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SYSTEMIC CONDITIONS > SKIN CONDITIONS > Flashcards

SKIN CONDITIONS Flashcards

1
Q

SCABIES - DEFINITION

A
  • Scabies is a skin condition caused by the Sarcoptes scabiei var hominis mite
  • These little bugs make tunnels (burrow) under the skin and cause small red bumps and severe itching
  • Scabies spreads easily from person to person, especially among people who live close together
  • Scabies is a worldwide problem but happens most often in tropical areal and in very crowded places
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2
Q

SCABIES - TYPES

A
  • Crusted (Norwegian)
    o Often happens in people with faulty immune systems
    o Tends to form crusted areas covering a large area of skin
  • Nodular
    o This type is common among children
    o The brown-red nodules can still be there long after the mites are gone
  • Bullous
    o In adults, this type of scabies can be mistaken for bullous pemphigoid, another condition involving skin blisters
  • Scalp
    o This type occurs on the scalp
    o May not present symptoms except for scales that may look like psoriasis
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3
Q

SCABIES - CAUSE

A
  • Scabies is a skin condition caused by the Sarcoptes scabiei var hominis mite
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4
Q

SCABIES - POPULATION AFFECTED

A
  • Anyone can get scabies
  • Slightly more common in infants and children because they have close physical contact with parents, friends, family members and classmates
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5
Q

SCABIES - RISK FACTORS

A
  • People who live in close, crowded conditions
  • Infants and children
  • People who are elderly, especially those living in nursing homes
  • Healthcare workers who care for people who aren’t aware they have scabies
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6
Q

SCABIES - CLINICAL PRESENTATION

A
  • You can be infected with scabies for 4 to 6 weeks before having the early symptoms of the red rash and bumps
  • The tiny spots may look like bumps and pimples
  • The rash spreads slowly over a period of weeks or months
  • In addition to the rash, signs and symptoms of scabies include
    o Intense itching, which is worse at nighty and could make it hard to sleep
    o Bumps that sometimes become infected as a result of scratching
    o A later rash that looks greyish or skin-coloured lines on the skin
  • Children with scabies may have itching all over their bodies and might be cranky or tired from lack of sleep due to itching at night
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7
Q

SCABIES - WHERE DO SCABIES MITES LIVE ON THE BODY?

A
  • Mites live in the folds and narrow cracks of the skin
  • Folds in between the fingers and toes
  • Folds in the thighs and genital area
  • Bends at the wrist and knees
  • The area around the waist
  • Under the fingernails
  • Under rings, watch bands and bracelets
  • The area around the nipples
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8
Q

SCABIES - DIAGNOSIS

A
  • Diagnosis involves a physical exam where the rash is inspected
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9
Q

SCABIES - TREATMENT

A
  • Cream that contains a medicine called permethrin to treat scabies
  • The cream is applied to the whole body below the head, including the hands, palms and soles of the feet
  • In children the cream may need to be applied to the scalp
  • Permethrin cream is left on the skin for 8 to 14 hours and then washed off
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10
Q

SCABIES - PREVENTION

A
  • Washing bed linens, towels and clothing in hot water and machine dry
  • Making sure family members and others in close contact with the infected person get checked for scabies
  • Limiting close contact with others if you know you have got scabies
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11
Q

SCABIES - PROGNOSIS

A
  • Prognosis is good
  • Scabies can be treated very quickly and easily
  • You can get scabies more than once, you can get it any time that you come into close contact with an infected person
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12
Q

PEDICULOSIS (BODY LICE) - DEFINITION

A
  • Body lice are small, oblong insects that feed on human blood
  • There are 3 types of lice that affect humans
    o Body lice
    o Head lice
    o Pubic lice
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13
Q

PEDICULOSIS (BODY LICE) - STAGES OF BODY LICE

A
  • Nit
    o Oval shaped, yellow-white lice eggs
    o They are very small and you may not see them on the skin
    o Nits hatch within 1 or 2 weeks
  • Nymph
    o A nymph is an adolescent louse that hatches from a nit
    o Nymphs are smaller than adult lice but will mature into adults after feeding on blood for 9 – 12 days
  • Adult
    o An adult louse looks yellow-grey or brown-red
    o They are about the size of a sesame seed (3mm)
    o Female lice are typically bigger than male lice and they lay over 300 nits during their lifespan
    o Body lice only live for about 20 days
    o If an adult louse cannot feed on blood it will die within 1 to 2 days
  • Body lice dint live on your body, they live and reproduce in the clothing
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14
Q

