Skin cancers Flashcards
Main malignant skin cancers?
Basal cell carcinoma (rarely met.)
Squamous cell carcinoma (can be very aggressive)
Malignant melanoma
Risk factors for skin cancer?
Sunlight exposure Fair skin Radiation exposure Chemical carcinogens Inherited disorders (e.g albinism) Naevi Pre-malignant conditions (e.g Actinic keratosis, Bowen's disease, Cornu cutaneum).
Clinical features of a high risk basal cell carcinoma?
Lesion on the head or neck Tumour diameter >20mm Poorly defined margins Recurrent BCC Age <40yrs old
Clinical features of a high risk squamous cell carcinoma?
Lesion on the head or neck Lesion on the lip Tumour diameter >20mm Recurrent SCC Site of previous radiotherapy Site of chronic inflammation (e.g at a scar from a burn) Immunosuppressed Neurological symptoms
Where are BCCs usually found?
Areas of sun exposure
- Face, forehead, hair margin
Typical appearance of BCC?
Small nodules with raised “pearl” edges. May ulcerate.
How to treat BCC?
Shave, cautery, currettage Photodynamic therapy Imiquimod Therapy (Aldara) Cryotherapy Radiotherapy Moh surgery Surgical excision
Are BCCs or SCCs more common?
BCCs are more common.
What factors influence the metastatic potential of SCCs?
Site Size >2cm Depth >4mm Patient immune status Poorly differentiated on histology If spread is perineural or perivascular
How to treat SCC?
Radiotherapy or surgical excision.
What is the ABCDE system for melanomas?
Method of assessing whether a naevus/lesion is a malignant melanoma.
A- Asymmetry
B- Irregular Borders
C- Colour change e.g Darker or reddish tinge
D- Diameter >6mm
E- Evolution (Changed, become itchy or painful)
Investigation of MM’s?
Excisional or incisional biopsy.
Most important prognostic factor in MM?
Breslow thickness.
What is the sentinel node?
The first node the tumour drains to.
How to carry out a SLN biopsy?
- Inject radio-labelled isotope
- Inject a blue dye pre-op
- Use a gamma probe to ID hot-spot
- ID the SLN on dissection by identifying the blue dye uptake.
