Skin Cancer

Question 1

What is melanoma ?

Answer 1

A malignant tumour that starts in melanocytes
Slow growing superficial tumour in the epidermis

Question 2

How can melanoma spread ?

Answer 2

Local spread
Lymphatic
Haematogenous

Question 3

What are some risk factors for melanoma ?

Answer 3

UV radiation
Genetics
Personal history
Immunosuppression

Question 4

What does ABCDE stand for ?

Answer 4

Asymmetry

Border irregularities

Colour variation

Diameter greater than 6mm

Evolving

Question 5

How are skin lesions evaluated ?

Answer 5

Dermoscopy
Biopsy

Question 6

What tests are performed for melanoma ?

Answer 6

LDH
USS
CXR - metastasis
CT - staging
MRI - metastasis

Question 7

What staging is used for melanoma ?

Answer 7

TNM staging

Question 8

What is the management for stage 1/2 melanoma ?

Answer 8

Surgical - wide margin local excision
Sentinel lymph node biopsy

Question 9

What is the management of stage 3/4 melanoma ( resectable ) ?

Answer 9

Surgery - resection and lymph nodes affected
Adjuvant therapy - immunotherapy and targeted therapy

Question 10

What is the management of non-resectable melanoma ?

Answer 10

Systemic therapy - immunotherapy and targeted therapy

Question 11

What are some non-melanoma skin cancers ?

Answer 11

Basal cell carcinoma
Squamous cell carcinoma

Question 12

What are some risks factors for non-melanoma skin cancers ?

Answer 12

UV exposure
Chronic arsenic exposure
Ionising radiation
Chronic Immunosuppression
Genetics

Question 13

What are some factors that reduce the risk of skin cancers ?

Answer 13

Avoid the sun during peak hours
Do not use tanning beds
Suncream with at least factor 30

Question 14

What are some types of BCC ?

Answer 14

Nodular
Superficial
Morpheaform

Question 15

How do BCC’s present ?

Answer 15

Pink
Slow growth
pearly
well demarcated
Ulcerated

Question 16

How does actinic keratosis present ?

Answer 16

Erythematous base
Overlying scale
Multiple of them
Typically non tender

Question 17

How does squamous cell carcinomas present ?

Answer 17

Erythematous base
Ulceration
Crusting
Non-healing wound
Faster growth than BCC
Pruritus and pain

Question 18

What are some differentials for SCC ?

Answer 18

Actinic keratosis
Superficial BCC
Warts

Question 19

What are some forms of biopsy for skin lesions ?

Answer 19

Excisional - total removal of lesion
Incisional - partial removal of lesion
Punch - remove a cone shaped section of tissue
Shave - remove protruding portion of raised skin

Question 20

What are some high risk features of basal cell carcinoma ?

Answer 20

Large area
Location - nose, eyelid, temple, pre auricular or post auricular
Poorly circumscribed
Recurrent
Lesion in area of previous radiation

Question 21

What are some high risk features of squamous cell carcinoma ?

Answer 21

Larger
Location - ear lip genitals
Rapid growth
Immunosuppressed patient
Recurrent
Multiple tumours
Poor differentiation
Intravascular invasion

Question 22

What is the management of low risk non-melanoma skin cancers ?

Answer 22

Excisional surgery
Radiation
Cryotherapy

Question 23

What is the management of high risk non-melanoma skin cancers ?

Answer 23

Excisional therapy
Radiotherapy

Question 24

What is the management of non curative non-melanoma skin cancers ?

Answer 24

Cryotherapy
Topical therapy
Watchful waiting