PEDICULOSIS (BODY LICE) - CAUSE

A
  • Body lice spread by direct, person-to-person contact
  • You may also get body lice by sharing
    o Clothing
    o Bedding
    o Towels
    o Other linens
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15
Q

PEDICULOSIS (BODY LICE) - POPULATION AFFECTED

A
  • Anyone can have lice
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16
Q

PEDICULOSIS (BODY LICE) - RISK FACTORS

A
  • People without housing
  • Refugees
  • Victims of natural disasters
  • Victims of war
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17
Q

PEDICULOSIS (BODY LICE) - CLINICAL PRESENTATION

A
  • Symptoms of body lice vary
  • If the body lice carry disease or an allergic reaction occurs symptoms may be more severe
  • Common symptoms
    o A tickling feeling on the skin
    o Itchy and irritated skin
    o Groups of small, discoloured (red, purple, brown) dots or bites. They may grow bigger and develop a lighter discoloured ring around the outside
  • More severe symptoms may include
    o Sores
    o Infections
  • If you have a long-term body lice infestation or if heavily bite certain areas of the skin, the skin may thicken and get darker
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18
Q

PEDICULOSIS (BODY LICE) - DISEASES SPREAD BY BODY LICE

A
  • Typhus
    o A bacterial infection that causes a skin rash, fever and headaches
  • Trench fever
    o A bacterial infection that causes fever, weakness, dizziness, headaches and pain in the legs and back
  • Louse-borne relapsing fever
    o A bacterial infection that causes recurring fever, nausea and vomiting and muscle pains
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19
Q

PEDICULOSIS (BODY LICE) - DIAGNOSIS

A
  • Diagnosis involves a physical exam
  • The examiner may also look at your clothing
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20
Q

PEDICULOSIS (BODY LICE) - TREATMENT

A
  • Most people get rid of lice by regularly bathing with soap and warm water and washing their clothes
  • To prevent them from coming back you should wash all fabric materials at least once a week
  • Wash clothing, bedding and other fabrics in hot water – 60 degrees
  • If you cant wash certain things you should put them in a sealed plastic bag for about 2 weeks
  • Treatments
    o Oral antiparasite medication – ivermectin tablets
    o Topical antiparasite powder, lotion cream or shampoo – permethrin
  • How to manage symptoms
    o Antihistamines
    o Hydrocortisone
  • Home remedies
    o Aloe vera gel
    o Ice
    o Oatmeal
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21
Q

PEDICULOSIS (BODY LICE) - PREVENTION

A
  • You can prevent body lice by
    o Bathing
    o Washing clothing, bedding and other personal items at least once a week
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22
Q

PEDICULOSIS (BODY LICE) - PROGNOSIS

A
  • Most people recover without medication
  • It may need 2 weeks for the infestation to go away
  • Nots hatch in 1 or 2 weeks and can be killed through proper washing of clothing or bedding in hot water
  • Adult lice and nymphs will die in one or two days if they cant deed on the blood
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23
Q

ACUTE HERPES ZOSTER - DEFINITION

A
  • Commonly known as shingles
  • Shingles is a viral infection that causes an outbreak of a painful rash or blisters on the skin
  • It is caused by the same virus that causes chicken pox
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24
Q

ACUTE HERPES ZOSTER - CAUSE

A
  • Shingles is caused by the varicella-zoster virus
  • This is the same virus that causes chicken pox
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25
Q

ACUTE HERPES ZOSTER - POPULATION AFFECTED

A
  • Typically affects older people and those who are inane suppressed
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26
Q

ACUTE HERPES ZOSTER - RISK FACTORS

A
  • Having a weakened immune system
    o Cancer
    o HIV
    o Organ transplant
    o Chemotherapy
  • Over 50
  • Been recently ill
  • Experienced trauma
  • Under stress
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27
Q

