Skin Cancers

Question 1

What are the risk factors for basal cell carcinoma?

Answer 1

UV, lighter skin, radiation, arsenic, poor immune system

Question 2

What are the types of basal cell carcinoma?

Answer 2

Superficial, infiltrative, nodular

Question 3

How is basal cell carcinoma best managed?

Answer 3

Surgical removal (mohs surgery), cryotherapy = imicramod + photodynamic therapy, electrodesiccation and curettage, radiation (not candidates for surgery)

Question 4

What are the signs and symptoms of basal cell carcinoma?

Answer 4

Present over a few months

Painless raised area of skin, shiny, small blood vessels, ulceration

Question 5

What are the risk factors for squamous cell carcinoma?

Answer 5

Older age, male, fair-skinned, exposure to UV, arsenic, bowen disease, HPV, HIV/AIDS, radiation

Question 6

What are the signs and symptoms of squamous cell carcinoma

Answer 6

Usually begins as a dome-shaped lesion or red scaly patch of skin, it enlarges and the centre becomes necrotic - turning into an ulcer, crusty, bleeds easily when scraped, itchiness, painful

Shorter presenting history than BCC as rapidly growing

Question 7

How is squamous cell carcinoma managed?

Answer 7

Topical

• sunscreen
• retinoids
• 5-fluorouracil

Surgical

• wide excision
• mohs surgery

Non-surgical

• photodynamic therapy (PDT)
• cryotherapy

Systemic
- retonoids

Question 8

Outline the risk factors for melanoma

Answer 8

FH, many moles, poor immune system

Question 9

What are the signs and symptoms of melanoma?

Answer 9

Mole that is increasing in size, has irregular edges, change in colour, itchiness, skin breakdown

Question 10

How should melanoma be investigated?

Answer 10

Skin exam, tissue biopsy (entire area of pigment), sentinel node biopsy

o A = asymmetry 
o B = border uneven, ragged, notched
o C = colouring of diff shades of brown
o D = diameter >6mm
o E = evolves over time 

1 = change in size
2 = irregular pigmentation 
3 = irregular outline
4 = >6mm
5 = inflam
6 = oozing or bleeding
7 = itch or altered sensation

Question 11

How should melanoma be managed?

Answer 11

Surgical removal, spread = immunotherapy, biologic therapy, radiation, chemo

Question 12

What are the hazards of UV radiation?

Answer 12

UV - B

• sunburn
• direct DNA damage and carcinogenesis

UV - A

• photo ageing
• potentates UV-B carcinogenesis
• immunological effects
• causes prod of ROS = cell mem, DNA, proteins

Question 13

Give 2 examples of a pre-malignant skin condition

Answer 13

Actinic keratosis - thick, scaly, crust skin

Bowens disease - considered early stage SCC