Week 8

Question 1

Most cSSCs that occur in sun-exposed areas of the skin and have a very _____ rate of metastasis.

Answer 1

very low rate of METs

Question 2

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.

Answer 2

True

Question 3

Genetic factors for SCCs are:

Answer 3

fair skin, light-colored eyes, red hair, and Northern European origin.

Question 4

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.

Answer 4

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

Question 5

T/F?

Sites of chronic inflammation, chronic wounds, or scars are susceptible to the development of cSCC

Answer 5

True

Question 6

A lesion on the vermillion border is BCC or SCC?

Answer 6

cSCC until proven otherwise! - pipe or cigar hanging on lip

BCC does not grow on vermillion border!

Question 7

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

Answer 7

5-10%

Question 8

Know the features of cSCC lesions that correlate with high risk for recurrence and regional or distant metastasis

Answer 8

• perineural invasion
• depth >4 mm
• poorly differentiated
• intravascular invasion
• size >2cm
• location: ear & lip

Question 9

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!

Answer 9

True

Question 10

Individuals with atypical nevi have a _________ fold elevated risk of developing malignant melanoma.

Answer 10

3-20

Question 11

There is a strong association between high nevus counts (more than ____) and malignant melanoma

Answer 11

> 25

Question 12

Studies demonstrate higher rates of malignant melanoma in adults with ___________ or _______________ _____________ exposure to sunlight.

Answer 12

extensive or repeated intense sunlight exposure.

Question 13

Case studies found the strongest association for malignant melanoma for ____________ sun exposure and ___________ in adolescence or childhood

Answer 13

intermittent exposure and sunburn

Question 14

During the ___________ growth phase the malignant melanoma is almost always curable by surgical excision alone

Answer 14

radial (superficial tumors confined to epidermis)

Question 15

Nodular melanomas have no identifiable __________ growth phase and enter the _____________ growth phase almost from their inception

Answer 15

radial….vertical

vertical growth= deep invasion into dermis and have METs potential

Question 16

Over 60% of superficial spreading malignant melanomas are diagnosed as thin, highly curable tumors of less than ___ mm thickness.

Answer 16

1 mm

MC type (70% of melanomas)

Question 17

Nodular malignant melanomas are the most difficult to diagnose at an early stage – at least half are greater than ____ mm in thickness when diagnosed!

Answer 17

2 mm

2nd MC type (37% of melanomas)

Question 18

The great majority of lentigo maligna melanomas are diagnosed at less than ___ mm of thickness!

Answer 18

1 mm

Question 19

Most common type of malignant melanoma among Asians and in African-Americans is the ______________ _____________ ____________ which arise most commonly on palmar, plantar, and subungual surfaces.

Answer 19

acral lengtiginous melanoma

arises on palmar, plantar and subungual areas because less pigmented

Question 20

______________ _______________ is the single most important determinant of prognosis for a malignant melanoma

Answer 20

tumor thickness

Question 21

Stage T1: ≤1 mm malignant melanomas have a ten year survival of ____ percent

Answer 21

92%

Question 22

The definitive “initial” surgical treatment for primary cutaneous melanoma is a ________ ________ __________ down to the deep fascia

Answer 22

wide local excision

Question 23

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

Answer 23

Mohs procedure!