Skin cancers & Paraneoplastic syndromes

Question 1

Moderate association with tumors ?

Answer 1

• Sweet’s syndrome.
• pyoderma gangrenosum.
• DM.

Question 2

SCC- types ?

Answer 2

• In-situ ( Bowen’s disease, erythroplasia of Queyrat )
• Invasive SCC.
• Keratoacanthoma.

Question 3

What is the most common skin cancer?

Answer 3

BBC (80%)

Question 4

How deep is the surgical excision should be in the TTT of malignant melanoma ? ( in situ and invasive )

Answer 4

• In situ: 5 mm margin.

- Invasive: 1-3 cm depending on Breslow’s depth.

Question 5

Invasive SCC is associated with mutation in ?

Answer 5

• p53.
• usually develop on pre-existing actinic keratosis.
• lymph node metastases are present in 5%.

Question 6

BCC- Clinical types ?

Answer 6

• Nodular ( pigmented, infiltrative )
• Superficial.
• Morpheaform.

Question 7

TTT of SCC?

Answer 7

• curettage electrodessication (ED/C)
• Surgical excision.
• Radiation therapy.
• liquid nitrogen cryotherapy.
• Efudex or Aldara.

Question 8

TTT of BCC?

Answer 8

• curettage electrodessication (ED/C)
• Surgical excision. ( 95% cure rate )
• Radiation therapy.
• Topical Imiquimod ( 50-75% )

Question 9

Higher risk of metastases ? BCC or SCC ?

Answer 9

SCC

Question 10

What is the most common tumor associated with “bazex syndrome” ?

Answer 10

SCC (esp. metastases)

Question 11

What is the most common tumor associated with “tripe palms” ?

Answer 11

Bronchial and gastric cancer (50%)

Question 12

Strong association with tumors ?

Answer 12

• Malignancy associated “Acanthosis nigricans”.
• Bazex syndrome.
• Erythema gyratum repens.
• Necrolytic migratory erythema.
• paraneaplastic pemphigus.
• Sign of laser-trelat.

Question 13

Liquid nitrogen “Cryotherapy” side effects?

Answer 13

• Residual hypopigmentation.

- Blister formation.

Question 14

What is the risk of malignant transformation of Actinic keratoses ?

Answer 14

10%

Question 15

Sign of laser-trelat is ? and What is the most common tumor associated with it?

Answer 15

• Sudden development of numerous seborrhoeic keratoses in an eruptive fashion.
• with or without pruritus.
• associated with adenocarcinoma (50%) in GI.

Question 16

What is the most common tumor associated with “malignant associated Acanthosis nigricans” ?

Answer 16

• Gastric carcinoma.

Question 17

Invasive SCC TTT ?

Answer 17

• Surgical excision. ( traditional & mohs surgery ) with histologic control of margins.
• Radiation therapy.

Question 18

Weak association with tumors ?

Answer 18

• Acquired ichthyosis.
• Erythroderma.
• Pruritis.
• Isolated acanthosis nigricans.**

Question 19

TTT of Actinic keratoses ?

Answer 19

• liquid nitrogen cryotherapy.
• Topicals ( 5-FU , Imiquimod ) (3-5 times a week for 6-8 wks) and (diclofenac in hyaluronic acid)
• Curettage of hypertrophic lesions.