ACUTE HERPES ZOSTER - CLINICAL PRESENTATION

A
  • Early symptoms of shingles
    o Fever
    o Chills
    o Headache
    o Feeling tired
    o Sensitivity to light
    o Stomach upset
  • Other signs and symptoms that appear after a few days
    o An itching, tingling or burning feeling in an area of your skin
    o Redness on the skin in the affected area
    o Raised rash in a small area of the skin
    o Fluid-filled blisters that break open then scab over
    o Mild to severe pain in the area of skin affected
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28
Q

ACUTE HERPES ZOSTER - PROGRESSION

A
  • It can take 3 to 5 weeks from the time the pt begins to feel symptoms until the rash totally disappears
    1. First, a few days before the rash appears, pt may feel pain in an area of the skin. The pain is described as itching, burning, stabbing or shooting. This usually happens before the rash comes
    2. Next, the raised rash appears as a band or a patch, usually on one side of the pt body. The rash usually appears around the waistline or on one side of the face, neck, or on the trunk, but not always. It can occur on other areas including the arms and legs
    3. Within 3 to 4 days, the rash develops into red, fluid-filled, painful, open blisters
    4. Usually, these blisters begin to dry out and crust over withing about 10 days
    5. The scabs clear up about 2 to 3 weeks later
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29
Q

ACUTE HERPES ZOSTER - DIAGNOSIS

A
  • Shingles can be diagnosed by the way the rash is distributed on the body
  • The blisters of a shingles rash usually appear in a band on one side of the body
  • May also be diagnosed in a laboratory using scrapings or a swab of the fluid from the blisters
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30
Q

ACUTE HERPES ZOSTER - TREATMENT

A
  • No cure
  • Antiviral medications
    o Used to ease discomfort and make symptoms stop sooner
    o Acyclovir
    o Famciclovir
    o Valacyclovir
  • Over the counter pain medications
  • Anti-inflammatory drugs
    o Prednisone
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31
Q

ACUTE HERPES ZOSTER - PREVENTION

A
  • Vaccination
  • Staying away from people who have shingles
32
Q

ACUTE HERPES ZOSTER - PROGNOSIS

A
  • Can be a very painful condition
  • If shingles involves the eye it can lead to blindness
  • In rare cases, shingles can lead to
    o Hearing problems
    o Pneumonia
    o Encephalitis
33
Q

HERPES SIMPLEX - DEFINITION

A
  • Herpes simplex, known as HSV is a viral infection that causes genital and oral herpes
  • Many people live with asymptomatic HSV which means they have the virus without ever having an outbreak or active episode of herpes
  • Others might experience occasional episodes of small, fluid-filled blisters or sores
  • These blisters most commonly appear on the genitals or mouth and lips but they can also show up on the hands or fingers and other parts of the body
34
Q

HERPES SIMPLEX - TYPES

A
  • 2 main types of herpes simplex
    o HSV-1
    o HSV-2
  • HSV-1
    o This type primarily causes oral herpes
    o Characterised by cold sores or fever blisters that appear around the mouth or on the face
  • HSV-2
    o Primarily causes genital herpes
    o Involves sores that appear on or around the genitals, anus, buttocks and inner thighs
    o Sores can also develop inside the vagina
35
Q

HERPES SIMPLEX - CAUSE

A
  • HSV is a contagious virus that can be transmitted through direct contact with sores
36
Q

HERPES SIMPLEX - POPULATION AFFECTED

A
  • Women and people who have had an STD before
37
Q

HERPES SIMPLEX - RISK FACTORS

A
  • Sex
    o Slightly more common in women than men
  • Contact with genitals through oral, vaginal or anal sex
  • Having sex with multiple partners
  • Having a partner who has the disease but is not taking medicine to treat it
  • People with a history of STDs
  • Older people
  • Race
    o Black and Hispanic more common than white
  • Men who have sex with men who have been diagnosed
38
Q

