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Y2 - Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

(47 cards)

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1
Q

What are the keratinocyte skin cancers, and why are they classed as that?

A

Basal Cell Carcinomas (BCC)
Squamous Cell Carcinomas (SCC)
They arise from keratinocytes

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2
Q

What cells do melanomas arise from?

A

Melanocytes

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3
Q

What are melanocytes?

A

The pigment forming cells scattered along the basal layer of the epidermis

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4
Q

Where do melanocytes migrate from?

A

Migrate from the neural crest

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5
Q

Which are more likely to metastasise: melanoma or keratinocyte skin cancers?

A

Melanomas

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6
Q

What clinical features shows that a melanoma has metastasised?

A

Micronodules - little black dots around the main melanoma

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7
Q

What factor correlates with the prognosis of a melanoma, and how is this measured?

A

Tumour depth
Breslow thickness - AKA the measurement of depth of the melanoma from the surface of the skin to the deepest point of the tumour

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8
Q

What factors are used to evaluate whether a pigmented nodule is a melanoma?

A 
Asymmetry
Border
Colour
Diameter
Evolution
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9
Q

How do basal cell carcinomas present?

A 
Slow growing lump or ulcer
Painless
Shiny appearance
Telangectasia
Central ulceration
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10
Q

In what way can BCCs spread?

A

Locally - very rarely metastasise

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11
Q

What are the different types of BCC?

A

Superficial
Nodular or nodulocystic
Infiltrative or morphemic
Pigmented

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12
Q

What do superficial BCCs look like?

A

Scaly plaque resembling dermatitis

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13
Q

How do squamous cell carcinomas present?

A

Kyperkeratotic lump or ulcer
On sun-damaged skin
Fast growing
May be painful and/or bleed

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14
Q

What is a keratoacanthoma?

A

A self-resolving SCC

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15
Q

What are high risk sites for SCC?

A

Ear
Lip
Scalp

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16
Q

Where can SCCs commonly metastasise to?

A

Lymph nodes

Bone

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17
Q

What are the main risk factors for skin cancer?

A 
Sun exposure
Family history
Genetic susceptibility 
Immunosuppression
Environmental carcinogens (smoking, coal tar etc)
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18
Q

What are examples of genetic conditions that predispose to skin cancer?

A

Xeroderma pigmentosum

Albanism

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19
Q

What is a benign skin tumour?

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A

Seborrheic keratosis

20
Q

What is seborrheic keratosis?

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A

Benign proliferation of epidermal keratinocytes

21
Q

What is the clinical presentation of seborrheic keratosis?

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A

‘Stuck-on’ appearance with a greasy keratitis surface

22
Q

What may an eruptive appearance of many keratotic lesions indicate?

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A

Internal malignancy

23
Q

What are the precursors of squamous cell carcinoma?

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A

Bowen’s disease
Actinic keratosis
Viral lesions

24
Q

What is Bowen’s disease?

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A

Scaly patch/plaque
Especially on legs
Females mostly
Irregular border

25
What is actinic keratosis?
Variable epidermal dysplasia Very common Sun exposed skin, especially head/neck, hands
26
What are rare presentations of SCC?
Chronic leg ulcers Sites of burns, sinuses Chronic lupus vulgaris Xeroderma pigmentosum
27
What are adverse prognosis features of SCC?
Breslow thickness >4mm with poor differentiation Lymphatic/vascular space invasion Periurnal spread Some sites - scalp, ear, nose
28
What are the types of melanoma?
Superficial spreading Acral or mucosal lentiginous Lentigo maligna melanoma Nodular
29
What is different about nodular melanomas?
No rapid growth phase, only vertical growth phase
30
What sites do melanomas metastasise to, and by which type of spread?
``` Skin/soft tossue Heart Lungs GI tract Liver Brain Haematological spread ```
31
What is the technical term for freckles?
Ephelides
32
What are ephelides?
A patchy area of increase in melanin pigmentation after UV exposure
33
What are actinic lentigenes better known as?
Age or liver spots
34
What are actinic lentigines?
Areas of increase in melanin and basal melanocyte population related to UV exposure
35
What are melanocytic naevi?
A broad range of benign pigmented lesions
36
What are the different types of melanocytes naevi?
``` Congenital Usual type Dysplastic Spitz Blue ```
37
What are classed as small, medium and giant congenital naevi?
Small - <2cm Medium - >2cm, <20cm Giant - >20cm
38
What is the risk of congenital naevi progressing to melanoma?
Larger lesions have 10-15% risk
39
What are usual type naevi?
Naevi acquired during infancy when the melanocyte:keratinocyte ratio breaks down at a number of cutaneous sites
40
What is the process of development of a usual type naevi?
Juntional phase - clusters of melanocytes form at the derma-epidermal junction, melanocytes proliferate Compound phase - junctional clusters at the demo-epidermal junction and groups of cells in the dermis Intradermal phase - all junctional activity has ceased, entirely dermal
41
What do dysplastic naevi look like?
Generally >6mm in diameter Variegated pigment Border asymmetry
42
What are sporadic dysplastic naevi?
Not inherited One to several atypical naevi Risk of malignant melanoma slightly raised
43
What are familial dysplastic naevi?
``` Strong family history of melanoma Autosomal inheritance High penetrance Multiple atypical naevi Lifetime risk of melanoma up to 100% ```
44
How are dysplastic naevi diagnosed histologically?
Atypical architecture and cells Host reaction - fibrosis and inflammation Epidermis not affected
45
What are halo naevi?
Have a peripheral help of depigmentation Show inflammatory regression Overrun by lymphocytes
46
What are blue naevi?
Entirely dermal | Consist of pigment-rich dendritic spindle cells
47
What are spitz naevi?
In people <20 Look like melanoma but most benign Consist of large spindle and/or epithelioid cells Pink appearance due to dilated capillaries

Y2 - Dermatology (12 decks)

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