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Dermatology > Skin Tumours > Flashcards

Skin Tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

Why do you get lots of primary cancers in the skin?

A

Because of a large background field of mutations accumulating.

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2
Q

What is an oncogene?

A

A gene that drives cell division.

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3
Q

Give three examples of oncogenes.

A

Ras, Raf, Growth factor receptors

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4
Q

What is a tumour suppressor gene?

A

A gene that inhibits cell growth.

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5
Q

Give an example of a tumour suppressor gene.

A

P53, Rb

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6
Q

What are the two broad categories of skin cancer?

A

Pigmented and Non-pigmented cancers

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7
Q

Give 5 risk factors for skin cancer development.

A 
UV exposure 
Age
Immunosuppression
Genetics
Chemical exposure
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8
Q

What are the two types of melanin produced?

A

Eumelanin- Brown/Black

Pheomelanin- Red/Yellow

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9
Q

What Fitzpatric group only produce pheomelanin?

A

1

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10
Q

What are the two categories of NMSC?

A

Basal Cell Carcinoma

Squamous Cell Carcinoma

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11
Q

What two categories of skin cancer are associated with intermittent burning?

A

BCC and MM

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12
Q

What skin cancer is associated with chronic sun exposure?

A

SCC

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13
Q

What cancers can chemical exposure increase?

A

BCC and SCC

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14
Q

Which autoimmune conditions can increase MM?

A

UC and Crohn’s.

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15
Q

What is the wavelength of UVB and how does it cause damage?

A

290-320nm and directly damages DNA

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16
Q

What is the wavelength of UVA and how does it cause damage?

A

320-400nm and causes oxidative stress.

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17
Q

WHat does UV radiation do the the immune system?

A

Immunosuppression.

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18
Q

What does UVB damage to the DNA look like?

A

Covalent bonding between adjacent pyrimidines causing a kink in the chain. Two forms: CPD and 6-4.

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19
Q

What type of UVB damage is most common and which is most damaging?

A

CPD most common

6-4 most damaging.

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20
Q

How does UVA cause DNA damage?

A

Oxidises bases therefore preventing repair.

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21
Q

What mutation is BCC strongly associated with?

A

PTCH1

22
Q

WHat mutation is MM strongly associated with?

A

B-Raf

23
Q

What drugs are given for B-Raf mutations?

A

Vemurafenib and Dabrafenib

24
Q

What cells do MM arise from?

A

Melanocytes

25
Q

What cells do NMSC arise from?

A

Keratinocytes

26
Q

What general term is used to describe a MM?

A

Ugly duckling

27
Q

How is the severity of a MM measured?

A

Breslow Thickness

28
Q

Where is the Breslow thickness measured from and to?

A

From the granular layer to the deepest point of MM.

29
Q

What are the categories in the Breslow thickness and what are their prognosis?

A

<1mm- Good. 95% chance of surviving.
1-4mm- Okay
>4mm- Bad. 5% chance of surviving.

30
Q

What is the ABCDE of MM?

A 
Asymmetry
Border- Ill Defined 
Colour- Mixed
Diameter- If over 5mm the problematic
Evolution- Evolves quickly
31
Q

What would be a differential diagnosis for MM?

A

Pyogenic Granuloma

32
Q

What form do BCC generally take?

A

Slow growing lumps or non-healing ulcers. Rodent ulcer
Pearly with visible blood vessels
Poorly defined
Painless
Can be pigmented
Generally seen in younger patients- 40YO
Do not metastasize but can get multiple primaries.

33
Q

How do you treat BCC?

A

Skin surgery

34
Q

What form do SCC generally take?

A

Warty or crusty lump or ulcer- Hyperkeratotic
Fast growing and can be painful or bleed.
Generally well defined but can be ill defined.
Can metastasize.

35
Q

What is a precursor lesion to SCC called?

A

Actinic keratoses and Bowen’s disease.

36
Q

What word is often used to describe SCC?

A

Cutaneous horn

37
Q

What do actinic keratoses look like?

A

Flat and red then progress to scale and hyperkeratosis.

38
Q

What do Bowen’s disease look like?

A

Erythematous plaques generally on lower leg.

Irregular border with no dermal invasion

39
Q

What fraction of SPF stated do you actually get?

A

1/3

40
Q

What is another term for each skin cancer category?

A

Malignant melanoma and Non-Melanoma Skin Cancer

41
Q

What are the two types of lesion in pigmented skin cancers?

A

MM and Melanocytic naevi.

42
Q

What is an actinic lentigines?

A

Solar lentigines or liver spots due to UV exposure.

Due to increase melanin and melanocytes.

43
Q

What percentage of MN are congenital?

A

1-2%

44
Q

What are the three size of MN?

A

Small <2cm
Med 2-20cm
Giant >20cm

45
Q

What are the 4 types of MN?

A

Normal/usual- All have them
Dysplastic
Spitz
Blue

46
Q

Describe dysplastic MN.

A

Asymmetrical border, pigmentation variation and >6mm

Can progress to MM

47
Q

Describe blue MN

A

Dermal in origin and can be found in prostate or oesophagus.

48
Q

Describe Spitz MN.

A

Mimics MM but is benign

Occurs in <20YO

49
Q

WHat are the 4 types of MM and where are they found?

A

Superficial spreading- Trunk and limbs
Acral/Mucosal lentiginous- Acral (nail) and Mucosal Surfaces
Lentigo maligna- Sun damaged skin. Can progress to Lentigo maligna melanoma.
Nodular- Often on trunk

50
Q

How are pigmented tumours graded?

A 
pTis- In situ
pT1- <1mm
pT2- 1-2mm
pT3- 2-4mm
pT4- >4mm
Not ulcerated gets a
Ulcerated gets b
51
Q

Where does MM often spread to?

A 
Start with lymph then:
Liver
Heart
Skin
Brain
GI 
Lungs
52
Q

How do you treat MM?

A

Excise it
Do a node biopsy
Chemotherapy
Immunotherapy

Dermatology (10 decks)

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