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57 Cards in this Set
- Front
- Back
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Describe an actinic keratosis.
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Flat, scaly, with underlying erythema
Small size, lack of strong pigmentation Confined to epidermis Progresses to a white scale or rough spot Poorly demarcated Most common on face/scalp and dorsum of hands |
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Which UV light is most responsible for melanoma?
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Used to think UVA, but now think UVB
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What skin cancer has a pearly or waxy appearance?
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Basal cell carcinoma
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What is the most common type of skin cancer?
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Basal cell carcinoma
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Describe a squamous cell carcinoma.
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Reddish, scaly lesions
Indistinct borders; may bleed easily May have ulcerated center Potential for rapid growth May develop keratin "horn" |
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What is the percentage of metastasis of squamous cell carcinoma?
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2-6%
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What are the complications of basal cell carcinoma?
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Direct structural or functional damage
Loss of tissue Scarring |
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What layers of skin does UVA penetrate?
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deep dermis
however, not as effective as UVB in causing biological change |
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What layers of skin does UVB penetrate?
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Penetrates epidermis to upper dermis
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Which UV is responsible for most biological changes?
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UVB
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How long does it take for UVB to redden skin?
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6 hours
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How long does it take for UVB to darken skin?
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48-72 hours
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What skin lesion is considered an early stage of squamous cell carcinoma?
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Actinic keratosis
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What is the treatment for an isolated actinic keratosis?
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cryotherapy
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What is the treatment for multiple actinic keratoses?
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topical 5-fluorouracil cream BID for 3 wks
may also use tretinoin, chemical peels, imiquimod, diclofenac |
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Describe a basal cell carcinoma.
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75-80% of non-melanocytic skin cancers
Pearly, waxy surface May be nodular with central depressed ulcer May resemble dermatitis - red, scaly, wrinkled plaque Morpheaform - look like scars, indurated |
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What is the histology of basal cell carcinoma?
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islands of basophilic keratinocytes
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Which UV light is most responsible for basal cell carcinoma and squamous cell carcinoma
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UVB
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What type of genetic disease is basal cell nevus syndrome?
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Autosomal dominant
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Other than skin manifestations, what are the other signs of basal cell nevus syndrome?
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Large cysts that can break jaw
Wideset eyes Prominent brow Medullablastomas in kidney Brain tumors |
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What is the histology of squamous cell carcinoma?
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pleomorphic keratinocytes
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What transplant recpients are at greatest risk for failed treatment of squamous cell carcinoma?
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Heart (most)
Kidney Liver |
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What is the 5 year recurrence percentage for large squamous cell carcinomas?
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70%
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Which UV light causes direct damage?
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UVB
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What is the 5 year recurrence percentage for primary squamous cell carcinomas?
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8%
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What is the 5 year recurrence percentage of lip/ear squamous cell carcinomas?
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10-25%
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At what rate do squamous cell tumors larger than 2 cm metastasize?
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30%
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What are the high risk areas of the body for squamous cell carcinoma?
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Lips, mucosa, ears
Hands, scalp, forehead, temple, eyelid, nose Penis, scrotum, anus Nail folds |
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What treatment is suitable for in situ squamous cell carcinoma?
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Electrodessication
Curettage |
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What excision size is suitable for a squamous cell carcinoma smaller than 2 cm and in a low risk site?
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Excision with 4 mm margin
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What excision size is suitable for squamous cell carcinomas larger than 2 cm or in a high risk site?
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Excision with 6 mm margin
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What are the ABCDEs of melanoma?
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Asymmetry
Border irregularity Color variation Diameter Evolving |
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Where does lentigo maligna melanoma usually occur?
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on the face
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What layer of skin does nodular melanoma start in, and what is the prognosis?
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deep in dermis
poor prognosis; by the time it is seen on the surface of the skin it's probably metastasized |
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What melanoma appears on the volar hands and feet?
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Acral-Lentiginous Melanoma
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What is the average number of moles for a 40-year-old person?
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50
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What is the current term for benign juvenile melanoma?
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Spitz nevus
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What are the most common forms of chemotherapy used for palliative treatment of metastatic melanoma?
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DTIC, thalidomide, temozolomide (MTIC)
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What does TNM stand for?
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Tumor
Nodes Metastasis |
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What Clark level describes penetration of the lesion into the lower dermis?
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Level 4
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What does the "a" stand for in this staging?
T2a |
a = not ulcerated
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In staging a melanoma, what would M1B mean?
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Metastases to the lung
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In staging a melanoma, what would M1A mean?
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distant metastases to the skin or subcutaneous tissue or distant lymph nodes
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In staging a melanoma, what would M1C mean?
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Metastases to other organs or distant site with elevated LDH
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In staging a melanoma, what does N2A mean?
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Melanoma has spread to 2 lymph nodes
A = means melanoma can be seen only under microscope |
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In staging a melanoma, what does N1B mean?
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Metastasis to one lymph node
B = melanoma is visible to naked eye |
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In staging a melanoma, what does N4C mean?
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Melanoma has spread to 4 or more lymph nodes
C = melanoma can be seen in nearby skin or can be found in lymphatic channels |
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Which UV light causes indirect damage?
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UVA
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What does Clark level 5 indicate?
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Lesion has invaded subcutaneous tissue
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What does Clark level 1 indicate?
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Lesion confined to epidermis
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Which Clark level would indicate that a lesion has begun to invade the dermis?
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Level 2
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What does Clark level 3 indicate?
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Lesion involves most of the upper dermis
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What is this?
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Basal cell carcinoma
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What is this?
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Amelanotic lentigo maligna melanoma
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What is this?
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Nodular melanoma
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What is this?
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Squamous cell carcinoma
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Which UV light penetrates deeper?
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UVA
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