1: Skin cancer

Question 1

What are the two broad types of skin cancer?

Answer 1

Malignant melanoma

Non-melanoma skin cancer (inc. SCC and BCC)

Question 2

What is the main feature of melanoma compared to BCC or SCC?

Answer 2

Pigmented

Question 3

When do skin cancers tend to present?

Answer 3

45 years of age onwards

Question 4

Which type of skin cancer causes the greatest proportion of deaths?

Answer 4

Malignant melanoma

Question 5

Melanoma prognosis depends on its ___.

Answer 5

thickness

Question 6

Which scale is used to match melanoma thickness to prognosis?

Answer 6

Breslow thickness

Question 7

What is the 5-year survival for melanomas under a milimeter thick?

Answer 7

95-100%

Question 8

What is the 5-year survival for melanomas more than 4mm thick?

Answer 8

50%

Question 9

The 5-year survival for melanomas with metastasis is (low / high).

Answer 9

low

Question 10

What piece of equipment is used to examine melanomas?

Answer 10

Dermoscope

Question 11

What is the ABCDE rule for identifying melanomas?

Answer 11

Asymmetry

Border irregularity

Colour changes

Diameter (longer is worse)

Evolution (changes in size, colour, appearance)

Question 12

What are two general classifications of malignant melanoma?

Answer 12

Superficial spreading

Nodular

Question 13

What are the two phases of superficial melanoma growth?

Answer 13

Horizontal growth phase

Vertical growth phase into the dermis afterwards

Question 14

Why do nodular melanomas progress much quicker than superficial ones?

Answer 14

Vertical growth phase starts immediately, invades dermis quickly

Question 15

What name is given to melanoma-in-situ i.e not invasive yet?

Answer 15

Lentigo maligna

Question 16

What are the most common types of skin cancer?

Answer 16

BCC

SCC

Question 17

Out of BCC and SCC, what is the most common type of skin cancer?

Answer 17

Basal cell carcinoma

Question 18

What are BCCs also known as?

Answer 18

Rodent ulcers

Question 19

How are BCCs described?

Answer 19

Round, pearly lesions with a rolled edge and central ulceration

Question 20

Are BCCs painful?

Answer 20

No

Question 21

What name is given to BCCs which send out strands of invasive cells which are not visible on the skin?

Answer 21

Morphoeic

Question 22

What morphological term, used to describe round lumps, describes most BCCs?

Answer 22

Nodular

Question 23

Like melanomas, BCCs can be ___ or ___.

Answer 23

superficial

nodular

Question 24

Why do BCCs have an ulcerated centre?

Answer 24

Poor blood supply

Question 25

What do squamous cell carcinomas look like?

Answer 25

**Hyperkeratotic** (i.e crusty) **lumps/ulcers**

Question 26

Are SCCs painful?

Answer 26

**Can be**

Question 27

Do SCCs bleed?

Answer 27

**Can do**

Question 28

What is the prognosis of BCCs and SCCs compared to melanomas?

Answer 28

**Really good**

Question 29

Where do SCCs tend to appear?

Answer 29

**Sun-damaged skin**

Question 30

What are some lesions which tend to be precursors to SCCs?

Answer 30

**Actinic keratoses** **Bowen's disease** (carcinoma-in-situ in a similar way to lentigo maligna melanoma)

Question 31

Horn-like, crusty lesions are likely to be \_\_\_.

Answer 31

**SCCs**

Question 32

What are some **high-risk** sites for SCCs?

Answer 32

**Ear** **Lip** **Scalp**

Question 33

What is the chance of an SCC metastasising?

Answer 33

**5%**

Question 34

SCCs can appear at the sites of chronic ___ such as ulcers and previous trauma, such as \_\_\_.

Answer 34

**wounds** **burns**

Question 35

Which lesions are highly associated with SCC and BCC?

Answer 35

**Actinic keratoses** (BCC and SCC) **Bowen's disease** (SCC)

Question 36

Where do actinic keratoses appear?

Answer 36

**Sites of sun damage** e.g forehead, scalp, hands

Question 37

What do Bowen's disease lesions look like?

Answer 37

**Scaly, erythematous plaques**

Question 38

Which syndrome can cause early onset BCCs?

Answer 38

**Gorlin syndrome**

Question 39

Which genetic disorder, causing widespread shedding and blistering of skin, is linked to skin cancer?

Answer 39

**Epidermolysis bullosa**

Question 40

Patients who have had ___ are at high risk of developing non-melanoma skin cancers.

Answer 40

**transplants**

Question 41

Patients at risk of skin cancer should be encouraged to regularly ___ their skin.

Answer 41

**inspect**

Question 42

Which factor sunscreen should patients use to reduce their risk of skin cancer?

Answer 42

**SPF25**+