Skin cancer overview

Question 1

Where do basal cell carcinomas and squamous cell carcinomas arise from?

Answer 1

Basal cell- hair follicles

Squamous- suprabasal keratinocytes

Question 2

What is the most common cancer in 15-24 year olds?

Answer 2

Melanoma

Question 3

What does survival in melanoma depend on?

Answer 3

Tumour depth

Question 4

What is the survival rate for metastatic melanoma?

Answer 4

5 year survival = 5%

Question 5

What does ABCDE stand for in assessing melanoma?

Answer 5

Asymmetry
Border
Colour
Diameter
Evolution

Question 6

What is the “ugly duckling” sign?

Answer 6

Deviation of a melanocytic lesion from the local pattern of naevi

Question 7

How does BCC typically present?

Answer 7

Slow-growing painless lump/non-healing ulcer
“Pearly” or translucent
Visible arborising blood vessels
Central ulceration

Question 8

How does squamous cell carcinoma typically present?

Answer 8

Hyperkeratotic lump or ulcer, usually on sun-damaged skin
Fast growing
May be painful
May bleed

Question 9

Name two precursor lesions for SCC.

Answer 9

Bowenoid plaques

Actinic keratosis

Question 10

Where are high-risk areas for SCC?

Answer 10

Ear, lip and scalp

Question 11

What is keratoacanthoma?

Answer 11

Self-limiting SCC- usually spontaneously involutes

distinguished by central “crater”/ulcer/keratin horn

Question 12

List the main risk factors for development of skin cancer.

Answer 12

Sun exposure (chronic & cumulative [SCC] versus intense and intermittent [BCC and melanoma])
Genetic predispostion (e.g. XP, Gorlin's syndrome, albinism)
Impaired immunity (e.g. post transplant)
Environmental carcinogens (smoking, radiation)