Week 7

Question 1

Why do basal cell carcinomas have a limited capacity to metastasize?

Answer 1

Due to the absence of growth factors derived from the stroma of the original tumor site.

Question 2

T/F?
Problem locations for BCCs are around the eyes, in the nasolabial folds, around the ear canal, and in the posterior auricular sulcus

Answer 2

True

Question 3

Persons aged 55-75 have a ______ -fold higher incidence of BCCs than those younger than 20.

Answer 3

Persons aged 55-75 have a 100-fold higher incidence than those younger than 20

Question 4

About ____ percent of patients who have had one BCC will develop another lesion within five years

Answer 4

About 40% of patients who have had one BCC will develop another lesion within five years

Question 5

What is the most important environmental risk factor for developing BCCs?

Answer 5

Chronic ultraviolet (UV) radiation exposure most important risk factor!

Question 6

T/F?
Frequency and intensity of sun exposure – intermittent, intense increments increases the risk of BCC more than a similar dose delivered more continuously over the same period of time.

Answer 6

True

Question 7

Describe a “rodent ulcer”

Answer 7

• Center ulcerates/bleeds, accumulates crust/scale
• Ulcerated areas heal with scarring
• Patients often assume their conditions are improving.
• Cycle of growth, ulceration, and healing continues as the mass extends peripherally and deeper
• Lesions may become enormous!

Question 8

T/F?
The borders of a morpheaform BCC are indistinct and blend with normal skin making border localization of this tumor by inspection or biopsy impossible

Answer 8

True

Question 9

T/F?

Treatment of morpheaform BCCs consists of wide excision or, preferably, Mohs micrographic surgery.

Answer 9

True

Question 10

Diagnosis of BCC must be confirmed by ______________

Answer 10

Biopsy

Question 11

T/F?
BCCs must be treated early on to avoid the locally invasive, aggressive, and destructive effects on skin and surrounding tissues

Answer 11

True

Question 12

T/F?
Surgical excision of BCCs is more effective than ED&C because there is better margin control, but has less effective margin control than Mohs surgery

Answer 12

True

ED&C= electrodesiccation and curettage

Question 13

Why would one chose radiation therapy to treat a BCC?

Answer 13

• Noninvasive – relative sparing of critical structures
• Relatively painless
• Good for patients who are not otherwise candidates for surgery
• High cure rate for selected lesions

Question 14

List three features of BCCs that account for a high likelihood for recurrence after initial treatment

Answer 14

size, borders, location???

Question 15

T/F?
Existing AKs may become more active after sunlight exposure and may undergo spontaneous remission if sunlight exposure is reduced.

Answer 15

True

Question 16

Induration, inflammation, and oozing of an AK suggests _______________ into ______________

Answer 16

Induration, inflammation, and oozing suggest degeneration into malignancy

Question 17

AKs are most commonly confused with a _________________ which have a “pasted-on” appearance

Answer 17

seborrheic keratosis (SK)

Question 18

T/F?
Because of the marked amount of inflammation that can occur when treating AKs with 5-FU, small regions should be treated at a time in those patients with extensive AKs.

Answer 18

True

Question 19

Over time ____ % of AKs may degenerate into SCCs.

Answer 19

0.3%

Question 20

T/F?
The lazy S excision uses the basic principle of camouflaging a scar in cutaneous surgery by breaking up a straight line, by making two curves

Answer 20

True