HERPES SIMPLEX - CLINICAL PRESENTATION

A
  • HSV doesn’t always cause symptoms
  • Primary symptoms
    o Symptoms will generally appear anywhere from a few days to a few weeks after exposure to the virus
    o Primary episodes often include flu-like symptoms
    o Fever
    o Swollen lymph nodes
    o Body aches and pains including headache
    o Unusual tiredness or fatigue
    o Lack of appetite
    o Shooting pain at the site of the infection
  • Recurrent HSV symptoms
    o Some people only have one episode while others have occasional episodes every several months or so
    o Blisters that appear during a recurrent episode may completely heal within several days rather than several weeks
    o Blisters may be less noticeable or painful during recurrent episodes
    o You may notice early signs at the site of the infection
     Pain
     Itching
     Burning
     Tingling
39
Q

HERPES SIMPLEX - DIAGNOSIS

A
  • Sometimes, HSV can be diagnosed by examining the blisters
  • They may also look at the symptoms and early signs
  • A culture is likely needed to confirm diagnosis
  • A blood test can also be done to determine whether or not you have HSV antibodies
  • General STI screenings typically don’t include testing for HSV
40
Q

HERPES SIMPLEX - TREATMENT

A
  • There is no cure
  • Blisters typically improve on their own, without medical treatment
  • Medications
    o For frequent outbreaks, you may be prescribed antiviral medications
    o Antivirals can help to reduce the number of episodes experienced and ease the severity of symptoms
    o Acyclovir
    o Famciclovir
    o Valacyclovir
    o Foscarnet or cidofovir for HSV infections that resist other medications
  • Home remedies
    o A warm or cold compress
    o A paste of baking soda or cornstarch or water
    o Mixture of crushed garlic and olive oil
    o Aloe vera
    o Tea tree, eucalyptus or peppermint oil
41
Q

HERPES SIMPLEX - PREVENTION

A
  • Avoid sharing a razor or toothbrush
  • If you have genital HSV, avoid all skin-to-genital contact from the time you notice early symptoms until the sores have completely healed
  • Wash hands thoroughly after touching sores or applying medicine to them
  • Apply medication with cotton swabs to reduce the contact with the sores
42
Q

HERPES SIMPLEX - PROGNOSIS

A
  • No cure
  • For most people the first outbreak is the most severe
  • Many outbreaks are less frequent and milder after the 1st year of infection
  • This does not pose a serious health risk
  • Health complications due to herpes is higher in infants and in people who have HIV/AIDS, cancer or an organ transplant
43
Q

MALIGNANT MELANOMA - DEFINITION

A
  • Melanoma means ‘black tumour’
  • This is the most dangerous type of skin cancer
  • It grows quickly and has the ability to spread to any organ
  • Melanoma comes from skin cells called melanocytes. These cells produce melanin, the dark pigment that gives the skin its colour
  • Most melanomas are black or brown but some are pink, red, purple or skin coloured
  • About 30% start in existing moles but the rest start in normal skin
44
Q

MALIGNANT MELANOMA - CAUSE

A
  • Major risk factor for melanoma is overexposure to sunlight
  • Especially sunburns when you are young
45
Q

MALIGNANT MELANOMA - POPULATION AFFECTED

A

White people

46
Q

MALIGNANT MELANOMA - RISK FACTORS

A
  • Personal history of melanoma
  • Family history of melanoma
  • Fair skin, freckles, blonde or red hair, blue eyes
  • Excess sun exposure, including blistering sunburns
  • Living near the equator or in high elevations
  • History of tanning bed use
  • Many moles, especially atypical moles
  • Weakened immune system
47
Q

MALIGNANT MELANOMA - CLINICAL PRESENTATION

A
  • An atypical mole
  • Melanoma can appear as moles, scaly patches, open sores or raised bumps
  • Asymmetry
    o One half does not match the other half
  • Border
    o Edges are not smooth
  • Colour
    o The colour is mottled and uneven, with shades of brown, black, grey, red or white
  • Diameter
    o The spot is greater than the tip of a pencil eraser (6.0mm)
  • Evolving
    o The spot is new or changing in size, shape or colour
48
Q

MALIGNANT MELANOMA - DIAGNOSIS

A
  • Biopsy
    o The unusual mole is removed and looked at under a microscope
  • Once the skin biopsy results show evidence of melanoma cells the next step is to determine if the melanoma has spread
    o This is called staging
  • Tests used to stage melanoma
    o Sentinel lymph node biopsy
    o CT scan
    o MRI scan
    o PET scan
    o Blood work
49
Q

