Skin Cancers Flashcards
What are non-melanoma skin cancers
Basal cell cancer (70%) and squamous cell cancer
What are the risk factors for non-melanoma skin cancers (5)
UV radiation
Chemical carcinogens
HPV
Familial cancer syndromes
Immunosuppression (patients with transplants are 100x more likely to develop SCCs)
What are characteristics of basal cell carcinomas
Slow growing
Locally invasive
Rarely metastasise
Nodular:
- pearly rolled edge
- central ulceration
What is the treatment of BCCs
Excision is the gold standard
- ellipse with rim of unaffected skin
- curative if fully excised
- leaves a scar (3x size of what was there to ensure fully excised)
Processed in lab to ensure full excision
What is the treatment for BCCs if they aren’t fully excised
Remove further pieces until confident full BCC is removed (useful if you don’t want to remove too much e.g. round the eyes)
What are characteristics of squamous cell carcinomas
Usually on sun exposed sites
Can metastasise
Fast growing, tender, scaly/crusted or fleshy growths
Can ulcerate
What is the treatment of SCC
Excision +/-radiotherapy
Needs to be well excised with a 5mm margin of skin (4mm for BCCs)
Radiotherapy if very close margin and cant take more skin (e.g. in scalp if you’ve gone down to the skull)
What is a keratoacanthoma - how is it treated
Variant of SCC
Erupts from hair follicles in sun damaged skin
grows rapidly (key for history) - may shrink after few months and resolve
Surgically excise
What are the risk factors for melanoma (3)
UV radiation
Genetic susceptibility (fair skin, red hair, blue eyes, tendency to burn)
Familial melanoma and melanoma susceptibility genes
What is the ABCDE rule for melanomas
Asymmetry
Border
Colour (blue white veil in centre suggests melanoma, pink lesions are concerning )
Diameter
Evolution
What major features suggest melanoma
Change in size, shape, colour
Which minor features suggest melanoma
Diameter >5mm
Inflammation
Oozing or bleeding
Mild itch or altered sensation
What is the treatment for melanomas
Urgent surgical excision (take extra 1-2cm of skin around scar)
The deeper the tumour goes the poorer the 10 year survival rate (want to catch them when they are thin)
Sentinel lymph node biopsy
Chemotherapy - almost never
Radiotherapy - rarely
Immunotherapy - metastasis or adjuvent therapy
How does immunotherapy help treat melanomas
Boosts the immune system so have renewed immune response to the melanoma
What are cutaneous lymphomas (primary and secondary)
Primary - abnormal neoplastic proliferation of lymphocytes in the skin
Secondary- cutaneous disease from systemic/nodal involvement
