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Flashcards in Skin Cancers Deck (26):
1

What is the 2 year recurrence rate of SCC in a patient with h/o of SCC

40%

2

What is the prevalence of SCC

1 in 3 people (33%)

3

What is the prevalence of BCC?

1 in 4 people gets BCC (sun and genetics)

4

What is the prevalence of Melanoma in AZ?

1 in 50 people in AZ

Cause: sun and genetics

5

When scheduling pt for cancer excision surgery, what questions must ask that pt?

Do you have any artificial joints, valves?

6

If a patient has an artificial heart valve, what is done before surgery

Take Keflex or Clindamycin (1 hour before?) Doxy ok but prefer those 2

7

In which cancer are negative margins not definitive?

Superficial BCC - it can reoccur because cancer cells skip around like pebbles (or loaf of bread with figs)

8

What is the risk of developing melanoma in a patient with h/o of any skin cancer?

4x risk of developing MM

9

How to treat SCCis (Bowens) to BASE in LE

MOHS

(If not to base on LE, ok to excise)

10

Not to use in breastfeeding

Rogaine
Gabapentin
Topical class 1 steroids

Dermasmooth ok
IL kenalog OK

Normal to lose hair after pregs x 6 months because of Telogen Effluvium

11

LPP associated pain tx

Can use gabapentin (not if breast feeding)

LPP can regrow if caught early, scars after hair falls out several times (IL kenalog is more effective)

Can use dermasmooth in breast feeding

12

NP with h/o MM

What color was it?
Any FH of MM?
ANy FH of any other cancers (kidney, pancreas, breast cancer is the highest RF for MM)

For genetic saliva test need 3 - either 3 MM on self or 3 among family members

13

Superficial BCC - how to tx

Always EDC but excise if large? (even if positive margins, even if to base)

14

How to tx Nodular BCC with negative margins

Always EDC

15

Nodular BCC with positive margins tx

Excision preferred if pos margins
Can EDC if pos margins and to base!!!
Ok to EDC back leg arm

NEVER EDC ON FACE - face goes to MOHS (+ or - margins))

16

Small Nodular BCC to base tx

Can excise or EDC

17

Ulcerated nodular BCC

EXCISE

18

Nodular BCC tx areas to avoid

Post auricular to base - ok to excise, not MOHS

AVOID: neck and Supra auricular (can cause numbness)

SCM muscle - CNXI Spinal Accessory nerve

19

Which BCC never to EDC

Micro Nodular (>7 mm): excise or MOHS
Invasive (always MOHS if LIza) but can excise if arm or leg

20

SCCis (BOWENS) to base

Excise or Mohs

To base on face or Finger - Mohs
>2 cm - Mohs

21

SCC T1 is how many risk factors and how Tx

0 risk factors

Tx: if WELL differentiated - EXCISE with 4 mm margins
If moderately differentiated = MOHS

All other SCC T2 T3 T4 - must MOHS

22

When to refer for urgent MOHS

SCC that’s MODERATELY differentiated AND (or OR?) in low immunity pt (CLL, HIV, transplant, on biological?)

23

Top 3 Mets to head

MM
Breast cancer
Renal cancer

24

Percent of risk for SCC to metastasize

4%

25

Tell pts with melanoma to do what once per year

Have eyes checked

26

What can be used instead of FUDEX for AKs

Solarace x 3 months (more gentle but less effective)

Aldabra (imiquimod) QD 2 wks on, 1 wk off, 2 wks on
But can cause flu sx

Blue light not effective - gets red x1 week bs 2 weeks on FUDEX