Flashcards in Week 8 Deck (23)
Most cSSCs that occur in sun-exposed areas of the skin and have a very _____ rate of metastasis.
very low rate of METs
In darker skinned people, cSCC tends to arise on non sun-exposed areas (e.g. the legs and anus) and are frequently associated with chronic inflammation, chronic wounds, or scarring.
Genetic factors for SCCs are:
fair skin, light-colored eyes, red hair, and Northern European origin.
Cumulative UVB sun exposure in the past ________ years of a person’s life increases the likelihood of cSCC in the presence of other risk factors.
*chronic cumulative UVB over a lifetime (and in particular last 5-10 years) —> SCC
*intense intermittent sun exposure (sunburn) —> BCC and melanoma
Sites of chronic inflammation, chronic wounds, or scars are susceptible to the development of cSCC
A lesion on the vermillion border is BCC or SCC?
cSCC until proven otherwise! - pipe or cigar hanging on lip
BCC does not grow on vermillion border!
In contrast to BCCs which only rarely metastasize (0.003%), _____of cSCCs spread to regional lymph nodes or more distant sites (the lungs, liver, brain, skin, or bone) --> a relatively poor outcome
Know the features of cSCC lesions that correlate with high risk for recurrence and regional or distant metastasis
-depth >4 mm
-location: ear & lip
Although there is no uniform agreed upon screening protocol for malignant melanomas in US a skin survey to identify suspicious lesions is considered the best option!
Individuals with atypical nevi have a _________ fold elevated risk of developing malignant melanoma.
There is a strong association between high nevus counts (more than ____) and malignant melanoma
Studies demonstrate higher rates of malignant melanoma in adults with ___________ or _______________ _____________ exposure to sunlight.
extensive or repeated intense sunlight exposure.
Case studies found the strongest association for malignant melanoma for ____________ sun exposure and ___________ in adolescence or childhood
intermittent exposure and sunburn
During the ___________ growth phase the malignant melanoma is almost always curable by surgical excision alone
radial (superficial tumors confined to epidermis)
Nodular melanomas have no identifiable __________ growth phase and enter the _____________ growth phase almost from their inception
vertical growth= deep invasion into dermis and have METs potential
Over 60% of superficial spreading malignant melanomas are diagnosed as thin, highly curable tumors of less than ___ mm thickness.
MC type (70% of melanomas)
Nodular malignant melanomas are the most difficult to diagnose at an early stage – at least half are greater than ____ mm in thickness when diagnosed!
2nd MC type (37% of melanomas)
The great majority of lentigo maligna melanomas are diagnosed at less than ___ mm of thickness!
Most common type of malignant melanoma among Asians and in African-Americans is the ______________ _____________ ____________ which arise most commonly on palmar, plantar, and subungual surfaces.
acral lengtiginous melanoma
arises on palmar, plantar and subungual areas because less pigmented
______________ _______________ is the single most important determinant of prognosis for a malignant melanoma
Stage T1: ≤1 mm malignant melanomas have a ten year survival of ____ percent
The definitive “initial” surgical treatment for primary cutaneous melanoma is a ________ ________ __________ down to the deep fascia
wide local excision