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33 Cards in this Set
- Front
- Back
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What is the casue of basal cell carcinoma?
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Chronic exposure to UV light
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What is the most common malignant skin tumor?
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Basal cell carcinoma
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Describe the clinical appearance of basal cell carcinoma
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Raised papule or nodule with a central crater
-Sides of the crater are surfaced by telangiectatic vessels |
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Where does basal cell carcinoma occur?
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Occurs in sun-exposed areas
a. Inner canthus of the eye, upper lip b. Very general rule of thumb is that BCCs favor upper lip and higher |
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Describe the spread of basal cell carcinoma
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Locally aggressive, infiltrating cancer that does not metastasize
a. Tumor is stromal dependent, hence precluding metastasis b. Arises from the basal cell layer of the epidermis c. Multifocal in origin -This makes it difficult to get free margins after surgery d. Cords of basophilic-staining basal cells infiltrate the underlying dermis |
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Where do basal cell carcinomas arise from?
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The basal cell layer
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Describe how to diagnose basal cell carcinomas
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Through punch biopsy or shave biopsy
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Describe the treatment of basal cell carcinomas
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1. Varies with location and size of cancer
2. Options include a. Topical 5-fluorouracil b. Cryotherapy c. Curettage and electrodesiccation d. Surgical excision e. Radiation (usually in elderly) |
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What are the risk factors for squamous cell carcinomas?
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1. Excessive exposure to UV light (most common)
2. Actinic (solar) keratosis 3. Arsenic exposure 4. Scar tissue in a 3rd degree burn 5. Orifice of chronically draining sinus tract 6. Immunosuppressive therapy |
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Describe the clinical appearance of squamous cell carcinoma
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Scaly to nodular lesions
a. Nodules are often ulcerated b. Majority occur in sun-exposed areas of the body -Examples- ears, lower lip, dorsum of hands -Very general rule of thumb is that SCCs favor lower lip c. Usually well differentiated -Minimal risk for metastasis |
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Describe the treatment of squamous cell carcinoma
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1. Varies with location and size of cancer
2. Options include a. Topical 5-fluorouracil b. Cryotherapy c. Curettage and electrodessication d. Surgical excision e. Radiation (usually in elderly) |
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What is the most common cancer complicating immunosuppressive therapy?
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Squamous cell carcinoma
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What is actinic (solar) keratosis associated with?
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Prolonged UV light exposure
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What is actinic (solar) keratosis a precursor for?
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Squamous cell carcinoma
-Squamous cancer occurs in 2-5% of cases |
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Describe the clinical appearance of actinic (solar) keratosis
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Hyperkeratotic, pearly gray-white appearance
a. Occurs on face, back of neck, dorsum of hands/forearms b. Commonly recurs when scraped off |
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Describe the treatment of actinic (solar) keratosis
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1. Protection of skin with sunscreen
2. Topical therapy - 5-fluorouracil 3. Cryotherapy |
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What are melanoma?
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Malignant tumor of melanocytes
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What is the most rapidly increasing cancer worldwide?
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Malignant melanoma
-More common in whites than blacks |
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What is the leading cause of death due to skin cancer?
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Melanoma
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What is the median age at diagnosis for melanoma?
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53yo
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What are the risk factors for malanoma?
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1. Exposure to excessive sunlight (UVA and UVB) at an early age
-Single most important risk factor 2. History of a family member with melanoma 3. Use of tanning booths 4. Dyspastic nevus syndrome 5. History of melanoma in first- or second-degree relative 6. Xeroderma pigmentosum |
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What is the most important risk factor for melanoma?
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Exposure to excessive sunlight (UVA or UVB) at an early age
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Describe the radial growth phase of melanoma
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1. Initial phase of invasion
2. Melanocytes proliferate a. Laterally within the epidermis b. Along the dermoepidermal junction c. Within the papillary dermis 3. No metastatic potential in this phase |
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Describe the vertical growth phase of melanoma
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1. Final phase of invasion
2. Malignant cells penetrate the underlying reticular dermis 3. Potential for metastasis |
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What are the signs of melanoma?
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Asymmetry
Borders irregular Color changes Diameter increased Elevation or Evolution |
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What are the types of malignant melanomas?
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1. Superficial spreading melanoma
2. Lentigo maligna melanoma 3. Nodular melanoma 4. Acral lentiginous melanoma |
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Describe superficial spreading melanomas
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1. Most common type (70% of cases)
2. Develops on lower extremities, arms, and upper back |
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Describe Lentigo maligna melanoma
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1. 4-10% of cases
2. Common in the elderly population 3. Extension of lentigo maligna (intraepidermal lesion) into the dermis 4. Occurs in parts of face most exposed to sun 5. Least likely to have a vertical phase |
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Describe Nodular melanoma
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1. 15-30% of cases
2. No radial growth phase 3. Can be found in any sun-exposed area -Most often the trunk 4. No radial phase only vertical phase 5. Poor prognosis |
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Describe Acral lentiginous melanoma
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1. 2-8% of cases
2. Not related to sun exposure 3. Located on the palm, sole, or beneath the nail -Often confused with a subungual hematoma 3. Most often occurs in Asians and blacks 4. Poor prognosis |
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What is the best indicated of biologic behavior of a melanoma?
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Depth of invasion
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Describe prevention of melanoma
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1. Sunscreen >15 SPF (controversial)
-Prevention for UVA and UVB light 2. Protective clothing |
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Describe treatment of melanoma
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1. Excision of entire lesion and surrounding normal tissue
-Sentinal lymph node biopsy to determine stage 2. More extensive disease -Immunotherapy; irradiation |
