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Dermatology > Skin Cancer + Leg Ulcers > Flashcards

Skin Cancer + Leg Ulcers Flashcards

1
Q

what are the 2 categories of skin cancer?

A
  • melanoma

- non-melanoma

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2
Q

within the non melanoma category of skin cancer, what are the 2 types of cancer?

A
  • squamous cell carcinoma

- basal cell carcinoma

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3
Q

where do basal cell carcinomas arise from?

A

keratinocytes within the basal layer of the epidermis

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4
Q

where do squamous cell carcinomas arise from?

A

keratiocytes within suprabasal layers of the epidermis

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5
Q

where do melanomas arise from?

A

melanocytes within the basal layer of the epidermis

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6
Q

what is the fastest increasing cancer in scotland?

A

melanomas

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7
Q

compare BCCs and SCCs in terms of onset?

A

BCCs- slow-growing

SCCs- grow much faster

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8
Q

compare BCCs and SCCs in terms of likelihood to metastasise?

A

BCCs rarely metastasise

SCCs metastasise much more frequently

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9
Q

compare BCCs and SCCs in terms of pain?

A

SCCs are more likely to be painful

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10
Q

compare BCCs, SCCs and melanomas in terms of possible sun exposure causes?

A

BCCs + melanomas- tend to be due to previous high intensity intermittent sun exposure (eg burning as a child)

SCCs- tend to be due to cumulative sun exposure

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11
Q

if a melanoma depth is less than 1mm, what is the 5 year survival rate?

A

95 - 100%

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12
Q

if a melanoma depth is greater than 4mm, what is the 5 year survival rate?

A

50%

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13
Q

if there is evidence of distant spread of a melanoma, what is the 5 year survival rate?

A

5%

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14
Q

what is the ABCDE rule for a suspected melanoma?

A 
Asymmetry
Border
Colour
Diameter
Evolution
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15
Q

what colour of a lesion should suggest a melanoma?

A

dark brown

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16
Q

what blood vessels can you usually see within a BCC?

A

absorbing blood vessels

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17
Q

why are morphoeic (infiltrative) BCCs the most difficult to manage?

A

even though they look small, they are sending roots into the surrounding skin

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18
Q

what are the 2 known precursor lesions to a SCC?

A

actinic keratoses

bowen’s disease

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19
Q

what is a keratoacanthoma?

A

a lesion which mimics an SCC but is benign and self-resolving

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20
Q

what does a bowen’s disease lesion look like?

A

erythematous plaque

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21
Q

in Europe and Australia, SCCs are more commonly caused by sun exposure, in Asia what is the most common cause?

A

caused by a chronic ulcer

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22
Q

what is skin type 1?

A

always burns, never tans

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23
Q

what is skin type 2?

A

usually burns, can tan

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24
Q

what is skin type 3?

A

usually tans, can burn

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25
Q

what is skin type 4?

A

always tans, never burns

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26
Q

what is skin type 5?

A

‘brown’ skin

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27
Q

what is skin type 6?

A

‘black’ skin

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28
Q

what skin type is most prone to developing skin cancers?

A

type 1 skin

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29
Q

recessive dystrophic epidermolysis bullosa is caused by a deficiency with what type of collagen?

A

type 7

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30
Q

what is carcinogenesis?

A

the process by which a normal cell becomes a malignant cancer cell

31
Q

how does UV radiation damage DNA?

A

by creating mutations

32
Q

does UVA cause DNA damage directly or indirectly?

A

indirectly

33
Q

does UVB cause DNA damage directly or indirectly?

A

directly

34
Q

which is more damaging to DNA- UVA or UVB?

A

UVB

35
Q

UVA causes damage indirectly to the DNA through what type of damage?

A

oxidative damage

36
Q

which absorbs UV more efficiently- eumelanin or pheomelanin?

A

eumelanin

37
Q

is solar ageing more due to UVA or UVB?

