skin cancers

Question 1

pallor

Answer 1

pale, decreased pigmentation
possibly from blood abnormality or liver disease

Question 2

cyanosis

Answer 2

blue from decreased O2

Question 3

jaundice

Answer 3

yellow, ornage/green
due to excess bilirubin

Question 4

rubor

Answer 4

dusky red from arterial insufficiency from peripheral vascular disease (PVD)
in lower leg

Question 5

hyperpigmentation

Answer 5

Addison’s disease
pregnancy

Question 6

assessing darker skin

Answer 6

• observe palms of hands/soles of feet, tongue, lips and gums, sclera and conjunctiva of eyes
• pallor presents as yellow/ashen
• texture changes
• edema may lighten skin
• normal mucosa can be freckled
• petechiae

Question 7

petechiae

Answer 7

pinpoint red
check areas with light skin - abdomen, gluteal area, volar aspect of arm

Question 8

moles are AKA

Answer 8

nevus
common skin lesions

Question 9

cherry angiomas

Answer 9

fiery red, round, smooth
small (up to 3 mm)
benign and genetic
increase with age

Question 10

spider angiomas

Answer 10

fiery red, radiating legs
small up to 2 mm
associated with liver disease, pregnancy, estrogen therapy
common with aging

Question 11

actinic keratosis

Answer 11

pre-cancerous scaly lesion: most common pre-cancer on skin with chronic exposure to UV rays
flat to raised, crusty, rough
red, tan, pink
tiny to an inch

Question 12

xanthomas

Answer 12

benign fatty fibrous yellow plaques/nodules in subcutaneous layer
in disorders of lipid metabolism, leukemia, lymphoma, myeloma
early sign of RA
can occur with normal aging

Question 13

herpes zoster/shingles

Answer 13

• susceptibility: over 50, had CP, under stress, weakened immune system
• warning: 1-3 days before skin may burn, itch, tingle, sensitive, pain
• rash/blisters: 2-3 weeks, rash -> blisters -> yellow -> scabs -> heals
• post-herpetic neuraliga: long lasting pain in area of original rash, reduced QOL/physical functioning

Question 14

broken capillaries

purpura, petechiae

Answer 14

• continuum:
• petechiae is < 3 mm
• purpura is > 3 mm
• ecchymosis: covers large area
• signs of underlying bleeding for:
• thrombocytopenia
• medication SE

Question 15

3 types of skin cancer

Answer 15

non-melanoma: basal cell, squamous cell
melanoma (malignant)

Question 16

non-melanoma skin cancers

Answer 16

• more new cases of skin cancer in US (4 million) than combined incidence of breast, prostate, lung, colon
• 1/5 Americans
• 40-50% of Americans who live to 65 will have one type
• two types: basal cell carcinoma, squamous cell carcinoma

basal cell carcinoma is most common

Question 17

melanoma or malignant melanoma

Answer 17

• steady increase in all age groups over 30 years
• 13% death rate
• incidence of melanoma rises rapidly in Caucasians after age 20
• more people develop skin cancer because of tanning bed use than develop lung cancer because of smoking
• moderate freckling 2-3 times increased risk
• 90% can be detected with the naked eye

highest risk

Question 18

advanced stage diagnosis

Answer 18

• late stage melanoma diagnosis is more prvalent among minority/darker skin patients than caucasian patients
• 52% of non-hispanic black patients
• 25% of hispanic patients
• vs 16% of non-hispanic white patients

Question 19

5 year survival rates

Answer 19

• detected early 98%
• reaches lymph nodes 62%
• metastasizes to distant organs 18%

Question 20

melanoma late stage diagnosis

Answer 20

• access disparities undoubtedly contribute to late stage diagnosis in people with darker skin
• location in people with darker skin: more likely to be in harder to detect areas or areas not typically considered (acral surfaces of body, toes and fingers)

Question 21

melanoma of the extremities

Answer 21

• rarest subtype of skin cancer: less than 5% of skin cancers, on nails/hands/feet
• account for 1/3 of all melanomas of african americans, native americans, asians, and others with darker skin
• 10 fold increase compared to general population

Question 22

skin cancer risk factors

Answer 22

• exposure to UV radiation and individual sensitivity to UV radiation
• type of exposure (high-intensity, short-duration vs chronic exposure) and pattern of exposure (continuous vs intermittent) may differ among the three types of skin cancer
• immune system role: those on immunosuppressive drugs are 100x elevated risk of skin cancer (SCC)

Question 23

vitamin D deficiency and sunscreen

Answer 23

• people with all skin colors should wear sunscreen
• but melanin competes for UVB with substance in skin that kick-starts vD production - so people with darker skin tend to require more UVB exposure to generate same amount of vD