Head and neck skin cancer Flashcards Preview

Human Disease > Head and neck skin cancer > Flashcards

Flashcards in Head and neck skin cancer Deck (23):
1

What are the predispositions to a malignant melanoma?

UV lights
Suppressed immune surveillance
Family history
Freckling
Skin, hair and eye colour

2

What are the 7 subtypes of melanoma?

Superficial spreading (radial growth)
Occular
Mucosal
Acral (extremities)
Lentigo malignant (more diffuse)
Amelanotic (non - pigmented)
Nodular (vertical growth, high risk, often deep)

3

What are the major signs to look for?

changes in shape, size and colour

4

What are the minor signs to look for?

inflammation, crusting, bleeding, sensory change (itch)

5

What changes occur to moles? (ABCDE)

Asymmetrical
Borders become jagged
Colour change
Diameter change >o.5cm
Evolution - change in size or shape or colour

6

Describe the clinical staging of tumours?

Stage 1 = local tumour
Stage 2 = involves local lymph nodes
Stage 3 = disseminated disease

7

What are Clarkes levels and Breslows thickness used to describe?

Both are used to define melanoma

8

What are Clarkes levels?

5 layers of the outermost epidermis (level I) to the underlying fat (level V)
Clarkes level refers to the deepest portion of skin involved with the tumour
I = pre invasive
II = thinly invasive
III
IV= moderately invasive
V = deeply invasive

9

What is Breslows thickness?

Measurement in mm of the actual thickness of the melanoma, which is a reflection of the depth of tumour into skin
4mm = high risk

10

What is a basal cell carcinoma? (BCC)

A slow growing locally invasive malignant epidermal skin tumour.
Infiltrates tissue in a 3D pattern
Metastasis is very rare
Mortality related to local invasion
Most common cancer in UK and USA

11

How does a BCC present?

nodular
cystic
ulcerating
superficial
pigmented

12

What are the risk factors for BCC?

chronic exposure to UV light
increased age
freckling
Gorlins syndrome

13

What affects to prognosis of BCC?

size, site, type, margins, growth pattern, recurrence, immune state of host

14

What 2 surgical techniques are used to remove BCC?

DESTRUCTIVE - laser, curettage
EXCISIONAL - surgery (risk incomplete excision)

15

What non surgical techniques are used to remove BCC?

Radiotherapy
photodynamic therapy
chemo
palliative therapy
retinoids

16

What are the 2 types of keratinosinic malignancy?

BCC or SCC

17

What is a squamous cell carcinoma (SCC)?

Arises from the epidermis and resembles squamous cells
Can occur all areas of the body, most commonly on areas exposed to the sun (face, neck, hands, shoulders, ears, back
2nd most common skin cancer

18

What are the causes of SCC?

Chronic exposure to sunlight
Chronic inflammation or conditions that suppress the immune system
Where skin has suffered injury - burns, sores, chemical

19

What are 2 premalignant conditions?

Actinic / solar keratosis
Actinic cheilitisis

20

What is Actinic / solar keratosis?

Rough, scaly, raised growths that range in colour fro brown to red.

21

What is actinic cheilitisis?

A type of actinic keratosis that occurs on the lips, causing them to be cracked, dry, scaly, pale, white.
Mainly affects lower lip which receives more sun

22

What is the treatment for pre malignant conditions?

Curettage
electrodissection
excisional surgery
x ray
laser surgery
Head and neck are well vascularised so flaps of skin heal well over vascular network not specific to certain areas

23

What is the prognosis of pre malignant conditions?

Slow progression to SCC
malignant transformation is often low aggression and distant metastasis are rare.