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Dermatology > Skin Cancers > Flashcards

Skin Cancers Flashcards

(55 cards)

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1
Q

Which skin cancer has the nickname rodent ulcer?

A

BCC

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2
Q

Which skin cancers can metastasise?

A

SCC and melanoma

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3
Q

Name the 3 common skin cancers

A

Squamous cell carcinoma (SCC)
Basal cell carcinoma (BCC)
Malignant melanoma

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4
Q

Name the ABCDE criteria for pigmented skin lesions

A

A = asymmetry
B = irregular border
C = multiple colours
D = diameter >6mm
E = evolution (growing)

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5
Q

BCC risk factors

A

UV radiation
Ionising radiation
Immunosuppression
Chronic scarring and ulceration
Arsenic
Hereditary factors

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6
Q

SCC risk factors

A

UV radiation
Ionising radiation
Immunosuppression
Chronic scarring and ulceration
Wart virus
Hereditary factors

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7
Q

Malignant melanoma risk factors

A

UV radiation
Immunosuppression
Hereditary factors

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8
Q

List 3 hereditary factors causing skin cancer

A

Germline mutation eg. Familial melanoma
Acquired mutation eg. BRAF^V600E
Epigenetic eg. Arsenic toxicity

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9
Q

Malignant melanoma protective factors

A

Constitutional pigmentation
Immune system
DNA repair
Accurate control of cell division
Behaviour (avoiding UV rays, covering up, SPF)

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10
Q

SCC protective factors

A

Constitutional pigmentation
Immune system
DNA repair
Accurate control of cell division
Behaviour (avoiding UV rays, covering up, SPF)

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11
Q

BCC protective factors

A

Constitutional pigmentation
Immune system
DNA repair
Accurate control of cell division
Behaviour (avoiding UV rays, covering up, SPF)

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12
Q

What is a precursor for SCC?

A

Actinic keratosis
Bowen’s disease

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13
Q

Describe actinic keratosis

A

Sun-exposed sites (face, backs of hands, bald scalp)
Rough area of skin/raised, keratosis lesion
Usually multiple
Hard, spiky keratin our surface
Proliferations of cytologically aberrant epidermal keratinocytes
Pruritis, burning or stinging pain, bleeding and crusting

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14
Q

Describe Bowen’s disease

A

Superficial intraepidermal tumour
Slow radial expansion
Localised erythematous, scaly or crusted plaque
Not usually ulcerated, moist or thickened
Overlying scale or crust
Sun-exposed areas

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15
Q

Describe the carcinogenesis cycle

A

DNA lesion -> mutation -> gene -> cell phenotype -> clinal expansion -> pre-cancer or carcinoma

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16
Q

What type of UV exposure is a risk factor for SCC?

A

Flash fry (blistering burns)

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17
Q

What type of UV exposure is a risk factor for BCC?

A

Intermittent simmer (frequently tanning/burns)

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18
Q

Do SCCs or BCCs present later in life?

A

SCCs present later

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19
Q

General skin cancer risk factors

A

Skin type (eg. Red hair, blue eyes, pale,)
Sunburns (especially in childhood)
Outdoor exposure in occupation/hobbies
Living in sunny location
Immunosuppression (eg. Transplant)
Sunbeds/sunbathing
Family history
PMH skin cancer
Genetic disorders (eg. Albinism)

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20
Q

What are the types of albinism?

A

Type 1 = more severe, no melanin
Type 2 = some melanin
Occular albinism = normal, or slightly paler than normal for their ethnicity, skin and hair

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21
Q

Actinic keratosis risk factors

A

Older age
Male
Fair skin (easily burns and freckles)
Blonde/red hair and blue eyes
Cumulative UV radiation exposure
Immunosuppression
Prior AKs/other skin cancers

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22
Q

Arsenical keratosis clinical findings and cause

A

Associated with chronic arsenicism
Yellow keratosis paperless
Areas of constant pressure or repeated trauma
The bar and lateral borders of hands
Sides of fingers, dorsal fingers over joints

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23
Q

Bowen’s disease risk factors

Study These Flashcards
A

UV exposure
Immunosuppression
Infection with Human Papillomagirus (HOV)
Chronic arsenicism

24
Q

Describe lentigo maligna

Study These Flashcards
A

Subtype of melanoma in situ
Seen on chronically sun-exposed areas (eg. Cheeks, nose, neck, scalp, ears)

