Skin Lumps Flashcards by Abby Lang

What is the ABCDE of skin lumps?

Asymmetry
Border/Bleeds
Colour
Diameter
Evolution

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Which skin cancer does chronic, intermittent, burning and artificial UV light predispose to?

Chronic = SCC
Intermittent and burning = BCC and melanoma
Artificial = all 3

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Where are organ transplant patients most likely to get skin cancer + what type?

Hands

SCC

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What histology do all SCC precursors show + name 3 treatments?

Squamous dysplasia
5-flurouracil
Imiquimod
Liquid nitrogen

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What is actinic keratosis + how does it present + 3 places it commonly affects?

Partial thickness dysplasia
Red scales
Scalp, face and arms

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What is Bowen’s disease + how does it present + who and where does it commonly affect?

Carcinoma-in-situ
Red plaque
Females
Lower leg

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What is seborrheic keratosis also know as + appearance + 2 histological signs?

Basal cell papilloma
Stuck on raisin
Hyperkeratosis and horn cysts

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What is Leser-Trelat sign?

Sudden multiple seb Ks indicating malignancy

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What is melanoma + mutation + who is it more common in?

Cancer of basal melanocytes
B-Raf
Women

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Which genes are associated with familial melanoma?

CDKN2A and CDK4

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2 ways melanoma spreads + 3 most common places?

Blood or lymph

Lungs, liver and brain

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Name the 2 growth phases of melanoma + which one can metastasise?

Vertical - can metastasise

Horizontal

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Name the 4 types of melanoma (+ most common) and which growth phases they go through.

Superficial (most common), acral/mucosal and lentigo = grow horizontally then vertically
Nodular = grows vertically

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Which scale is used for cancer referrals + when do you refer?

Glasgow scale

> 3 points or 1 if suspicious

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What are the 7 categories of the Glasgow scale?

Size
Shape
Colour
Inflammation
Crusting/bleeding
Sensory change
> 7mm

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What is used after skin biopsy to determine severity of cancer + where is the measurement to and from?

Breslow thickness

Granular layer to deepest tumour cell

What is pTis and survival rate + what does pT”b” mean?

CIC
100%
Ulceration

What is the 5-year survival rate for pT1, pT4 and metastasis?

95-100%
50%
6%

Treatment for melanoma if < 1 mm deep + > 1mm deep or mitoses?

< 1mm = removal with 1-2cm margin
> 1mm = removal + sentinal node biopsy + lymphadenectomy (if +VE)
Chemotherapy (if needed)

Name 2 B-Raf inhibitors + an MEK inhibitor.

Dabrafenib and vemurafenib

Trametinib

What is the most common skin cancer + what is it?

BCC

Cancer of the basal keratonocytes

What is BCC in terms of mutation, speed, metastasis, and general appearance?

PTCH1
Slow progressing
No metastasis
Nodular with ulceration and arborizing blood vessels

Name 4 types of BCC.

Superficial
Pigmented
Nodular
Locally invasive

2 histological signs of BCC?

Groups of basal cells in dermis

Peripheral palisading

What is the treatment for nodular + superficial BCC?

Surgical removal | Imiquimod/5-fu/liquid nitrogen

Which drug blocks the PTCH1 hedgehog pathway?

Vismodegib

What is SCC and what is it in terms of speed, metastasis and general appearance?

Cancer of the superficial keratinocytes Fast growing Metastasis in 5% Warty, hyperkeratotic lump

Which 3 places of SCC have a poorer prognosis?

Lip, ear and scalp

Treatment for SCC?

Surgical removal + radiotherapy

What does one + 2 defective copies of the MCR1 gene cause?

``` 1 = freckles (ephilides) 2 = red hair + freckles ```

What are actinic/solar lentigines known as + cause + histology?

Age or liver spots Increased melanin via sun exposure Elongated rete ridges

Name 3 types of naevus + where they are + who they are seen in + how they form.

Junctional = DEJ = kids Compound = DEJ + dermis = teen Intradermal = dermis = adult Keratinocyte: melanocyte ratio breaks down leading to dense clusters of melanocytes

What is the treatment for congenital naevi + why?

Surgical removal | Risk of melanoma

What are the 2 superficial signs of a dysplastic naevus>?

> 6 mm | Atypical colour/borders

Name 3 rare types of naevus + their associated cells.

``` Halo = lymphocytes Blue = pigmented spindle cells Spitz = spindle or epitheliod cells ```