Squamous Cell Carcinoma Flashcards
Actinic Keratosis
how does it occur?
cumulative & prolonged UV exposure resulting in genetic mutation of keratinocytes
Actinic Keratosis
Risk Factors
5
- increasing age
- fair skin, light eyes/hair (Fitzpatrick 1/2)
- immunosuppression
- prior radiation hx
- albinism
Actinic Keratosis
can turn into what over time?
squamous cell carcinoma
Actinic Keratosis
clinical manifestation
4
- erythematous/flesh colored
- flat papule or thin plaue
- characteristic rough/gritty scale (sandpaper like)
- may be tender to touch
Actinic Keratosis
where are these usually located?
- sun exposed areas (damaged skin)
Actinic Keratosis
what to consider before tx?
6
- number of lesions
- thickness
- location
- color
- pt tolerance to meds/compliance
- cost of tx
Actinic Keratosis
Localized Therapy tx
what is done?
cryotherapy
Actinic Keratosis
Field therapy tx- which 2 meds can be used?
- 5-fluorouracil (5-FU)
- Imiquimod 5% cream
Actinic Keratosis
how pt should use/apply 5-FU
4 things
- BID
- apply to affected area
- 2-4 wks
- until erythematous, hemorrhagic crust forms
Actinic Keratosis
how to prescribe Imiquimod 5% cream
- MWF at night
- 4 wks
- until erythematous, hemorrhagic crust forms
Actinic Keratosis
which med has better compliance?
5-FU or Imiquimod 5%?
Imiquimod 5% because it’s only QD not BID.
SCC in Situ
AKA
Bowen’s Disease
SCC in Situ/Bowen’s Disease
Clinical Manifestation
- circumscribed pink to red patch or thin plaque w/ scaly/rough surface
SCC in Situ/Bowen’s Disease
what procedure should be done?
- biopsy: for pathology
SCC in Situ/Bowen’s Disease
tx options
2 options
- cryotherapy followed by 5-FU or Imiquimod
- Electrodesiccation and curettage
Squamous Cell Carcinoma
why does SCC have higher mortality than BCC?
higher rate of metastasis
Squamous Cell Carcinoma
cell of origin?
keratinocyte
Squamous Cell Carcinoma
risk factors
- fair skinned pts (Fitzpatrick 1/2)
- Hx tanning bed use
- chemical carcinogen exposure
Squamous Cell Carcinoma
Clinical Manifestations
5 things
- papule, plaque, or nodule
- pink, red, flesh-colored, or mixed pigment
- scaly, deratotic, hypertrophic, indurated
- may be friable, tender to touch, pruritic
- may present as a cutaneous horn
Squamous Cell Carcinoma
Tx options- 3
what it is/when to use
- standard of care: surgical excision/MOHS
- poor surgical candidates: radiation therapy
- non-surgical candidates: 5-FU, imiquimod, etc