Basal Cell Carcinoma

Question 1

Which of the following is the most common form of cancer?

1 - Malignant Melanoma
2 - Breast cancer
3 - Squamous Cell Carcinoma
4 - Basal Cell Carcinoma

Answer 1

4 - Basal Cell Carcinoma

Question 2

Typically how many basal cell carcinomas are there per year in the UK?

1 - 2000
2 - 20,000
3 - 200,000
4 - 2,000,000

Answer 2

3 - 200,000

Question 3

What is the most common location for basal cell carcinomas to appear on an individual?

1 - back and legs
2 - head and neck
3 - arms and legs
4 - feet and legs

Answer 3

2 - head and neck
- typically those with the most exposure to the sun

Question 4

Do basal cell carcinomas typically metastasise?

Answer 4

• no
• typically do not move beyond the basal cells of the skin
• BUT in rare cases they can

Question 5

Of the 4 images below, which is a basal cell carcinoma?

Answer 5

• top left

Question 6

There are 3 main types of basal cell carcinomas, which of the following is NOT one of these?

1 - Bulla
2 - Superficial
3 - Nodular
4 - Morphoeic/infiltrative

Answer 6

1 - Bulla

• Superficial= just surface of skin
• Nodular = raised up with clear margins
• Morphoeic/infiltrative = margins difficult to see with some spread on surface

Question 7

In the image below, which type of basal cell carcinoma is this?

1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular

Answer 7

2 - Superficial

• stretching the skin will show a rolled edge
• can be shiny with some pigmentation

Question 8

Which of the following remains the main stay treatment for superficial BCC?

1 - Excision
2 - Curettage
3 - Imiquimod 5% cream 5-6 wks
4 - Efudix (5-FU) chemo drug
5 - Cryotherapy (2 cycles 20s)
6 - photo dynamic therapy (PDT)

Answer 8

1 - Excision

Curettage = inject local anaesthetic, scrape and repeat

Efudix = 2 cycles typically

PDT = cream applied to lesion and then red light applied, needs 2 treatments

Question 9

In the image below, which type of basal cell carcinoma is this?

1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular

Answer 9

3 - Nodular
- typically they have an ulcerative centre, similar to a rodent bite

• can contain telangiectasia, where small capillaries become clear and appear like spider webs

Question 10

Which of the following remains the main stay treatment for nodular BCC?

1 - Excision
2 - Curettage
3 - Efudix (5-FU) chemo drug
4 - Radiotherapy

Answer 10

1 - Excision
- MOHS surgery is often the preferred choice

Curettage = inject local anaesthetic, scrape and repeat

Efudix = 2 cycles typically

Question 11

In the image below, which type of basal cell carcinoma is this?

1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular

Answer 11

1 - Morphoeic/infiltrative
- most aggressive form of BCC

• ill defined edges and centre is eroded away
• MOHS surgery is often the preferred choice

Question 12

Is curettage typically used to treat squamous cell carcinoma?

Answer 12

• no, unless small and well differentiated

Curettage = inject local anaesthetic, scrape and repeat

Question 13

What is the ONLY modifiable risk factor for skin cancer?

1 - sun exposure
2 - weight
3 - immunotherapy
4 - smoking

Answer 13

1 - sun exposure

Question 14

Avoiding peak UV times can help mitigate the risks associated with skin cancer. What are peak UV times?

1 - 9am - 1pm
2 - 11am - 12pm
3 - 11am - 3pm
4 - 1-3pm

Answer 14

3 - 11am - 3pm

Question 15

Which of the following are ways to minimise UV exposure and reduce the risk of skin cancer?

1 - Wear hats, sun glasses, clothes
2 - Sunscreen on face and as needed elsewhere
3 - Broad spectrum of >SPF30
4 - Suncream containing UVA: 4-5 stars
5 - all of the above

Answer 15

5 - all of the above