Skin tumour and cancer

Question 1

most common skin cancer?

Answer 1

BCC

Question 2

how metastatic is BCC

Answer 2

not very

Question 3

where does SCC appear

Answer 3

sun damaged skin

Question 4

what is bowens disease

Answer 4

erythmatous plaque - CIS

Question 5

what is an actinic keratosis

Answer 5

precursor lesion indicating sun damage

Question 6

what is keratoacanthoma

Answer 6

spontaneously resolving SCC

Question 7

true false - 25% of SCC patients will get another

Answer 7

false - 50% will

Question 8

where else may SCC be found

Answer 8

chronic ulceration
scars
wounds

Question 9

why are melanocytes more likely to metastasise

Answer 9

they are mobile as they moved form neural crest

Question 10

prognosis of melanoma is dependent on?

Answer 10

breslow thickness

Question 11

ABCDE of melanoma?

Answer 11

asymmetry 
irregular border 
colour 
diameter >0.7mm
evolves quickly

Question 12

how does xeroderma pigmentosum predispose melanoma

Answer 12

defective NER so increased likelihood

Question 13

how does albinism increase likelihood of skin cancer

Answer 13

congenital absence of melanin so increased chance of DNA damage

Question 14

how does immunosuppression increase likelihood of skin cancer

Answer 14

less likely to destroy cancer cells - thought to be

Question 15

environmental carcinogens for skin cancer

Answer 15

coal tar, smoking
ionising radiation
chronic ulceration
previous skin cancer

Question 16

how to prevent skin cancer

Answer 16

avoiding bad sunlight 
shade 
look after kids
avoid sunbeds
use darker/wear clothes 
sunscreens - at least SPF30
self-surveillance

Question 17

weinbergs hallmarks of cancer?

Answer 17

evading immune response 
angiogenesis 
replicative immunity 
invasion
evading tumour suppressors 
resisting cell death 
proliferative signalling 
genomic instability 
tumour promoting inflammation

Question 18

true/false - if a cell has a p53 mutation it immediately becomes cancerous

Answer 18

false - many have mutant p53 in sun damage or older age but regulated by NER

Question 19

UVB causes skin damage directly/indirectly

Answer 19

directly

Question 20

describe how UVB causes skin damage

Answer 20

makes CPDs

and 6-4PPs causing a covalent CC-TT

Question 21

how are CPDs and 6-4PPs removed

Answer 21

NER excises an DNA pol repairs

DNA sometimes causes further mutation

Question 22

UVA causes direct/indirect skin damage

Answer 22

indirect

Question 23

photoageing is produced by UVA/UVB

Answer 23

UVA

Question 24

describe how UVA causes skin damage

Answer 24

forms 8-oxy-dG to cause C-A point mutation

repaired by BER

Question 25

risk factors for photocarcinogenesis

Answer 25

skin sensitivity

sun exposure

Question 26

SCC arises from lifetime/intermittent sun exposure

Answer 26

lifetime

Question 27

melanoma and BCC arise from lifetime/intermittent sun exposure

Answer 27

intermittent, and sunbed

Question 28

true/false - childhood sunburn drastically increases melanoma risk

Answer 28

true

Question 29

phototoxic drugs and how to manage

Answer 29

azathioprine, thiazides, NSAIDs, anti-TNF, voriconazole

sun protection all the time and vigilance

Question 30

what target treatment is used for BCC and target?

Answer 30

vismodegib

binds smoothened to block hedgehog pathway to prevent angiogenesis

Question 31

what target treatment is used for SCC and target?

Answer 31

vemurafenib
BRAF inhibitor, effective 50%
add MEK inhibitor to reduce resistance