Flashcards in Actinic Keratosis & Squamous Cell Carcinoma Deck (41)
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1
Who gets SCC more commonly?
white/fair skin
2
Where is SCC located?
head, neck, forearms, dorsal hands, (sun exposed areas)
3
What increases you risk of SCC?
tanning beds, heat
4
Which has higher motality SCC or BCC?
SCC - higher rate of metastasis
5
What is the cell of origin in SCC?
keratinocytes
6
What causes SCC?
UV expsoure, chemical carinogen exposures
7
What is the SCC clinical manifestation?
papule, plaque, nodule
pink, red, skin colored
exophytic
indurated
horn
friable
asymptomatic, pruritic/tender
8
What is Bowen's disease?
in situ SCC, pink to red patch or thin plaque with scaly or rough surface >1 cm size, only epidermis
9
Who get SCC of the nail?
males 50-69
10
A premalignant neoplasm of the epidermis caused by excessive exposure to sunlight and manifesting as an ill-marginated, erythematous, scaling, rough papule or patch.
Actinic Keratosis
11
A malignant neoplasm of keratinocytes derived from stratified squamous epithelium. These usually present as indurated, scaling, erythematous papules, nodules or plaques that occasionally ulcerate and bleed.
squamous cell carcinoma
12
What is the initial treatment for actinic keratosis?
incisional biopsy
13
What does incisional biopsy show in actinic keratosis?
dermal extension of well differentiated keratinocytes, keratin pearls
14
What can cause SCC in non sun exposed areas?
chemical carcinogen exposure
15
What are the various morphologies of SCC?
papules, plaque, nodule
pink red or skin colored
exophytic
indurated
cutaneous horn
16
What does friable mean?
bleed with minimal trauma and then crust
17
How does SCC of nail present?
warty, subungual hyperkeratosis, onycholysis, oozing, destruction of nail plate
18
What is the best for dx SCC?
Mohs
19
What does invasive squamous cell carcinoma mean?
SCC cells in dermis
20
What is atypical squamous proliferation?
biopsy is superficial, rebiopsy may be needed
21
What are the surgical options for SCC?
surgical excision - best for invasive SCC
Curettage and electrodesiccation or cryosurgery
22
What are the non surgical treatment options for SCC?
radiation
5-fluorouracil cream, imiquimod cream, diclofenac gel, ingenol mebutate, photodynamic therapy
23
What is 5-fluorouracil?
antimetabolite taht interferes with DNA synthesis
1,2,5% approved for actinic keratosis treatment
5% for superficial basal cell carcinoma
24
What is imiquiod?
synthetic immune response modifers
2.5,3.75, 5 for actinic keratosis
5% for superficial BCC
better inflammaory response = better cure
25
What is diclofenac?
downregulates cyclooxygenase enzymes and increases apoptosis
3,2.5% for actinic keratosis
nonsteroidal antiinflammatory
26
What is ingenol mebutate?
cellular death followed by inflammatory response
actici keratosis
27
When do you follow up with non metastatic SCC?
3-6 mo for 2 years, 6-12 mo for 3 years, annually for life
28
What does AK become?
SCC
29
Does AK go to SCC a lot?
not really, 8%
30
