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73 Cards in this Set
- Front
- Back
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What are the key cellular constituents of the epidermis?
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Keratinocytes
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What are the key cellular constituents of the dermis?
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Fibroblasts
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What is included in the subcutaneous layer?
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Fat cells
Nerves Blood vessels |
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From what layer do basal cell carcinomas arise?
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Lowest layers of the epidermis
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What is the precancerous stage of squamous cell carcinoma?
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Actinic Keratosis
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What are the non-melanocytic skin cancers?
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Actinic keratosis (pre-cancer)
Basal cell carcinoma Squamous cell carcinoma |
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Basal cell carcinomas comprise what percentage of NMSCs?
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80%
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Describe the appearance of a basal cell carcinoma.
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Pearly or waxy appearance
Distinct borders |
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Describe the appearance of a squamous cell carcinoma.
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Reddish, scaly lesions
Indistinct borders, may bleed easily |
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Describe the appearance of an actinic keratosis.
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Flat, may be difficult to discern
Scaly, with underlying erythema |
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A shave biopsy is indicated for what NMSC?
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BCC
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A punch biopsy is indicated for what NMSC?
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SCC
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Between BCC and SCC, which is more likely to metastasize?
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SCC
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Xeroderma pigmentosum and epidermodysplasia verruciformis are risk factors for what?
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NMSCs - BCC & SCC
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UV radiation has a longer wavelength and lower energy than visible light, true or false?
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False - (shorter & higher)
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Which UV causes most biological damage?
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UVB
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Which UV is mostly blocked by the ozone layer?
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UVC
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Which UV has the greatest amount of radiation to reach Earth's surface?
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UVA
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Which UV penetrates deeper into the skin?
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UVA
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How long does it take for UVB to redden the skin?
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about 6 hours
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How long does it take for UVA to darken skin?
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48-72 hours
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Which UV is most responsible for tumor production?
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UVA
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Which UV is clearly implicated in the generation of reactive oxygen species?
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UVA
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UVB generates what in DNA?
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Pyrimidine dimers
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Alteration of what gene can disable the cell's ability to repair UV damage?
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p53
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Damage of genes from what family can result in loss of control of cell division?
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ras
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Where is actinic keratosis most often found?
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Face/scalp
Dorsum of hands |
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A white scale or rough spot is indicative of what?
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actinic keratosis
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Actinic keratoses are often poorly demarcated, true or false?
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True
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Actinic keratoses are confined to what layer of the skin?
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Epidermis
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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 weeks
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What is diclofenac?
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Topical non-steroidal drug
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What type of therapy must be used for subclinical lesions?
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Field therapy
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What type of therapy can be used for clinical lesions?
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Ablative therapy
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What is the histology of basal cell carcinomas?
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Islands of basophilic keratinocytes
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What are the three possible appearances of basal cell carcinoma?
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Nodular - dome shaped with possible central depressed ulcer
Superficial spreading, resembling dermatitis Morpheaform - look like scars, indurated |
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Basal cell nevus syndrome is what kind of genetic disorder?
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Autosomal dominant
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What is the pathway associated with basal cell nevus syndrome?
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Sonic hedgehog pathway
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Wideset eyes, prominent brow, medullablastomas in kidney, and brain tumors are all symptoms of what?
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Basal cell nevus syndrome
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SCCs make up what percentage of NMSCs?
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20%
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What cancer may develop a keratin "horn?"
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SCC
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What is the histology of SCC?
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Pleomorphic keratinocytes
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What are the risk factors for metastatic SCC?
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Recurrent lesions
Lesions arising from chronic ulcers |
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Some strains of HPV, organ transplants, ulcers, XP, albinism, arsenic, ionizing radiation, and PUVA are risk factors for what cancer?
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SCC
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What is PUVA?
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Psoriasis treatment
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What transplant recipients have the highest risk of SCC?
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Heart
followed by kidney, then liver |
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Chronic inflammatory conditions like lupus and lichen planus are risk factors for what cancer?
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SCC
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What is the 5 year cure rate for large SCC lesions?
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70%
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SCC tumors larger than 2 cm metastasize at what rate?
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30%
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What is the 5 year recurrence rate of lip and ear SCC lesions?
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10-25%
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What is the life expectancy for SCC patients with a perineural tumor?
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usually less than 5 years
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What size margin is recommended for excision of SCCs from low risk sites and less than 2 cm diameter?
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4 mm
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What is margin is recommended for SCC lesions in high risk areas and greater than 2 cm in diameter?
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6 mm
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What treatments are acceptable for in situ SCC?
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Electrodessication and currettage
Cryosurgery |
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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 do lentigo maligna melanomas usually occur?
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On the face
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Nail bed melanoma is a variant of what other melanoma?
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Acral-lentiginous melanoma
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Nodular melanoma is described as what?
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Isolated nodule without typical pigment spread
Poor prognosis |
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What layer do nodular melanomas arise from?
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Deep in the dermis
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What is melanoma of the volar hands and feet known as?
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Acral-lentiginous melanoma
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Acral-lentiginous melanoma is most frequent in what populations?
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African Americans
Asians |
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How many moles may a Caucasian have by age 40 without being considered to have an increased mole count?
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50
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Benign juvenile melanomas are now called what?
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Spitz nevus
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Spitz nevi carry what chance of melanoma?
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5%
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Congenital nevi located in what region increase the risk for neurocutaneous melanoma?
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Posterior axial
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What is the most important indicator of prognosis for recurrence and prediction of survival?
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Sentinel lymph node status
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What tests should be used to stage melanoma?
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PET scans
Brain MRI |
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What should be the surgical margins for in-situ melanoma?
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5 mm
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What should be the surgical margins for melanomas up to 2 mm depth?
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1 cm
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Interferon is indicated for what stages of melanoma?
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2B, 2C, 3
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How long does interferon typically preserve relapse free survival?
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11 months
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What 3 chemo agents are usually given for melanoma?
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DTIC
Thalidomide Temozolomide (MTIC) |