MALIGNANT MELANOMA - STAGES OF MELANOMA

A
  • Stage 0
    o Melanoma in situ
    o The melanoma is only on the top layer of skin (the epidermis)
  • Stage 1
    o Low-risk primary melanoma with no evidence of spread
    o This stage is generally curable with surgery
  • Stage 2
    o Features are present that indicate higher risk of recurrence
    o There is no evidence of spread
  • Stage 3
    o The melanoma has spread to nearby lymph nodes or nearby skin
  • Stage 4
    o The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs
50
Q

MALIGNANT MELANOMA - TREATMENT

A
  • Treatment will depend on the stage of the melanoma and general health
  • Surgery is usually the main treatment
  • Procedure involves cutting out the cancer and some of the normal skin surrounding it
  • Usually this removal can be performed under local anaesthesia
  • More advanced cases may require other types of treatment in addition to or instead of surgery
    o Melanoma surgery
    o Lymphadenectomy – removal of the lymph nodes near the primary diagnosis may be done if the melanoma has spread
    o Metastasectomy – used to remove small melanoma bits from organs
    o Targeted cancer therapy – drugs are used to attack specific cells
    o Radiation therapy – treatment with high energy rays of attack cancer cells and shrink tumours
    o Immunotherapy – stimulates the immune system to help fight the cancer
51
Q

MALIGNANT MELANOMA - PREVENTION

A
  • Avoid sun and seek shade, especially between 10am and 4pm
  • Don’t use tanning beds
  • Wear hats with brims, sunglasses, long sleeved shirts and pants where possible
  • Use a broad-spectrum sunscreen with a SPF of 30 or higher
  • Reapply sun cream aften, usually every 1.5 hours or more often if you are swimming or sweating
  • Use a lip balm with a sun cream
  • Apply sun cream to young children and infants older than 6 months
52
Q

MALIGNANT MELANOMA - PROGNOSIS

A
  • Most skin cancers can be cured if they are treated before they have a chance to spread
  • More advanced cases of melanoma can be fatal
  • The earlier skin cancer is found and removed, the better the chances of a full recovery are
53
Q

BASAL CELL CARCINOMA - DEFINITION

A
  • Basal cell carcinoma is a type of skin cancer that forms in the basal cells of the skin
  • Basal cells exist in the lower part of the epidermis, which is the outside layer of the skin
  • Basal cell carcinoma looks like a small, sometimes shiny bump or scaly flat patch on the skin that slowly grows overtime
  • Basal cells are responsible for making new skin cells by dividing and copying themselves
  • When basal cells create new cells, the older skin cells push to the surface of the epidermis, where they die and leave the body
  • The most common type of skin cancer
54
Q

BASAL CELL CARCINOMA - TYPES

A
  • Nodular
    o The most common type of BCC
    o Looks like a round pimple with visible blood vessels surrounding it (telangiectasias)
  • Superficial spreading
    o This type causes lesions that appear as small, shallow marks on the skin that are slightly lighter in colour than the surrounding skin
    o These lesions form on the trunk, arms and legs
  • Sclerosing (morpheaform)
    o These cancerous lesions look like scars that slowly expand over time
    o This type is most common on the face
    o This type can also take the form of a small red dot on the skin
  • Pigmented
    o This is a rare type of BCC
    o It causes hyperpigmentation, where an area of the skin becomes darker than the skin surrounding it
55
Q

BASAL CELL CARCINOMA - CAUSE

A
  • A change in DNA causes basal vell carcinoma
  • This change usually happens after the skin has too much exposure to UV rays from sunlight ot tanning beds
  • The genes give the body’s DNA instructions to make new cells to replace cells that reach the end of their lifespan by copying and replicating themselves
  • If a mutation affected one of the genes, your DNA won’t have the instructions to make new cells as it should
  • If a genetic mutation targets the DNA, the basal cells wont be able to turn off which causes the basal cells to make too many cells, which causes tumours or lesions to form in the epidermis
  • A rare inherited condition called basal cell nevus syndrome (Gorlin’s syndrome) causes BCC to appear in childhood
56
Q

BASAL CELL CARCINOMA - POPULATION AFFECTED

A
  • Men over 50 with a fair complexion
57
Q

BASAL CELL CARCINOMA - RISK FACTORS

A
  • Sex
    o Slightly more common in men
  • Age
    o Most common in people over 50
  • People with fair skin
  • People with light eyes
58
Q

