Skin Cancers Flashcards

1
Q

Types of Skin Cancer

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Malignant melanoma
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2
Q

Malignant Melanoma: What is it?

A
  • tumors arising from malignant transformation of melanocytes (pigment-producing cells)
  • leading cause of death due to skin disease
  • incidence has doubled over past 30 years
  • tumor thickness is the single most important prognostic factor
  • lymph node involvement and metastases decrease survival
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3
Q

Malignant Melanoma: Assessment

A
  • use the ABCDE mnemonic
  • be suspicious of any moles that look different than the others
  • look on the hands, soles of feet, and nails of dark-skinned individuals
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4
Q

Malignant Melanoma: ABCDE

A

A - asymmetry of lesion
B - borders, irregular
C - color (blue/black or variegated)
D - diameter greater than 6 mm
E - elevation above skin level
** Refer immediately if suspected!!!

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5
Q

Malignant Melanoma: Diagnostic Tests

A
  • clinical exam
  • biopsy
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6
Q

Malignant Melanoma: Prevention

A
  • sunscreen with at least 45 SPF
  • wide brimmed hats
  • long sleeves when in the sun
  • avoid tanning bed use
  • avoid sun exposure at peak hours (10-4)
  • instruct to do a full body exam once per month and notify HCP of any changes
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7
Q

Malignant Melanoma: Treatment

A
  • complete excision of the melanoma
  • refer for sentinel lymph node biopsy, complete excision, and chemotherapy
  • F/U every 3-6 months after treatment complete for skin reassessment
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8
Q

Squamous Cell Carcinoma: What is it?

A
  • epithelial tumors arising from the keratinocytes of the epidermis
  • may arise from actinic keratosis
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9
Q

Squamous Cell Carcinoma: Risk Factors

A
  • fair skinned organ transplant patients
  • smokers
  • Same risk factors as other skin cancers
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10
Q

Squamous Cell Carcinoma: Assessment

A
  • indistinct margins
  • surface is firm, scaly, irregular
  • may bleed easily
  • may appear as a nonhealing ulcer or warty nodule
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11
Q

Squamous Cell Carcinoma: Prevention

A
  • nicotinamide 500 mg PO BID can decrease the rate of development by 30% in high risk groups
  • sunscreen with at least 45 SPF
  • wide brimmed hats
  • long sleeves when in the sun
  • avoid tanning bed use
  • avoid sun exposure at peak hours (10-4)
  • instruct to do a full body exam once per month and notify HCP of any changes
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12
Q

Squamous Cell Carcinoma: Diagnostic Tests

A
  • clinical exam
  • biopsy
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13
Q

Squamous Cell Carcinoma: Treatment

A
  • Preferred treatment for invasive SCC is excision or Mohs micrographic surgery
  • SCC in situ can be treated with imiquimod
    OR
  • 5-fluorouracil
    OR
  • curettage and electrodessication
    *** REFER
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14
Q

Squamous Cell Carcinoma: Follow-Ups

A

Complete skin assessment is needed every 3 months with careful examination of lymph nodes for a year, then twice yearly afterward

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15
Q

Basal Cell Carcinoma: What is it?

A
  • tumors arising from the basal cell layer of the skin and skin appendages
  • most common form of skin cancer
  • metastasis is rare
  • slow growing
  • commonly found on the face, head, and neck
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16
Q

Basal Cell Carcinoma: Risk Factors

A
  • more common in men
  • common in 40 to 60 year olds
  • same risk factors as other skin cancers
17
Q

Basal Cell Carcinoma: Assessment

A
  • waxy, pearly papule
  • erythematous patch greater than 6 mm
  • non healing ulcer in sun exposed areas
  • history of bleeding
18
Q

Basal Cell Carcinoma: Prevention

A
  • nicotinamide 500 mg PO BID can decrease the rate of development by 20% in high risk groups
  • sunscreen with at least 45 SPF
  • wide brimmed hats
  • long sleeves when in the sun
  • avoid tanning bed use
  • avoid sun exposure at peak hours (10-4)
  • instruct to do a full body exam once per month and notify HCP of any changes
19
Q

Basal Cell Carcinoma: Diagnostic tests

A
  • clinical exam
  • biopsy
20
Q

Basal Cell Carcinoma: Treatment

A

** The histologic classification determines the therapy
1. imiquimod applied topically 5 nights per week for 6-10 weeks and 5-FU applied topically bid for up to 12 weeks for select patients with superficial BCC
2. superficial or nodular type lesions can be treated with curettage and electrodessication, excision, or Mohs micrographic surgery;
3. micronodular or infiltrative should be treated with excision or Mohs micrographic surgery.