMH or FH of Melanoma
14
Q
How can you identify between a normal mole and melanoma?
A
- “ABCDE” symptoms*
- Asymmetrical – melanomas usually have 2 very different halves and are an irregular shape
- Border – melanomas usually have a notched or ragged border
- Colours – melanomas will usually be a mix of 2 or more colours
- Diameter – most melanomas are usually >6mm in diameter
- Evolution: enlargement or elevation – a mole that changes size over time is more likely to be a melanoma
15
Q
Which instrument would you use to identify a suspicious mole?
A
- Dermatoscope