BASAL CELL CARCINOMA - CLINICAL PRESENTATION - SIGNS

A

o Lumps, bumps, pimples, scabs or scaly lesions on the skin
o The kump may be slightly see-through and close to the normal skin colour or white to pink, brown to black or black to blue
o The lump may appear shinier than the skin around it with tiny visible blood vessels
o The lump may grow slowly over time
o The lump may be itchy or painful
o The lump may form an ulcer, which can ooze clear fluid or bleed with contact

59
Q

BASAL CELL CARCINOMA - CLINICAL PRESENTATION - SYMPTOMS

A

o Basal cell carcinomas most commonly appear on areas of the body exposed to the sun
o Face
o Scalp
o Nose
o Eyelids
o Legs
o Ears
o Arms

60
Q

BASAL CELL CARCINOMA - DIAGNOSIS

A
  • Diagnosis involves physical examination
    o Looking at the size, shape and location of the lump or lesion
  • A questionnaire
    o When did you notice the lump on the skin?
    o Did this lump change in size from when you first noticed symptoms?
    o Is it itchy or painful?
    o Does the lesion look different today from when you first noticed it?
    o Have you had skin cancer previously?
  • Tests
    o Skin biopsy
    o Imaging tests
61
Q

BASAL CELL CARCINOMA - TREATMENT

A
  • Treatment is by removing cancer from the body
  • Cryosurgery
    o Freezing the cancer cells
  • Photodynamic therapy (PDT)
    o Using blue light and light sensitive agents to remove the cancer form the skin
  • Curettage and electrodesiccation
    o Scratching off the cancerous lump with a spoon like instrument then burning the area with an electric needle
  • Excision
    o Cutting the cancer out and stitching the skin back together
  • Chemotherapy
    o Powerful medications to kill cancerous cells in the body
  • Laser therapy
    o Using lasers to remove cancer instead of using a scalpel
  • Medications
    o Vismodegib
    o Sonidegib
62
Q

BASAL CELL CARCINOMA - PREVENTION

A
  • Avoid sun exposure from 10am to 4pm
  • Avoiding tanning beds
  • Using sunscreen with SPF 30 or higher each day and reapply every 2 hours throughout the day of you are outdoors or participating in activities like swimming
  • Wearing clothing that has built-in sun protection (UPF), broad brimmed hats and sunglasses
  • Performing a skin self-exam once per month
  • Visiting a dermatologist annually
  • Contacting a healthcare provider if you have any questions about the skin or changes to the skin
  • Taking nicotinamide (vitamin B3)
63
Q

BASAL CELL CARCINOMA - PROGNOSIS

A
  • Prognosis is excellent
  • BCC will rarely spread to other areas of the body and cause harm
  • There is a low chance that it can return after it is removed
64
Q

SQUAMOUS CELL CARCINOMA - DEFINITION

A
  • Squamous cell carcinoma is a type of skin cancer caused by an overproduction of squamous cells in the epidermis
  • The epidermis is the top layer of the skin
  • This is the 2nd most common type of skin cancer
  • Usually SCC’s form on the areas of the skin that receive the most sun exposure
65
Q

SQUAMOUS CELL CARCINOMA - TYPES

A
  • Cutaneous
    o Cancer that only affects the top layer of the skin or cancer that spreads beyond the top layer of the skin
  • Metastatic
    o Cancer that’s spread to other parts of the body beyond the skin
66
Q

SQUAMOUS CELL CARCINOMA - CAUSE

A
  • A mutation on the p53 gene causes SCC
  • The most common way the p53 gene mutates is from UV exposure from the sun or from using indoor tanning beds
  • The p53 gene provides instructions from the cells to divide and replicate to replace cells when they reach the end of their lifespan
  • The p53 gene is a tumour suppressor
  • A mutation in the p53 gene means that the cells don’t have the instructions they need to do their job properly
  • As a result, the squamous cells divide and replicate too often, causing tumours to form in the body
67
Q

