Skin cancers Flashcards
What factors predispose to skin cancers?
Sun exposure / damage - important
Immunosuppression
Family history of skin cancer
What are the three most common skin cancers to know?
Basal cell carcinoma
Squamous cell carcinoma
Melanoma
What is actinic keratosis?
Partial thickness keratinocyte dysplasia of the epidermis
Non-malignant grey thickening of skin that predisposes to squamous cell carcinoma
Where does basal cell carcinoma arise from?
Basal keratinocytes
Where does squamous cell carcinoma arise from?
Supra-basal keratinocytes
What is ABCD(E) in relation to dermatological history taking?
Asymmetry
Border
Colour
Diameter
Elevation
Used in the investigation of pigmented lesions on the skin that suggest cancer
Which type of sun exposure is more likely to be found in squamous cell carcinoma?
Chronic sun exposure
Which type of sun exposure is more likely to be found in melanoma and basal cell carcinoma?
Intense but intermittent sun exposure
What is the typical history of basal cell carcinoma?
Slow growing (typically 6 months or longer)
Won’t heal
Rolled pearly shiny edge with central ulceration
Surface telangiectasia
What are the three main types of basal cell carcinoma?
Superficial BCC
Nodular BCC
Infiltrative BCC
What can be used to treat superficial basal cell carcinoma?
Non-surgical treatments
Creams - topical imiquimod
Liquid nitrogen spray
Photodynamic therapy
How is infiltrative basal cell carcinoma treated?
Mohs surgery
What is a typical history for squamous cell carcinoma?
Fast growing (typically 2-3 months)
Often tender, can bleed
Scaly / ulcerated lumps
May metastasise - most don’t
What is the most common skin cancer in the immunosuppressed population?
Squamous cell carcinoma
What is Bowen’s disease?
Full thickness dysplasia of the epidermis
Red non-malignant thickening of skin that predisposes to squamous cell carcinoma
How should actinic keratosis and Bowen’s disease be treated?
Liquid nitrogen spray
5-flurouracil cream
Patient education - report if anything changes
What are the most common areas of aggressive squamous cell carcinoma?
Lips and ears
What is the management of squamous cell carcinomas?
Surgical removal and follow up
What is the typical history of melanoma?
Changing pigmented lesion
Itching and bleeding
ABCDE assessment
Worst prognosis
Potential to metastasise
In patients with multiple atypical moles what should be done?
General examination of moles
Mole surveillance
Patient advice - notify about changes
What are the four main types of melanoma?
Superficial spreading melanoma
Acral lentiginous malignant melanomas
Lentigo maligna melanoma
Nodular malignant melanoma
What is the most common type of melanoma?
Superficial spreading melanoma
What is Breslow thickness?
The depth of the tumour
Determines prognosis of melanoma
Where is acral melanomas found?
Soles of the feet
Around the nails
Which type of melanoma is the most aggressive?
Nodular malignant melanoma
What does ‘amelanotic’ mean?
Non-pigmented melanoma
