skin cancer.txt

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Author:
kavinashah
ID:
85611
Filename:
skin cancer.txt
Updated:
2011-05-13 09:31:37
Tags:
skincancer
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Description:
skincancer
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  1. 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
  2. what are the 3 BENIGN pigmented lesions?
    • melanocytic naevi
    • seborrheic keratosis
    • dermatofibroma
  3. what is the epidermis and dermis linked by?
    basement membrane
  4. what is the commonest type of melanocytic naevi?
    junctional naevus
  5. how do you describe junctional naevi?
    • FUBAR
    • flat
    • uniform
    • brown
    • acquired
    • regular
  6. what is an intradermal naevus?
    • raised melanocytic naevus
    • dome shaped
  7. what is it called when a mole starts flat and becomes raised?
    compound naevus
  8. what is atypical mole syndrome?
    • > 100 moles
    • > 5mm diameter
  9. 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
  10. what % of population is affected by atypical mole syndrome?
    2%
  11. who does seborrheic keratosis affect?
    • over 30 yo
    • very common
  12. how would you describe seborrheic keratosis?
    • pale to dark brown appearance
    • stuck on
    • waxy
    • 'warty'
    • keratin cysts
    • face trunk limbs
  13. can seborrheic keratosis turn malignant?
    no
  14. how do you describe a dermatofibroma?
    • firm dermal nodule
    • pale to dark brown
    • may be dimpled/tethered
  15. what can dermatofibromas follow?
    insect bites
  16. is dermatofibroma more in f or m?
    f
  17. where do you commonly see dermatofibromas?
    lower limbs
  18. what is lentigo maligna?
    • in situ melanoma
    • pre malignant
  19. who is at higher risk of lentigo maligna and where on body?
    • face
    • elderly
    • sun damaged skin
  20. how would you describe a lentigo maligna?
    large irregularly pigmented macule
  21. what is a lentigo maligna melanoma?
    • a melanoma that has developed form a lentigo maligna
    • ie not it has breached BM and is malignant
  22. 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
  23. what are the 4 main RF for malignant melanoma?
    • fair skin
    • intermittent intense sun exposure
    • atypical mole syndrome
    • family history of MM
  24. 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
  25. what are the 4 prognostic indicators for melanoma?
    • breslow thickness
    • ulceration
    • mitotic index
    • sentinel node biopsy if breslow > 1mm
  26. what is definition of breslow thickness?
    measurement (histologically) in mm from granular layer to the deepest level of invasion
  27. what is Rx of melanoma?
    excision +/e SNB (if breslow >1mm)
  28. what is the commonest human cancer?
    basal cell carcinoma
  29. how would you describe a BCC?
    • skin coloured
    • papular
    • pearly
    • telangiectasia
    • rolled border
    • ulcerated or central umbilication
  30. where do BCCs commonly dorm?
    on danger area of the face
  31. 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
  32. where do AK's occur?
    • face
    • dorsal hand
    • bald scalp
  33. who gets AKs?
    • sun exposed
    • older
  34. what is bowens disease?
    SCC in situ
  35. how would you describe bowens disease?
    well circumscribed erythematous scaly plaque
  36. what is differential for bowens disease?
    • eczema
    • psoriasis
  37. what causes bowens disease?
    • solar radiotion
    • hpv 16
    • arsenic
    • radiotherapy
  38. how do you confirm diagnosis of bowens?
    histologically - skin biopsy
  39. what are the features of SCC?
    • keratotic
    • or ulcerated
  40. what is the rate of growth of SCC?
    rapid!
  41. who has an increased risk of SCC?
    • fair skin
    • sun exposed
    • transplant recipients
  42. 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)
  43. where in the body does SCC have a higher metastatic potential?
    head and neck
  44. 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)
  45. which skin cancers/pre-cancers can be treated with topical therapies?
    • actinic keratoses
    • bowen's disease
    • superficial BCC
    • lentigo maligna (cryotherapy)
  46. what are the 4 main topical therapies?
    • 5FU - fluorouracil
    • imiquimod
    • PDT
    • cryotherapy

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