SQUAMOUS CELL CARCINOMA - POPULATION AFFECTED

A
  • Males over 65 with a fair complexion
68
Q

SQUAMOUS CELL CARCINOMA - RISK FACTORS

A
  • Have long-term sun exposure or sun damage to the skin at a young age
  • Have a pale complexion
  • Having blue or green eyes
  • Having blonde or red hair
  • Are 65 years old or older
  • Have a weak immune system or receive an organ transplant
  • Have chemical exposure e.g. cigarettes
  • Sex
    o Males are 2x more likely to develop SCC
69
Q

SQUAMOUS CELL CARCINOMA - CLINICAL PRESENTATION - SIGNS

A

o A bump or lump that can feel dry, itchy, scaly or have a different colour from the skin around it (actinic keratosis)
o A lesion on the lower lip where the tissue becomes pale, dry and cracked (cheilitis). This may have a burning sensation when exposed to the sun
o White or pale spots in the mouth, on the tongue, gums or cheeks (leukoplakia)

70
Q

SQUAMOUS CELL CARCINOMA - CLINICAL PRESENTATION - SYMPTOMS

A

o A rough feeling bump or growth which might crust over like a scab and bleed
o A growth that’s higher than the skin around it but sinks down in the middle
o A wound or sore that wont heal, or a sore that heals and then comes back
o An area of skin that’s flat, scaly and red that’s larger, about 1 inch

71
Q

SQUAMOUS CELL CARCINOMA - CLINICAL PRESENTATION - WHERE CAN YOU GET SCC?

A

o Skin
o Mouth, tongue and throat (oral carcinoma)
o Face, lips, nose, ears, eyelids and scalp
o Stomach (oesophageal or epidermoid carcinoma)
o Hands, arms and legs
o Anal cavity

72
Q

SQUAMOUS CELL CARCINOMA - DIAGNOSIS

A
  • Diagnosis involves physical examination
    o Looking at the size, shape and location of the lump or lesion
  • A questionnaire
    o When did you notice the lump on the skin?
    o Did this lump change in size from when you first noticed symptoms?
    o Is it itchy or painful?
  • Tests
    o Skin biopsy
    o CT or MRI scan
73
Q

SQUAMOUS CELL CARCINOMA - STAGES

A
  • Stage 0 – cancer is only in the top layer of the skin. This is also called squamous cell carcinoma in situ
  • Stage 1 – cancer is in the top and middle layers of the skin
  • Stage 2 – cancer is in the top and middle layers of the skin and moves to target the nerves or deeper layers of skin
  • Stage 3 – cancer has spread beyond the skin to the lymph nodes
  • Stage 4 – cancer has spread to other parts of the body and the organs like the liver, lungs and brain
74
Q

SQUAMOUS CELL CARCINOMA - TREATMENT

A
  • Treatment focuses on removing cancer from the body
  • Treatment options vary depending on size, shape and location of the cancer
  • Cryosurgery
    o Freezing the cancer cells
  • Photodynamic therapy (PDT)
    o Using blue light and light sensitive agents to remove the cancer form the skin
  • Curettage and electrodesiccation
    o Scratching off the cancerous lump with a spoon like instrument then burning the area with an electric needle
  • Excision
    o Cutting the cancer out and stitching the skin back together
  • Mohs surgery
    o Removing layers of skin affected by cancer – most common for facial cancers
  • Systemic chemotherapy
    o Using powerful medicines to destroy cancer cells in the body
  • Medications
    o Skin creams containing imiquimod (for carcinoma that is in the top layer of skin)
    o Cemiplimab-rwlc
    o Pembrolizumab
75
Q

SQUAMOUS CELL CARCINOMA - PREVENTION

A
  • Avoiding excessive sun exposure
  • Avoiding tanning beds
  • Using sunscreen when outdoors
  • Wearing protective clothing and accessories
    o Sunglasses
    o Hats
    o Clothing with UPF protection
  • Stopping smoking
  • Avoiding exposure to chemicals without wearing personal protective equipment
76
Q

SQUAMOUS CELL CARCINOMA - PROGNOSIS

A
  • Most cases have a positive prognosis and excellent survival rate with an early diagnosis
  • Early detection and treatment prevent the tumour from growing and damaging other parts of the body
  • However, the cancer can return

SYSTEMIC CONDITIONS (13 decks)

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