A

UVA

38
Q

is sunburn/solar lentigo more due to UVA or UVB?

A

UVB

39
Q

what gene determines the balance of pigment in skin and hair?

A

MC1R

melanocortin 1 receptor

40
Q

what is the function of MC1R? (melanocortin 1 receptor)

A

turning phaeomelanin into eumelanin

41
Q

what phenotype is caused by one defective copy of MC1R?

A

freckling

42
Q

what phenotype is caused by two defective copies of MC1R?

A

red hair and freckling

43
Q

what are freckles?

A

patches of increased pigment associated with increased basal melanocytes

44
Q

when do freckles occur?

A

after UV exposure

45
Q

when do actinic/solar lentigines occur?

A

after UV exposure

46
Q

what pathology occurs in actinic/solar lentigines?

A

acanthosis

elongation of rete ridges

47
Q

are most naevie congenital or acquired?

A

acquired

48
Q

when are most naevi acquired?

A

childhood

49
Q

how do simple naevi’s form?

A

break down of melanocyte: keratinocye ratio during infancy

50
Q

what are the 3 stages of acquired naevus development?

A
  1. junctional naevus in childhood
  2. compound naevus in adolescence/early adulthood
  3. intradermal naevus in adulthood
51
Q

what is a junctional naevus?

A

clusters of melanocytes at the DE junction

52
Q

what is a compound naevus?

A

clusters of melanocytes at DE junction and also clusters within dermis

53
Q

what is a intradermal naecus?

A

clusters of melanocytes within dermis

all junctional activity has ceased

54
Q

what can happen to dysplastic naevi if left?

A

develop into a melanoma

55
Q

what is a halo naevi?

A

a benign naevi where the melanocytes are attacked by lymphocytes causing a peripheral halo of depigmentation

56
Q

what are blue naevi?

A

a benign naevie which is entirely dermal and consists of pigment-rich dendritic spindle cells

57
Q

what can Spitz naevi closely mimic?

A

melanoma

58
Q

what are the 4 main types of melanoma?

A
  • superficial spreading
  • acral/mucosal lentiginous
  • lentigo maligna
  • nodular
59
Q

which are the 2 most common types of melanoma?

A
  • superficial spreading

- lentigo maligna

60
Q

where do superficial spreading melanomas commonly occur?

A

trunk and limbs

61
Q

where do acral/mucosal lentiginous melanomas occur?

A

acral (palms, fingers, soles of feet, nails)

and mucosal areas

62
Q

where do lentigo maligna melanomas commonly occur?

A

sun-damaged face, neck, scalp

63
Q

what causes regressed areas within melanomas?

A

lymphocytes attacking the melanocytes

64
Q

with superficial spreading melanomas, acral/mucosal lentiginous melanomas and lentigo maligna melanomas, what is the progression of a melanoma?

A

radial growth phase (a macule is formed)

followed by

vertical growth phase (dermis is invaded)

65
Q

in what growth phase can melanomas metastasise?

A

only in vertical growth phase

66
Q

what is the main difference with nodular melanomas to the other types?

A

no radial growth phase

only a vertical growth phase

67
Q

which is the most common type of melanoma?

A

superficial spreading melanoma

68
Q

what are the 3 main subtypes of basal cell carcinoma?

A
  • nodular
  • superficial
  • infiltrative (morphoeic)
69
Q

what is the definition of a leg ulcer?

A

any break in the skin of the lower leg above the ankle

which has been present for more than 4 weeks

70
Q

what are the normal ranges of ABPI?

A

0.8 - 1.3

71
Q

what ranges of ABPI show vascular disease?

A

less than 0.8

72
Q

compare venous and arterial ulcer in terms of the border?

A

venous have a much more shallow edge/border

73
Q

where do venous ulcers tend to develop?

A

around the malleoli

74
Q

what are the 5 layers of the scalp?

A 
Skin
Connective tissue
Aponeurosis
Loose connective tissue
Parietal bone

Dermatology (4 decks)

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