25
Lentigo maligna clinical findings
Flat, slowly-enlarging brown freckle-like macule Irregular shape and differing shades of brown and tan Usually arising in background of photo damage, ill-defined borders
26
Where do BCCs originate?
Derived from non-keratinising cells from basal layer of epidermis
27
Genetic causes of BCCs?
Gorlin’s syndrome (dental facts, palm pits) Xeroderma pigmentosum
28
Describe BCC clinically
Intermittent bleeding May appear to heal Pearly, translucency, ulceration, telangiectasia Rolled edge Slow-growing
29
Describe Nodular BCC
Sun-exposed areas Translucent Paul’s or nodule Telangiectasia Rolled border
30
Describe pigmented BCC
Subtype of nodular BCC Increased melanisation Hyperpigmented, translucent Paul’s/nodule May be eroded
31
Describe superficial BCC
Commonly on trunk Erythematous patch May resemble eczema Localised, red plaque Scaly Usually solitary or few Slowly enlarge
32
Describe infiltration BCC
Scar-like (lack of skin creases/indented) Difficult to define edges of lesion Shiny Tenlangiectasia
33
What cells cause SCC?
suprabasal epidermal keratinocytes
34
SCC clinical findings
Flesh-coloured or erythematous Hyperkeratotic, bleeding, oozing, crusting Papule, nodule or plaque May be pigmented or ulcerate May have cutaneous horn May be verrucous
35
List 4 melanoma subtypes
Superficial spreading malignant melanoma (SSMM) Nodular melanoma Lentigo maligna melanoma Acral lentiginous melanoma
36
Describe seborrhoeic keratosis
Common benign lesion Well-demarcated, stuck on appearance Varied colours Nodular or macular Surface normally rough No increases malignancy risk Can bleed/ulcerate if traumatised
37
Should you biopsy melanomas?
No
38
Describe the Glasgow 7-point checklist for melanoma
Major features = change in size, irregular shape, irregular colour Minor features = diameter >7mm, inflammation, oozing, change in sensitisation
39
Dermoscopy melanoma findings
Pigment network = atypical irregular, variable and widened lines that end abruptly at periphery Brown globules = correlate with pigmented nests of melanocytes in papillary dermis Black dots = focal collections of melanocytes and clumps of melanin in stratum corneum Blue-grey veil = represents regression in melanoma
40
Describe cutaneous lymphoma
Consider in eczema which has not responded to topical steroids Usually scaly, red rash Less itchy than eczema Not as thick as psoriasis Progressive over decades
41
Which cells are in the epidermis?
Keratinocytes Melanocytes Basal cells Langerhans cells
42
What is found in the dermis?
Capillaries Fibroblasts Lymphocytes Macrophages Mast cells Granulocytes
43
What is found in the subcutaneous tissue?
Collagen Vessels Elastic fibres GAGs Fibronectin
44
When does an acquired naevus appear?
after birth
45
When does a congenital naevus appear?
present at birth
46
What are the 4 clinical types of acquired naevi?
junctional malanocytic neavus compound melanocytic naevus intradermal melanocytic naevus rare naevi (eg. spitz, blue)
47
What does a junctional naevus look like?
brown/black and flat usually small
48
What does a compound naevus look like?
pigmented papules raised and palpable
49
What does a dermal/intradermal naevus look like?
fawn or skin-coloured papules (raised) can be hairy
50
Describe congenital naevi
solitary often relatively large do not go through normal mole ageing process
51
List the 4 main types of melanoma
lentigo maligna melanoma superficial spreading malignant melanoma acral lentiginous malignant melanoma (hands and feet) nodular malignant melanoma
52
Features of melanocytic lesions on dermoscopy
pigment network (regular, reticular pattern is good) blue white veil peripheral hypo/hyper-pigmentation vascular structure dots and globules (globular pattern)
53
What is a marjolin ulcer?
SCC arising in a chronic site of inflammation, most commonly on an old burn scar or a venous ulcer presents as new, persistent site of ulceration
54
Which HPV types can cause HPV-associated SCC?
16 and 18
55
Describe a keratoacanthoma
BCC or SCC like nodule with central hard keratin or rolled edge rapid growth mimics histologically a SCC good prognosis normally excised as difficult to distinguish from SCC clinically

Dermatology (23 decks)

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