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28 Cards in this Set
- Front
- Back
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What are the most common skin cancers? |
1. Basal cell carcinoma (75%) 2. Squamous cell carcinoma (20%) 3. Melanoma (4%) |
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What is the most common fatal skin cancer? |
Melanoma |
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What is malignant melanoma? |
A redundancy - all melanomas are considered malignant! |
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What is squamous cell carcinoma? |
Carcinoma arising from epidermal cells |
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What are the most common sites of squamous cell carcinoma? |
Head, neck, and hands |
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What are the risk factors for squamous cell carcinoma? |
- Sun exposure - Pale skin - Chronic inflammatory process - Immunosuppression - Xeroderma pigmentosum - Arsenic |
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What is a precursor skin lesion to squamous cell carcinoma? |
Actinic keratosis |
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What are the signs/symptoms of squamous cell carcinoma? |
Raised, slightly pigmented skin lesion; ulceration/exudate; chronic scab; itching |
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How do you diagnose squamous cell carcinoma? |
- Small: excisional biopsy - Large: incisional biopsy |
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What is the treatment of squamous cell carcinoma? |
- Small (<1 cm): excise with 0.5 cm margin - Large (>1 cm): resect with 1-2 cm margins of normal tissue (large lesions may require skin graft/flap) |
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What is the dreaded sign of squamous cell carcinoma metastasis? |
Palpable lymph nodes (remove involved lymph nodes) |
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What is a Marjolin's ulcer? |
Squamous cell carcinoma that arises in an area of chronic inflammation (eg, chronic fistula, burn wound, osteomyelitis) |
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What is the prognosis for squamous cell carcinoma? |
Excellent if totally excised (95% cure rate); most patients with positive lymph node metastasis eventually die from metastatic disease |
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What is the treatment for solitary metastasis of squamous cell carcinoma? |
Surgical resection |
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What is basal cell carcinoma? |
Carcinoma arising in the germinating basal cell layer of epithelial cells |
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What are the risk factors for basal cell carcinoma? |
- Sun exposure - Fair skin - Radiation - Chronic dermatitis - Xeroderma pigmentosum |
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What are the most common sites of basal cell carcinoma? |
Head, neck, and hands |
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What are the signs/symptoms of basal cell carcinoma? |
- Slow growing skin mass (chronic, scaly) - Scab - Ulceration with or without pigmentation - Often described as "pearl-like" |
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How do you diagnose basal cell carcinoma? |
Excisional or incisional biopsy |
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What is the treatment for basal cell carcinoma? |
Resection with 5-mm margins (2-mm margin in cosmetically sensitive areas) |
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What is the risk of metastasis with basal cell carcinoma? |
Very low (recur locally) |
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What is an epidermal inclusion cyst? |
EIC = benign subcutaneous cyst filled with epidermal cells (should be removed surgically), filled with waxy material; no clinical difference from a sebaceous cyst |
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What is sebaceous cyst? |
Benign subcutaneous cyst filled with sebum (waxy, paste-like substance) from a blocked sweat gland (should be removed with a small area of skin that includes the blocked gland); may become infected; much less common than EIC
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What is actinic keratosis? |
- Premalignant skin lesion from sun exposure - Seen as a scaly skin lesion (surgical removal eliminates the 20% risk of cancer transformation) |
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What is seborrheic keratosis? |
- Benign pigmented lesion in the elderly - Observe or treat by excision (especially if there is any question of melanoma), curettage, or topical agents |
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How do you remember actinic keratosis vs seborrheic keratosis malignant potential? |
- Acute Keratosis = AK = Asset Kicker = premalignant - Seborrheic Keratosis = SK = Soft Kicker = benign |
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What is Bowen's disease of the skin? |
Squamous carcinoma in situ (should be removed or destroyed, thereby removing the problem) |
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What is "Mohs" surgery? |
Mohs technique or surgery: repeats thin excision until margins are clear by microscopic review (named after Dr. Mohs) - used to minimize collateral skin excision (eg, on the face) |
