Cancerous Lumps and Bumps Flashcards Preview

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Flashcards in Cancerous Lumps and Bumps Deck (49)
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1

What 2 pre-cancerous lesions can evolve into Squamous Cell Cancers?

  • Acitinic Keratosis
  • Squamous Cell Carcinoma in Situ (e.g. Intraepidermal Carcinoma)

2

What type of pre-cancer is this?

Erythroplasia of Queyrat

(IEC of the glans penis)

3

Apart from BCC and SCC,

What are some other forms of skin cancer?

(Not including Melanoma)

  • Cutaneous Lymphoma - B or T Cell Lineage.
  • Merkel Cell Carcinoma
  • Porocarcinoma - in immunocompromised patients.

4

What is the average age of?

BCC?

SCC?

BCC = 60 years

SCC = 70 years

5

What is the most common NMSC?

BCC

6

What are the risk factors for NMSC?

  • Sunlight
  • PUVA
  • Arsenic
  • HPV - anogenital and periungal SCCs.

7

What NMSC comes from chronic sunexposure +/- acute episodes of sunlight?

SCC

8

What NMSC comes from acute episodes of suburn (especially in childhood)?

BCC

9

What risk factors are important for oral SCC?

  • Smoking
  • Poor oral hygeine

10

What condition is this?

Xeroderma Pigmentosum

  • Autosomal recessive
  • Defective DNA repair
  • Freckling and sunsensitivity
  • Increased risk of NMSC
  • Strict sun avoidance.

11

At what rate do Solar keratoses progress to SCC?

Only 2-5%

12

What % of Solar Keratoses remit?

25%

13

Decribe the field treatments for solar keratoses.

  • Efudix (5-FU) -nightly for 3-4 weeks.
  • Solaraze (Diclofenac) - nightly for 3 months
  • Aldara (5% Imiquimod) - 3 times per week for 4 weeks.
  • Picato (Ingenol Mebutate) - 3 days to face or 2 days to body.

14

Describe the treatment instructions with Efudix (5-FU) and why we would choose that?

  • Nightly for 3-4 weeks
  • Effective but can cause painful blisters.

15

Describe the treatment instructions with Solaraze (Diclofenac) and why we would choose that?

  • Nightly for 3 months
  • Gentle but less effecive than 5-FU

16

Describe the treatment instructions with Aldara (5% Imiquimod) and why we would choose that?

  • 3 times per week for 4 weeks.
  • Expensive
  • Gentle

17

Describe the treatment instructions with Picato (Ingenol Mebutate) and why we would choose that?

  • Short course of treatment
    • 3 days to face
    • 2 days to body
  • Local reactions -aggresive like 5FU

18

What is the management of IEC?

  • Topical 5-FU
  • Topical Imiquimod
  • Gentle cryotherapy
    • Avoid overzealous in lower leg due to risk of ulceration.
  • Curetage & Cautery
  • Excision

19

What is the treatmentfor Erythoplasia of Queyrat?

Refer to urologist or dermatologist

  • Medical treatments -5-FU or Imiquimod
  • Surgical - Mohs Micrographic Surgery or  CO2 laser ablation.

20

SCCs are more likely to metastasise on what sites of the body?

Ears or lips

21

If an SCC is found in a skin type of 4-6, what might this indicate?

Immunosuppression

22

BCCs grow slowly over months to years. How do SCCs grow?

Quickly over 6-12 weeks.

23

What type of biopsy is peferred?

Punch or incisional biopsy.

  • Superficial shaves give diagnostic uncertainty so therefore ensure it is deep enough if done.

24

What SCCs are more likely to metastasize?

  • 2cm diameter are 3x more likely to metastasise.
  • Subcutis invasion
  • Poorly differentiated
  • Perineural invasion.
  • Host immunosupression

25

What is the recommended margin for SCC excision?

4mm

26

What is the follow up for high risk SCCs?

4 monthly for 2-3 years.

27

What is this?

Keratocanthoma

  • Treated like an SCC - excise.
  • Though to be SCCs but can involute whereas SCCs get larger.

28

What are the 3 types of BCC?

  • Nodular - most common
  • Superficial
  • Morphoeic

29

What is the most common type of BCC?

Nodular BCC

30

Where do nodular BCC's usually ocur?

Head and neck