Skin cancers

Question 1

3 common skin cancers caused by UV light

Answer 1

SCC
BCC
Malignant melanoma

Question 2

never tans 
freckles 
red hair 
blue eyes 
always burns

Answer 2

skin type 1

Question 3

skin type 2

Answer 3

tans with difficulty
burns
less freckled

Question 4

tans easily, after the initial burn
dark hair
brown eyes

Answer 4

skin type 3

Question 5

skin type 4

Answer 5

always tans
burns minimally
mediterranean skin

Question 6

brown skin - indian

rarely burns

Answer 6

skin type 5

Question 7

skin type 6

Answer 7

black skin - african

never burns

Question 8

_____ skin types

Answer 8

FITZPATRICK

Question 9

invasive malignant tumour of melanocytes

Answer 9

melanoma

Question 10

which skin types are at risk of melanoma

Answer 10

fitzpatrick skin type 1 + 2

Question 11

prognosis of melanoma is related to….

Answer 11

thickness of the lesion:

BRESLOW THICKNESS

Question 12

risk factors for melanoma

Answer 12

• sun exposure
• skin types 1 + 2
• pre existing moles: congenital naevi + multiple dysplastic naevi
• sun bed
• smoking
• fhx
• immunosuppression

Question 13

ABCD appearance of malignant melanomas

Answer 13

A - Assymetry
B - irregular borders
C - multiple colours
D - increasing size/dimension

Question 14

3 major criteria: diagnostic features of Melanoma

Answer 14

1) change in size
2 change in shape
3) change in colour

Question 15

minor criteria: diagnosing melanoma

Answer 15

• diameter > 6 mm
• inflammation
• oozing/bleeding
• altered sensation

Question 16

trx suspicious lesions

Answer 16

excisional biopsy

Question 17

next step once suspicious lesions has been excised?

Answer 17

diagnosed confirmed by pathology lab –> review as to whether further re excision of margins is required.

Question 18

most common type of skin cancer

Answer 18

Basal cell carcinoma

Question 19

risk factors for both BCC + SCC (3)

Answer 19

• chronic UV light exposure
• skin types 1+2
• immunosuppression

Question 20

genetic condition of predisposition to BCC

Answer 20

Gorlin’s syndrome

Question 21

rare condition where BCC starts at around 30 years

Answer 21

gorlin syndrome

Question 22

other medical conditions in those with gorlin syndrome (4)

Answer 22

• skin tags + skin cysts
• medulloblastoma
• longer + larger bones than usual
• benign tumour of ovary

Question 23

genetic condition of predisposition to SCC

Answer 23

Xeroderma pigmentosa

Question 24

what is xeroderma pigmentosa

Answer 24

rare skin disorder where the individual is extremely sensitive to sun
autosomal recessive
SCC

Question 25

features of BCC

Answer 25

- initially: pearly, flesh coloured papules with telengiectasia - later: ulceration

Question 26

management options for BCC

Answer 26

- surgical excision - curettage - cryotherapy - radiotherapy - topical cream: fluorouracil

Question 27

SCC is

Answer 27

malignant tumour arising from keritoncytes of the epidermis typically have crusted/hyperkeratotic surfaces + painful

Question 28

common sites for SCC

Answer 28

- face - scalp - back of hands

Question 29

management of SCC if > and < 20 mm diameter

Answer 29

surgical excision with margins... 4 mm margins if < 20 mm 6 mm margins if > 20 mm

Question 30

well differentiated tumours have a ___prognosis

Answer 30

good

Question 31

what is bowens disease

Answer 31

squamous cell carcinoma in situ characterised by - well defined - erythematous - macule - little induration - slight crusting

Question 32

risk factors for bowens disease

Answer 32

following ingestion of arsenic, exposure to sheep dip, weed killer, industrial process

Question 33

management of bowens disease and why

Answer 33

curettage+cautery/cryotherapy/excision ---- reduce risk of SCC

Question 34

what are actinic/solar keratosis + appearance?

Answer 34

scaly spot on sun damaged skin, early SCC - crusty - scaly - irregular edges

Question 35

treatment of actinic keratosis

Answer 35

liquid nitrogen/cryotherapy/shave/curettage/electocautery | followed by diclofenac na gel BD 3 months

Question 36

UV protection advice

Answer 36

- SPF 30, UVA + UVB protection, star raring 3 or 4 - apply 30 min before sun exposure + re apply every 2 hours - thin film - appropriate clothing including darker rather than lighter coloured - shade between 11 and 3 - ensure you never burn

Question 37

frequency of review following SCC

Answer 37

3 monthly | 12 month review appt

Question 38

which skin ca rarely metastasises

Answer 38

BCC