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22 Cards in this Set

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Name 2 pre-malignant skin lesions and two non-melanoma skin cancers
Pre-malignant lesions = actinic keratosis, squamous cell carcinoma in situ
Malignant = basal cell carcinoma, squamous cell carcinoma
What is the most common type of pre-malignant skin lesion?
Actinic keratosis = 11-25% prevalance
What percentage of actinic keratosis progresses to NMSC?
5-20%
What does actinic keratosis look like?
Erythematous, scaly papule that is superficial
What percentage of squamous cell cacinoma in situ (Bowen's disease) progresses to SCC?
5% but higher if in genital area
What does SCC in situ look like?
Well-defined, thin, erythematous, scaly plaque (larger than AK)
What is the most common human cancer?
Non-melanoma skin cancer
(1 in 3 whites, 2x more in males)
What percentage of NMSC is BCC and what percent is SCC?
BCC = 75%
SCC = 20%
(opposite in immunosuppressed)
What is the risk of developing a second NMSC?
50% in 5 years
What percentage of BCC and SCC metastasize?
BCC = 0
SCC = 3%
What are risk factors for developing NMSC? (6)
UV
Radiation
Immunosuppression
Genodermatoses (Albinism, Xeroderma pigmentosum, Nevoid BCC syndrome)
Precursor lesion (AK, SCC in situ)
Chronic skin disorders - SCC only (HPV, burns, scars, ulcers)
What are the risks of UVB and UVA?
UVB = Burning>aging>skin cancer
UVA = Aging>skin cancer (penetrates deeper and through windows)
What is the risk of developing skin cancer in transplant patients?
>50% in 20 years
Why is xeroderma pigmentosum a risk factor for developing skin cancer?
DNA repair gene malfunctional so more at risk for developing cancer from UV exposure
What does squamous cell carcinoma look like?
Firm, flesh-coloured or red, keratotic papule/plaque/nodule (raised)
What are different sub-types of basal cell carcinoma and what do they look like? (4)
Nodular: pearly, flesh-coloured papule or plaque with rolled border and possible telangiectasias
Superficial: Red dermatitic papule or plaque
Sclerosing: Scar-like, flesh coloured papule or plaque
Pigmented: Dark pigmented papule/plaque/nodule
How do you prevent non-melanoma skin cancer?
Sun protection = sunscreen, shade, protective clothing, avoid midday exposure
What percentage of UV rays are blocked with SPF 2, 4, 8, 15, 30 and 60 sunscreen?
2 = 50%
4 = 75%
8 = 87%
15 = 93%
30 = 97%
60 = 98%
How do you calculate SPF for sunscreen?
SPF= minimum erythema dose with sunscreen/minimum erythema dose without sunscreen
How do you treat non-melanoma skin cancer? (3)
Topical - 5-fluorouracil, imiquimod
Destroy without margins (scrape, burn, freeze, photochemical, irradiate)
Surgery with margins
What are options for destroying a NMSC without margins?
Scraping = curettage
Burning = electrosurger, laser
Freezing = cryotherapy
Photochemical = photodynamic therapy
Irradiation = Radiation
What are 2 types of surgical techniques used to remove non-melanoma skin cancer (with margins)?
Standard excision
Mohs micrographic excision - for high risk cancers of head and neck