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39 Cards in this Set
- Front
- Back
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What's the most common kind of skin cancer?
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Basal cell carcinoma
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What's the rarest kind of cancers?
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Merkel cell carcinoma
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What are risk factors for cutaneous SCC?
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UV radiation/fair skin
immunosupression Ulcers, scars Environmentla toxins Radiation HPV Genodermatoses |
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What's the most commonly mutated gene in skin cancer?
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p53
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What happens in xeroderma pigmentosum?
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Inability to repair DNA
Severe skin cancers. |
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What's the distribution of SCC?
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Where you have the sun!
-Head -Neck -Upper extremities |
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What's the appearance of SCC?
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Pink papule, nodule, or plaque
Firm to hard Scaling If ulcers, indurated border |
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What cells go awry in cutaneous SCC?
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Epithelial cells invade the dermis
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What are features of cutaneous SCC under the scope?
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Horn Pearls
Variable layers of keratinization If aggressive, mitotic figures and nuclear pleiomorphism |
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What layers of the epidermis give rise to cutaneous SCC?
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Cornified
Spinous |
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What are the cutaneous precursors of cutaneous SCC?
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Actinic keratoses
Arsenical keratoses SC in situ Warts |
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What are the properties of an actinic keratoses?
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Local area of rough, scaly surface; feels like sandpaper
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How often does SCC metastasize? Where does it do so at a higher rate?
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Overall rate: 2-4%, so no.
Risks are higher in places where there's radiation/burn scars or chronic osteomyelitis of the sinus tracts |
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What's the trearment for cutaneous SCC?
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Surgery!
Cryosurgery Chemo |
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What are risk factors for basal cell carcinoma?
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UV/fair skin
Immunosupression Arsenic Scars, radiation Genodermatoses -Nevoid basal cell carcionma syndrome |
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What are the different kinds of BCC?
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Nodular BCC
Superficial Morpheaform |
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What's the appearance of nodular BCC:?
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Smooth papule with translucent appearance
Telangiectasias Occasional ulceration |
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What is the appearance of superficial BCC?
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Think, flat, scaly, pink lesions
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What is the appearance of a morpheaform BCC?
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hypopigmented
depressed scar-like |
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What should you do if there's a lesion?
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Biopsy, always.
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What are the features of BCC histologically?
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Nests of cells in dermis
Resemble epidermal basal cells -Lots of blue cells -Scant cytoplasm -Columnar cells atperiphery Abnormal dermis surrounding it. Palisading |
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What does morpheaform BCC look like?
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Not like other BCCs
Cells invading the dermis surrounded by fibrotic stroma |
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What's the prognosis of BCC?
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Very little metastasis
Severe local damage |
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What's the treatment of BCC?
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Electrodessication and curettage
Excision Cryosurgery Radiation |
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If you have high risk BCC, what do you do?
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Mohs Micrographic Surgery
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What makes a BCC tumor high risk?
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Large/recurrent
On the face Morpheaform Poorly defined borders Incompletely excised tumors |
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What genes are mutated in BCC?
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Patched1 gene
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What is the function of PTCH1?
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Receptor for hedgehog proteins
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What is the active for SHH in embryogenesis?
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Turning on of certain TFs that cause differentiation
PTCH, GLII |
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What tumors are associated with SHH?
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Medulloblastoma
BCCs Rhabdomyosarcoma |
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What kind of drug is good for treating BCC?
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Vismodegib
Blocker of Smo, which acts in the SHH pathway Doesn't kill the tumors; just decreases the size. YOu've got to be on the drugs all the time. |
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What are the side effects of SHH blockers?
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Hair loss
Taste loss |
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What's the best treatment for BCC?
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Surgery!
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What are the risk factors for merkel cell carcinoma?
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Age
UV radiation Immunosupresion |
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What virus can cause MCC?
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Polyomavirus
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What does merkel cell carcinoma look like?
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Red/blue papule
Hard Shiny Ulceration is rare |
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Where does merkel cell carcinoma occur?
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Head, neck, extremities
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What does merkel cell carcinoma look like under the scope?
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Small blue cells
Large nodules in dermis High N:C ratio Invasion of nerves, vessels LOTS OF MITOSIS! |
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What's the prognosis of merkel cell carcinoma?
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Poor if it metastasizes, which it tends to do often.
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