Squamous Cell Carcinoma Flashcards

1
Q

Actinic Keratosis

how does it occur?

A

cumulative & prolonged UV exposure resulting in genetic mutation of keratinocytes

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2
Q

Actinic Keratosis

Risk Factors

5

A
  1. increasing age
  2. fair skin, light eyes/hair (Fitzpatrick 1/2)
  3. immunosuppression
  4. prior radiation hx
  5. albinism
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3
Q

Actinic Keratosis

can turn into what over time?

A

squamous cell carcinoma

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4
Q

Actinic Keratosis

clinical manifestation

4

A
  • erythematous/flesh colored
  • flat papule or thin plaue
  • characteristic rough/gritty scale (sandpaper like)
  • may be tender to touch
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5
Q

Actinic Keratosis

where are these usually located?

A
  • sun exposed areas (damaged skin)
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6
Q

Actinic Keratosis

what to consider before tx?

6

A
  1. number of lesions
  2. thickness
  3. location
  4. color
  5. pt tolerance to meds/compliance
  6. cost of tx
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7
Q

Actinic Keratosis

Localized Therapy tx

what is done?

A

cryotherapy

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8
Q

Actinic Keratosis

Field therapy tx- which 2 meds can be used?

A
  1. 5-fluorouracil (5-FU)
  2. Imiquimod 5% cream
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9
Q

Actinic Keratosis

how pt should use/apply 5-FU

4 things

A
  • BID
  • apply to affected area
  • 2-4 wks
  • until erythematous, hemorrhagic crust forms
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10
Q

Actinic Keratosis

how to prescribe Imiquimod 5% cream

A
  • MWF at night
  • 4 wks
  • until erythematous, hemorrhagic crust forms
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11
Q

Actinic Keratosis

which med has better compliance?

5-FU or Imiquimod 5%?

A

Imiquimod 5% because it’s only QD not BID.

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12
Q

SCC in Situ

AKA

A

Bowen’s Disease

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13
Q

SCC in Situ/Bowen’s Disease

Clinical Manifestation

A
  • circumscribed pink to red patch or thin plaque w/ scaly/rough surface
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14
Q

SCC in Situ/Bowen’s Disease

what procedure should be done?

A
  • biopsy: for pathology
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15
Q

SCC in Situ/Bowen’s Disease

tx options

2 options

A
  1. cryotherapy followed by 5-FU or Imiquimod
  2. Electrodesiccation and curettage
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16
Q

Squamous Cell Carcinoma

why does SCC have higher mortality than BCC?

A

higher rate of metastasis

17
Q

Squamous Cell Carcinoma

cell of origin?

A

keratinocyte

18
Q

Squamous Cell Carcinoma

risk factors

A
  1. fair skinned pts (Fitzpatrick 1/2)
  2. Hx tanning bed use
  3. chemical carcinogen exposure
19
Q

Squamous Cell Carcinoma

Clinical Manifestations

5 things

A
  1. papule, plaque, or nodule
  2. pink, red, flesh-colored, or mixed pigment
  3. scaly, deratotic, hypertrophic, indurated
  4. may be friable, tender to touch, pruritic
  5. may present as a cutaneous horn
20
Q

Squamous Cell Carcinoma

Tx options- 3

what it is/when to use

A
  1. standard of care: surgical excision/MOHS
  2. poor surgical candidates: radiation therapy
  3. non-surgical candidates: 5-FU, imiquimod, etc