Skin Cancer

Question 1

number of patients with a recurrence of skin squamous cell carcinoma in 5 years

Answer 1

50%

Question 2

High risk areas for skin squamous cell carcinoma to metastasize

Answer 2

lips and scalp

Question 3

5 year survival for Breslow thickness >4mm

Answer 3

50%

Question 4

Examples of environmental carcinogens

Answer 4

coal tar, smoking, ionising radiation, arsenic, trauma

Question 5

Common place for skin squamous cell carcinoma to occur

Answer 5

on sun exposed/damaged areas - ear, scalp, lips

Question 6

Type of clothing used to avoid UV exposure

Answer 6

tightly woven, loose fitting, dark clothing

Question 7

What is this lesion? Describe it

Answer 7

Squamous cell carcinoma: Small crusted nodule

Question 8

What is this and describe the features?

Answer 8

Basal cell carcinoma: Has pearly appearance, visible vessels, small

Question 9

Where does basal cell carcinoma form from?

Answer 9

the keratinocytes at the basal layer

Question 10

What is a lenti malignant melanoma?

Answer 10

a slow growing carcinoma in situ found commonly in the head and neck of elderly people

Question 11

Where does skin squamous cell carcinoma originate from?

Answer 11

the keratinocytes from the supra basal layers

Question 12

How long does it take for a skin cancer to develop from a 1mm to a 4mm Breslow thickness?

Answer 12

6 months average

Question 13

How does the skin squamous cell carcinoma present?

Answer 13

hyperkeratotic lump or ulcer, may be painful or bleed

Question 14

Most aggressive form of melanoma

Answer 14

Nodular melanoma - grows vertically very quickly and metastasizes quickly

Question 15

Acral Lentiginous Melanoma

Answer 15

Melanoma found on the palms, soles and the subungual areas - common in black and asian skin types

Question 16

what is xeroderma pigmentosa?

Answer 16

a skin condition where there is extreme photosensitivity

Question 17

precursor lesions to skin squamous cell carcinoma

Answer 17

Actinic keratosis; Bowens disease

Question 18

What lesion is seen on this man’s scalp?

Answer 18

actinic keratosis

Question 19

Risk factors for skin cancer (7)

Answer 19

1. Sun exposure 2. Xeroderma pigmetosa 3. albinism 4. naevoid BCC (Gorlin’s syndrome) 5. Immunosuppression (transplant patients) 6. HPV infection 7. environmental carcinogens

Question 20

What is this lesion and what is it a precursor for?

Answer 20

Bowens disease –> squamous cell carcinoma

Question 21

Risk of metastases from skin squamous cell carcinoma

Answer 21

5%

Question 22

Commonest form of skin cancer

Answer 22

Basal cell carcinoma

Question 23

Mutation associated with basal cell carcinoma

Answer 23

PTCH1

Question 24

description of a basal cell carcinoma

Answer 24

painless, slow growing lump or ulcer which can be pearly and translucent. Some may have superficial blood vessels

Question 25

What type of skin cancer are renal patients more likely to get?

Answer 25

Squamous cell carcinoma

Question 26

What is Bowen's disease?

Answer 26

an erythematous plaque although the cells do not originate from the epidermis

Question 27

Mutation common in melanoma

Answer 27

B-raf (50%)

Question 28

Basal cell carcinoma is likely to metastasize - true or false

Answer 28

false

Question 29

5 year survival for skin cancer with metastases

Answer 29

~5%

Question 30

What is the Breslow thickness?

Answer 30

the thickness of a malignant skin cancer growing vertically into the epidermis/dermis

Question 31

What is this and describe it?

Answer 31

Basal cell carcinoma: small, pearly "ulcer" found in a common location for such cancers

Question 32

Three main types of skin cancer

Answer 32

Basal cell carcinoma, squamous cell carcinoma, melanoma

Question 33

typical age group for Basal cell carcinoma

Answer 33

\> 40 years

Question 34

What is this lesion? Describe it

Answer 34

Squamous cell carcinoma: Small, red nodule which may have crusted and bled.

Question 35

Where does melanoma form from?

Answer 35

the melanocytes in the skin

Question 36

ABCDE of skin cancer

Answer 36

Asymmetry, Border, Colour, Diameter (growing more than \>6mm), Evolution

Question 37

5 year survival for Breslow thickness \<1mm

Answer 37

95-100%

Question 38

What is actinic keratosis?

Answer 38

precursor lesions which tend to occur together indicating a field of abnormality - areas of extensive sun damage

Question 39

What is Naevoid BCC a.k.a. Gorlin's syndrome?

Answer 39

an AD familial cancer syndrome; frequently develop multiple BCCs around the age of 20 years