Week 8 Flashcards
Most cSSCs that occur in sun-exposed areas of the skin and have a very _____ rate of metastasis.
very low rate of METs
T/F?
In darker skinned people, cSCC tends to arise on non sun-exposed areas (e.g. the legs and anus) and are frequently associated with chronic inflammation, chronic wounds, or scarring.
True
Genetic factors for SCCs are:
fair skin, light-colored eyes, red hair, and Northern European origin.
Cumulative UVB sun exposure in the past ________ years of a person’s life increases the likelihood of cSCC in the presence of other risk factors.
5-10 yrs
- chronic cumulative UVB over a lifetime (and in particular last 5-10 years) —> SCC
- intense intermittent sun exposure (sunburn) —> BCC and melanoma
T/F?
Sites of chronic inflammation, chronic wounds, or scars are susceptible to the development of cSCC
True
A lesion on the vermillion border is BCC or SCC?
cSCC until proven otherwise! - pipe or cigar hanging on lip
BCC does not grow on vermillion border!
In contrast to BCCs which only rarely metastasize (0.003%), _____of cSCCs spread to regional lymph nodes or more distant sites (the lungs, liver, brain, skin, or bone) –> a relatively poor outcome
5-10%
Know the features of cSCC lesions that correlate with high risk for recurrence and regional or distant metastasis
- perineural invasion
- depth >4 mm
- poorly differentiated
- intravascular invasion
- size >2cm
- location: ear & lip
T/F?
Although there is no uniform agreed upon screening protocol for malignant melanomas in US a skin survey to identify suspicious lesions is considered the best option!
True
Individuals with atypical nevi have a _________ fold elevated risk of developing malignant melanoma.
3-20
There is a strong association between high nevus counts (more than ____) and malignant melanoma
> 25
Studies demonstrate higher rates of malignant melanoma in adults with ___________ or _______________ _____________ exposure to sunlight.
extensive or repeated intense sunlight exposure.
Case studies found the strongest association for malignant melanoma for ____________ sun exposure and ___________ in adolescence or childhood
intermittent exposure and sunburn
During the ___________ growth phase the malignant melanoma is almost always curable by surgical excision alone
radial (superficial tumors confined to epidermis)
Nodular melanomas have no identifiable __________ growth phase and enter the _____________ growth phase almost from their inception
radial….vertical
vertical growth= deep invasion into dermis and have METs potential
Over 60% of superficial spreading malignant melanomas are diagnosed as thin, highly curable tumors of less than ___ mm thickness.
1 mm
MC type (70% of melanomas)
Nodular malignant melanomas are the most difficult to diagnose at an early stage – at least half are greater than ____ mm in thickness when diagnosed!
2 mm
2nd MC type (37% of melanomas)
The great majority of lentigo maligna melanomas are diagnosed at less than ___ mm of thickness!
1 mm
Most common type of malignant melanoma among Asians and in African-Americans is the ______________ _____________ ____________ which arise most commonly on palmar, plantar, and subungual surfaces.
acral lengtiginous melanoma
arises on palmar, plantar and subungual areas because less pigmented
______________ _______________ is the single most important determinant of prognosis for a malignant melanoma
tumor thickness
Stage T1: ≤1 mm malignant melanomas have a ten year survival of ____ percent
92%
The definitive “initial” surgical treatment for primary cutaneous melanoma is a ________ ________ __________ down to the deep fascia
wide local excision
Because of the potential of metastasis and possible death, any biopsy that comes back positive for malignant melanoma needs to be referred for additional surgery via ______________ procedure
Mohs procedure!
