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Dermatology > Skin tumours > Flashcards

Skin tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the commonest sin cancer?

A

BCC

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2
Q

What is actinic keratoses?

A

Pre-malignant crumbly yellow-white scaly crust on sun-exposed skin from dysplastic intra-epidermal proliferation of atypical keratinocytes

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3
Q

What can actinic keratoses progress to?

A

SCC

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4
Q

What might the following be?

A
  • Actinic keratosis
  • Bowen’s Disease
  • Psoriasis
  • BCC
  • Seborrhoeic keratosis
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5
Q

What measures would you take to prevent someone developing actinic keratosis?

A

Education

  • Sunhats
  • Suncream
  • Monitor skin
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6
Q

What options are available for managing actinic keratosis?

A

No treatment, or:

  • Emollient
  • Diclofenac gel
  • Fluorouracil
  • Imiquimod
  • Crytherapy
  • Photodynamic therapy
  • Surgical excision + curettage
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7
Q

What is bowen’s disease?

A

Intraepidermal SCC/SCC in situ - superficial well-defined slowly enlarging red scaly plaque with a flat edge. It is a full thickness dysplasia/carcinoma in situ

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8
Q

What is the cause of Bowen’s disease?

A
  • UV exposure
  • Radiation
  • Immunosuppression
  • Arsenic
  • HPV infection
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9
Q

How would you manage someone with Bowen’s Disease?

A
  • Cryotherapy
  • Topical flourouracil
  • Imiquimod
  • Photodynamic therapy
  • Curettage
  • Excision
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10
Q

What is the following?

A

Seborrhoeic keratosis

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11
Q

What is basal cell carcinoma?

A

Slow-growing, locally invasive malignant tumour of the epidermal keratinocytes normally in older individuals

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12
Q

What are risk factors for BCC?

A
  • UV exposure
  • History of frequent/severe sunburn in childhood
  • Skin type I - (always burns, never tans)
  • Increasing age
  • Male sex
  • Immunosuppression
  • Previous history of skin cancer
  • Genetic predisposition
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13
Q

How does BCC present?

A

Various morphological types:

  • Nodular - small, skin-coloured papule or nodule with surface telangiectasia, a pearly rolled edge - may have necrotic/ulcerated centre
  • Superficial (plaque-like)
  • Cystic
  • Mephoeic (sclerosing)
  • Keratotic and pigmented
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14
Q

What could the following be?

A

BCC

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15
Q

What options are available for treating BCC?

A
  • Remove the lesion - mohs micrographic excision, cryotherapy, photodynamic, Curettage and cautery
  • Radiotherapy
  • Low risk - Topical treatment (imiquimod)
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16
Q

What are complications of BCC?

A

Local tissue invasion and destruction

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17
Q

What is squamous cell carcinoma?

A

Locally invasive malignant tumour of the epidermal keratinocytes or its appendages, which has the potential to metastasise

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18
Q

What are causes of SCC?

A
  • UV exposure
  • Pre-malignant skin conditions - actinic keratoses
  • Chronic inflammation - leg ulcers, wound scars
  • Immunosuppresion
  • Genetic predisposition
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19
Q

How does SCC present?

A

Keratotic, ill defined nodule which eventually ulcerates

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20
Q

How would you manage someone with SCC?

A
  • Surgical excision - Mohs micrographic surgery
  • Radiotherapy - large, non-resectable tumours
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21
Q

What is malignant melanoma?

A

Invasive malignant tumour of the epidermal melanocytes, which has the potential to metastasise

22
Q

What are risk factors for the development of malignant melanoma?

A
  • Excessive UV exposure
  • Skin type I (always burns, never tans)
  • History of multiple moles or atypical moles
  • Family history
  • Previous history of melanoma
23
Q

What are signs of malignant melanoma?

A

ABCDEF

  • Asymmetry in outline of the lesion
  • Border irregularity or blurring
  • Colour variation
  • Diameter > 6mm
  • Evolution/Enlargement
  • Funny looking mole

Also new or changing lesion

24
Q

What are types of malignant melanoma?

A
  • Superficial malignant melanoma
  • Nodular melanoma
  • Lentigo maligna melanoma
  • Acral lentiginous melanoma
25
Q

What are features of superficial spreading melanoma?

A
  • Common on lower limbs
  • Young/middle aged adults
  • Related to intermittent high-intensity UV exposure
26
Q

What are features of nodular melanoma?

A
  • Common on the trunk
  • Affects on young and middle aged
  • Related to intermittent high-intensity UV exposure
27
Q

What are features of lentigo maligna melanoma?

A
  • Common on the face
  • Affects Elderly
  • Related to long-term cumulative UV exposure
28
Q

What are features of acral lentiginous melanoma?

A
  • Common on the palms, soles and nail beds
  • Affects elderly more commonly
  • No clear relation with UV exposure
29
Q

What is the most common type of melanoma?

A

Superficial spreading melanoma70%

30
Q

How would you manage someone with malignant melanoma?

A
  • Surgical excision
  • Radiotherapy
  • Chemotherapy
31
Q

What margin is used for excision of malignant melanoma?

A
  • Any unusual lesion - 2mm margin of normal skin + cuff of subcut fat
  • If malignant melanoma - 3mm
32
Q

What is breslow thickness?

A

Thickness of tumour - gives an idea of risk of recurrence

33
Q

What does a breslow thickness of <0.76mm indicate in terms of risk of recurrence?

A

Low risk

34
Q

What does a breslow thickness of 0.76-1.5mm indicate in terms of risk of recurrence?

A

Medium risk

35
Q

What does a breslow thickness of >1.5mm indicate in terms of risk of recurrence?

A

High risk

36
Q

What is classed as stage I malignant melanoma?

A
  • T < 2mm
  • N0
  • M0
37
Q

What is classed as stage II malignant melanoma?

A
  • T>2mm
  • N0
  • M0
38
Q

What is classed as stage III malignant melanoma?

A
  • T>2mm
  • N >/= 1
  • M0
39
Q

What is classed as stage IV malignant melanoma?

A
  • T>2mm
  • N>/=1
  • M1
40
Q

What might be your differential diagnosis for someone who is presenting with features of malignant melanoma?

A
  • Benign melanocytic lesions
  • Non-melanocytic pigmented lesion e.g. seborrhoeic keratosis
41
Q

What might the following be?

A

Acral lentiginous melanoma

42
Q

What might the following be?

A

Superficial spreading melanoma

43
Q

What might the following be?

A

Lentigo maligna melanoma

44
Q

What might the following be?

A

Nodular melanoma

45
Q

What is the best diagnostic test for melanoma?

A

Fill thickness excisional biopsy - can properly estimate thickness

46
Q

What is the gold standard for management of malignant melanoma?

A

Complete excision

47
Q

What would prompt lymph node bipopsy in malignant melanoma?

A

Tumour thickness > 1 mm

48
Q

Where are SCCs most commonly found?

A

Most commonly face - typically lower lip

49
Q

What is the classic presentation of SCC?

A
  • Painless
  • Non-healing, bleeding ulcer
50
Q

How would you investigate a suspected SCC?

A
  • Punch biopsy
  • Wedge biopsy
  • Excision biopsy

Dermatology (13 decks)

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