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what are the main risk factors for skin cancer?
excess sun exposure
fair skin type - always gets red in sun
radiotherapy
arsenic
phototherapy
previous UV therapy
atypical mole syndrome
xeroderma pigmentosum
gorlins syndrome
: predisposition for BCC
immunosuppressed eg renal transplant
what are the 3 BENIGN pigmented lesions?
melanocytic naevi
seborrheic keratosis
dermatofibroma
what is the epidermis and dermis linked by?
basement membrane
what is the commonest type of melanocytic naevi?
junctional naevus
how do you describe junctional naevi?
FUBAR
flat
uniform
brown
acquired
regular
what is an intradermal naevus?
raised melanocytic naevus
dome shaped
what is it called when a mole starts flat and becomes raised?
compound naevus
what is atypical mole syndrome?
> 100 moles
> 5mm diameter
what is the risk with atypical mole syndrome and can this be reduced by removing the benign moles?
risk of melanoma
NOT reduced by removing the moles
what % of population is affected by atypical mole syndrome?
2%
who does seborrheic keratosis affect?
over 30 yo
very common
how would you describe seborrheic keratosis?
pale to dark brown appearance
stuck on
waxy
'warty'
keratin cysts
face trunk limbs
can seborrheic keratosis turn malignant?
no
how do you describe a dermatofibroma?
firm dermal nodule
pale to dark brown
may be dimpled/tethered
what can dermatofibromas follow?
insect bites
is dermatofibroma more in f or m?
f
where do you commonly see dermatofibromas?
lower limbs
what is lentigo maligna?
in situ melanoma
pre malignant
who is at higher risk of lentigo maligna and where on body?
face
elderly
sun damaged skin
how would you describe a lentigo maligna?
large irregularly pigmented macule
what is a lentigo maligna melanoma?
a melanoma that has developed form a lentigo maligna
ie not it has breached BM and is malignant
how do you asses if a mole looks atypical?
Asymmetry
Border irregularity/notching
Colour
: variable pigmentation
Diameter >6mm
Evolving?
skin markings lost
may ulcerate, bleed, itch
what are the 4 main RF for malignant melanoma?
fair skin
intermittent intense sun exposure
atypical mole syndrome
family history of MM
what is the prognosis of amelanotic melanoma? why?
bad as highly malignant
as melanoma cells become more dysplastic, and less well differentiated they lose capacity to produce melanin
what are the 4 prognostic indicators for melanoma?
breslow thickness
ulceration
mitotic index
sentinel node biopsy if breslow > 1mm
what is definition of breslow thickness?
measurement (histologically) in mm from granular layer to the deepest level of invasion
what is Rx of melanoma?
excision +/e SNB (if breslow >1mm)
what is the commonest human cancer?
basal cell carcinoma
how would you describe a BCC?
skin coloured
papular
pearly
telangiectasia
rolled border
ulcerated or central umbilication
where do BCCs commonly dorm?
on danger area of the face
what does actinic damage consist of and what causes it?
solar damage - sun
pigmentary change
actinic keratoses - rough areas of skin
pre-malignant to SCC
where do AK's occur?
face
dorsal hand
bald scalp
who gets AKs?
sun exposed
older
what is bowens disease?
SCC in situ
how would you describe bowens disease?
well circumscribed erythematous scaly plaque
what is differential for bowens disease?
eczema
psoriasis
what causes bowens disease?
solar radiotion
hpv 16
arsenic
radiotherapy
how do you confirm diagnosis of bowens?
histologically - skin biopsy
what are the features of SCC?
keratotic
or ulcerated
what is the rate of growth of SCC?
rapid!
who has an increased risk of SCC?
fair skin
sun exposed
transplant recipients
what are the 2 main additional risk factor for SCC that doesn't apply to BCC?
SCC may develop in any chronic wound or scar
marjolin's ulcer
HPV (more in immunosupp)
where in the body does SCC have a higher metastatic potential?
head and neck
describe the evolution of SCC in terms of dysplasia
AK
: partial dysplasia
bowen's disease
: full dysplasia
SCC
: full dysplasia with invasion (covered with keratin)
which skin cancers/pre-cancers can be treated with topical therapies?
actinic keratoses
bowen's disease
superficial BCC
lentigo maligna (cryotherapy)
what are the 4 main topical therapies?
5FU - fluorouracil
imiquimod
PDT
cryotherapy
Author
kavinashah
ID
85611
Card Set
skin cancer.txt
Description
skincancer
Updated
5/13/2011, 1:31:37 PM
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