Skin Cancers - Melanoma

Question 1

Prevalence of skin cancers

Answer 1

BCC > SCC > Melanoma

Question 2

Prognosis of skin cancers

Answer 2

BCC > SCC > Melanoma (in 5 years, 90 percent survival rate)

Question 3

Risk factors for skin cancer

Answer 3

Family History
Sun exposure - sunbed, blistering sunburn in childhood, cumulative and intermittent sun exposure
Immunosuppression - azathioprine (x100 risk)

Question 4

Which immunosuppressed patients are most at risk?

Answer 4

Transplant patients

Question 5

Investigations

Answer 5

History and examination
Dermoscopy
Biopsy
Further imaging

Question 6

Management of skin cancers

Answer 6

Excision
Topical therapy (creams)
Cryotherapy
Radiotherapy

Question 7

Which cell is problematic in malignant melanoma?

Answer 7

Melanocytes

Question 8

How do you investigate malignant melanoma?

Answer 8

Diagnostic excision with a border of 2-3mm

Question 9

What is the prognostic factor used to for malignant melanomas?

Answer 9

Breslow thickness of depth

Question 10

Management of malignant melanoma

Answer 10

Wide local excision up to 3cm margin
Systemic therapy if spread

Question 11

Types of malignant melanoma

Answer 11

Superficial spreading
Nodular
Acral
Subungal
Amelanotic

Question 12

What is another name for nail melanoma? What does it look like? How would you distinguish between them?

Answer 12

Subungal
Black lines across nails
Looks like someone’s shut their nails in a door - but if the cuticle is also black, this is subungal melanoma not nail trauma

Question 13

What do you call it when the nail cuticle is also involved?

Answer 13

Hutchin’s sign

Question 14

Which of these melanomas has bad prognosis?

Answer 14

Nodular prognosis

Question 15

What does acral melanoma mean? Who does this affect the most? What are the risk factors?

Answer 15

Palms and soles - especially on dark skinned patients; NOT from UV exposure