Skin Cancers Flashcards
What are the risk factors for basal cell carcinoma?
UV, lighter skin, radiation, arsenic, poor immune system
What are the types of basal cell carcinoma?
Superficial, infiltrative, nodular
Describe the pathophysiology of basal cell carcinoma
Originate from folliculo-sebaceous-apocrine germ, also known as trichoblast
Cumulative DNA damage leading to mutations
How is basal cell carcinoma best managed?
Surgical removal (mohs surgery), cryotherapy = imicramod + photodynamic therapy, electrodesiccation and curettage, radiation (not candidates for surgery)
What are the signs and symptoms of basal cell carcinoma?
Present over a few months
Painless raised area of skin, shiny, small blood vessels, ulceration
What are the risk factors for squamous cell carcinoma?
Older age, male, fair-skinned, exposure to UV, arsenic, bowen disease, HPV, HIV/AIDS, radiation
Outline the pathophysiology of squamous cell carcinoma
Tend to arise to pre-malignant lesions, can spread to tissue, bone, LNs (more malignant than basal cell)
What are the signs and symptoms of squamous cell carcinoma
Usually begins as a dome-shaped lesion or red scaly patch of skin, it enlarges and the centre becomes necrotic - turning into an ulcer, crusty, bleeds easily when scraped, itchiness, painful
Shorter presenting history than BCC as rapidly growing
How is squamous cell carcinoma managed?
Topical
- sunscreen
- retinoids
- 5-fluorouracil
Surgical
- wide excision
- mohs surgery
Non-surgical
- photodynamic therapy (PDT)
- cryotherapy
Systemic
- retonoids
Outline the risk factors for melanoma
FH, many moles, poor immune system
Outline the pathophysiology of melanoma
Devel from melanocytes that have out-of-control growth
What are the signs and symptoms of melanoma?
Mole that is increasing in size, has irregular edges, change in colour, itchiness, skin breakdown
How should melanoma be investigated?
Skin exam, tissue biopsy (entire area of pigment), sentinel node biopsy
o A = asymmetry o B = border uneven, ragged, notched o C = colouring of diff shades of brown o D = diameter >6mm o E = evolves over time
1 = change in size 2 = irregular pigmentation 3 = irregular outline 4 = >6mm 5 = inflam 6 = oozing or bleeding 7 = itch or altered sensation
How should melanoma be managed?
Surgical removal, spread = immunotherapy, biologic therapy, radiation, chemo
What are the hazards of UV radiation?
UV - B
- sunburn
- direct DNA damage and carcinogenesis
UV - A
- photo ageing
- potentates UV-B carcinogenesis
- immunological effects
- causes prod of ROS = cell mem, DNA, proteins
