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Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

What is this?

A

Superficial Basal cell carcinoma

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2
Q

What is this

A
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3
Q

What is this?

A

Morphoeic Basal Cell carcinoma

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4
Q

What is this?

A

Squamous cell carcinoma

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5
Q

What is this?

A

Keratoacanthoma

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6
Q

What is this?

A

Superficial spreading malignant melanoma

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7
Q

What is this?

A

Lentigo malignant melanoma

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8
Q

What is this?

A

Acral Malignant melanoma

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9
Q

What is this?

A

Nodular Malignant melanoma

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10
Q

What is this?

A

Subungal malignant melanoma

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11
Q

What is this?

A

Ocular melanoma

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12
Q

What could this be?

A

Mycosis Fungoides

Eczema

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13
Q

What is this?

A

Mycosis fungoides (plaque stage)

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14
Q

What is this?

A

Mycosis Fungoides (tumour stage)

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15
Q

What is this?

A

Sezary syndrome

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16
Q

What is this?

A

Cutaneous metastases

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17
Q

What is the most common skin cancer?

A

Basal cell carcinoma

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18
Q

What is the incidence of basal cell carcinoma?

A

146-788/100,000

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19
Q

What is the incidence of squamous cell carcinoma?

A

38-250/100,000

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20
Q

What are the risk factors for skin cancer?

A

UV radiation

Photochemotherapy

X-ray thermal radiation

HPV

Familial cancer syndromes

Immunosuppression

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21
Q

What type of tumour is basal cell carcinoma?

A

Slow growing

Locally invasive

Rarely metastasise

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22
Q

How does basal cell carcinoma present?

A

Nodular (pearly edge, telangiectasia, central ulceration)

Superficial

Pigmented

Morphoeic

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23
Q

How are Basal cell carcinomas treated?

A

Excision

Curettage

Mohs Surgery

Vismodegib

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24
Q

When is Mohs surgery indicated?

A

Site

Size

Subtype

Poor clinical margin

Recurrent

Perineural/perivascular involvement

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25
Q

When is Vismodegib indicated?

A

Locally advanced/metastatic BCC

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26
Q

Vismodegib is indicated in what?

A

Locally advanced/metastatic BCC not suitable for surgery

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27
Q

How does Vismodegib work?

A

Selectively inhibits abnormal signalling in Hedgehog pathway

(molecular driver in BCC)

28
Q

What is the median progression free survival for patients on Vismodegib?

A

9.5 months

29
Q

What side effects are associated with Vismodegib?

A

Hair/weight loss

Altered taste

Muscle spasms

Nausea

Fatigue

30
Q

Squamous cell carcinoma is derived from which cells?

A

Keratinising squamous cells

31
Q

How do squamous cell carcinoma tend to appear?

A

Faster growing

Tender

Scaly/crusted/fleshy growths

May ulcerate

32
Q

How is squamous cell carcinoma treated?

A

Excision

Radiotherapy

High risk: follow up

33
Q

Which patients are considered high risk with squamous cell carcinoma?

A

Immunosuppressed

>20mmdiameter

>4mm depth

Ear, nose, lip, eyelid

Perineural invasion

Poorly differentiated

34
Q

What is a Keratoacanthoma?

A

SCC varient

Erupts from hair follicles

Grows rapidly, may shrink

35
Q

How is Keratoacanthoma treated?

A

Surgical excision

36
Q

What is the incidence and mortality of malignant melanoma?

A

Incidence
10-40/100,000

Mortality
1.9/100,000

37
Q

What are the risk factors for Malignant melanoma?

A

UV radiation

Genetic susceptibility

Familial melanoma/melanoma genes

38
Q

What is the ABCDE rule?

A

High risk melanomas

A - Asymmetry
B - Border
C - Colour
D - Diameter
E - Evolution

39
Q

What are the major features of melanoma?

A

Change in:

Size

Shape

Colour

40
Q

What are the minor features of melanoma?

A

Diameter >5mm

Inflammation

Oozing/bleeding

Mild itch/altered sensation

41
Q

What is the best way to investigate suspected melanoma?

A

Dermoscopy

42
Q

Name 6 different types of malignant melanoma

A

Superficial spreading

Lentigo

Nodular

Acral lentiginous

Ocular

Subungal

43
Q

How is malignant melanoma treated?

A

Surgical excision based on breslow thickness

Wide local excision

Sentinel node biopsy

44
Q

How is stage 4 malignant melanoma treated?

A

Chemotherapy

Immunotherapy

Regular followup

Ipilimumab/Pembroluzimab/Dabrafenib

45
Q

Which MM drug acts on CTLA-4?

A

Ipilimumab

46
Q

Which MM drug acts on PD-1?

A

Pembrolizumab

47
Q

Which MM drug acts on B-RAF mutation?

A

Vemurafenib/Dabrafenib

48
Q

What is Cutaneous Lymphoma?

A

Secondary cutaneous disease or

Primary cuteanous disease

49
Q

What is primary cutaneous lymphoma?

A

Abnormal neoplastic proliferation of lymphocytes in the skin

50
Q

What cells are involved in cutaneous lymphoma?

A

Cutaneous T-cell (65%)

Cutaneous B-cell (20%)

51
Q

How does T-cell Cutanous lymphoma typically present?

A

Mycosis fungoides

Sezary Syndrome

52
Q

How does Cutaneous B-cell lymphoma typically present?

A

Follicle centre

Marginal zone

Diffuse large B-cell

53
Q

What is Mycosis fungoides?

A

Most common cutaneous t-cell lymphoma (50%

6/1,000,000

54
Q

Mycosis fungoides is more common in which patients?

A

Elderly men

55
Q

What are the stages of Mycosis fungoides?

A

Patch

Plaque

Tumour

Metastatic

56
Q

How is suspected mycosis fungoides investigated?

A

Bloods

Sezary cells

CT (staging)

57
Q

How does the patch stage of mycosis fungoides present?

A

Flat, dry, red oval lesions

May spontaneously resolve

Itch

Looks like eczema

58
Q

How does the plaque stage of mycosis fungoides present?

A

Patches become thickened

Itching

59
Q

How does the tumour stage of mycosis fungoides present?

A

Large irregular lumps - may ulcerate

Arise from existing plaques/normal skin

Metastases likely

60
Q

What is Sezary syndrome?

A

Red man syndrome

Cutaneous T-cell lymphoma affecting skin of entire body

61
Q

How is Sezary syndrome diagnosed?

A

Sezary cells in peripheral blood (atypical T-cells)

62
Q

What is the prognosis of Sezary syndrome?

A

Survival 2-4 years

Opportunistic infection likely

63
Q

How does Sezary syndrome present?

A

Skin thickened, scaly, red

Itchy++

64
Q

What are the steps involved in Extracorporeal photophoresis?

A

Draw blood and collect leucocytes

White cells mixed with Psoralen (makes T-cells sensitive to UVA)

UVA exposure

Treated cells re-infused

65
Q

How is cuntaneous lymphoma treated?

A

•Dependant on stage

–Topical steroids
–PUVA or UVB
–Localised radiotherapy
–Interferon
–Bexarotene
–Low dose Methotrexate
–Chemotherapy
–Total skin electron beam therapy
–Extracorporeal photophoresis
–Bone marrow transplantation

66
Q

Which origin sites most commonly metastasise to the skin?

A

Breast

Colon

Lung

67
Q

How are cutaneous metastases managed?

A

Treat underlying malignancy

Local excision

Localised radiotherapy

Symptomatic

Dermatology (8 decks)

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