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what are the main risk factors for skin cancer?
excess sun exposure
fair skin type - always gets red in sun
previous UV therapy
atypical mole syndrome
: predisposition for BCC
immunosuppressed eg renal transplant
what are the 3 BENIGN pigmented lesions?
what is the epidermis and dermis linked by?
what is the commonest type of melanocytic naevi?
how do you describe junctional naevi?
what is an intradermal naevus?
raised melanocytic naevus
what is it called when a mole starts flat and becomes raised?
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?
who does seborrheic keratosis affect?
over 30 yo
how would you describe seborrheic keratosis?
pale to dark brown appearance
face trunk limbs
can seborrheic keratosis turn malignant?
how do you describe a dermatofibroma?
firm dermal nodule
pale to dark brown
may be dimpled/tethered
what can dermatofibromas follow?
is dermatofibroma more in f or m?
where do you commonly see dermatofibromas?
what is lentigo maligna?
in situ melanoma
who is at higher risk of lentigo maligna and where on body?
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?
: variable pigmentation
skin markings lost
may ulcerate, bleed, itch
what are the 4 main RF for malignant melanoma?
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?
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?
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
actinic keratoses - rough areas of skin
pre-malignant to SCC
where do AK's occur?
who gets AKs?
what is bowens disease?
SCC in situ
how would you describe bowens disease?
well circumscribed erythematous scaly plaque
what is differential for bowens disease?
what causes bowens disease?
how do you confirm diagnosis of bowens?
histologically - skin biopsy
what are the features of SCC?
what is the rate of growth of SCC?
who has an increased risk of SCC?
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
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
: partial dysplasia
: full dysplasia
: full dysplasia with invasion (covered with keratin)
which skin cancers/pre-cancers can be treated with topical therapies?
lentigo maligna (cryotherapy)
what are the 4 main topical therapies?
5FU - fluorouracil