Skin Cancer Flashcards
(16 cards)
What are seven risk factors for getting skin cancer?
UV radiation Photochemotherapy - PUVA Chemical carcinogens X-ray and thermal radiation Human papilloma virus Familial cancer syndromes Immunosuppression
What is the appearance of BCC?
Nodular Pearly rolled edge Telangiectasia Central ulceration Arborising vessels on dermoscopy Can have pigmented and morpheic Slow growing and rarely metastasise
What is Moh’s surgery?
Excising BCC using pathology at the same time as surgery to see if excised all of the cancer.
What are the characteristics of SSC?
Derived from keratinising squamous cells Usually on sun exposed sites Can metastasise Faster growing, tender, scaly/crusted or fleshy growths Can ulcerate
What is keratocanthoma?
Varient of squamous cell carcinoma
Erupts from hair follicles in sun damaged skin
Grows rapidly, may shrink after a few months and resolve
What are the risk factors for malignant melanoma?
UV Radiation
Genetic susceptibility- fair skin, red hair, blue eyes and tendency to burn easily
Familial melanoma and melanoma susceptibility genes
What are the seven important features to look for in malignant melanoma?
Major features Change in size Change in shape Change in colour Minor features Diameter more than 5 mm Inflammation Oozing or bleeding Mild itch or altered sensation
What are the types of malignant melanoma?
Lentigo Maligna Melanoma (facial) Nodular melanoma Acral Lentiginous Melanoma (palms and soles) Subungal Melanoma (in nail matrix) Ocular melanoma
How is the extent of malignant melanoma measured?
Breslow's depth in mm (0-5) Clarks Levels (1-5)
What drugs are used in the treatment of malignant melanoma?
Ipilimumab Inhibits CTLA-4 molecule Pembrolizumab Blocks activity of PD-1 Vemurafenib and Dabrafenib Blocks B-RAF protein so only useful if B-RAF mutation
What is cutaneous lymphoma and what are the two types?
Abnormal neoplastic proliferation of lymphocytes in the skin
Cutaneous T Cell lymphoma
Cutaneous B Cell lymphoma
What kind of cutaneous lymphoma are mycosis fungoides and sezary syndrome?
Cutaneous T cell lymphoma
What is the appearance of mycosis fungoides?
Large irregular lumps, can ulcerate
Arise from existing plaques or in normal skin
More likely to have metastatic spread
What investigations should be done in mycosis fungoides?
Bloods for sezary cells and CT imaging for staging
What is the appearance of sezary syndrome?
“Red Man Syndrome” CTCL affecting skin of entire body Skin thickened, scaly and red Itchy++ Lymph node involvement Sezary cells in peripheral blood
What are possible treatments for primary cutaneous lymphoma?
Dependant on stage Topical steroids PUVA or UVB Localised radiotherapy Interferon Bexarotene Low dose Methotrexate Chemotherapy Total skin electron beam therapy (delivers radiation to only epidermis and dermis) Extracorporeal photophoresis (takes blood out of body and collects the leukocytes which are treated with psoralen to make T cells sensitive to UVA radiation, they are treated with it and returned back to the body) Bone marrow transplantation
