Malignant Tumors of the Skin (complete)

Question 1

What are the common types of skin cancer?

Answer 1

• BCC
• SCC
• Melanoma

Question 2

What is the incidence of skin cancer in the US?

Answer 2

2 million diagnosed annually

Question 3

What are the risk factors for non-melanoma skin cancers?

Answer 3

• Occurs more frequently in fair skinned ppl
• High UV exposure
• Also after ionizing radiation, arsenic or polycyclic hydrocarbon exposure

Question 4

What are the risk factors for melanoma skin cancers?

Answer 4

• Fair skin
• Excessive skin exposure
• Immunosuppression
• MM in first degree relative
• Whites
• Large congenital nevus (birthmark)
• Sporadic dysplastic nevus syndrome
• FAMMM

Question 5

What is a common precursor to SCC? What are tx’s?

Answer 5

Actinic keratosis
- it’s a precancer

Tx:

• Liquid nitrogen (cryosurgery)
• Chemo creams
• Immune stimulating creams

Question 6

What are the common mutations leading to BCC?

Answer 6

patch1 mutation

• Loss of function
• Normally blocks smoothened (SMO), a transmembrane protein

Question 7

What are the chemotherapeutic interventions used to treat BCC?

Answer 7

Vismodegib

- an inhibitor of SMO

Question 8

What are the common mutations leading to melanoma?

Answer 8

BRAF mutation

- Increases transcription of genes => increases growth and proliferation

Question 9

What are the chemotherapeutic interventions used to treat melanoma?

Answer 9

Vemurafinib

- Prevents increased transcription of genes that affect growth and proliferation

Question 10

Describe Breslow depth

Answer 10

• Measures thickness from top to bottom of mass
• Number 1 indicator of prognosis
• Thicker melanoma => worse prognosis

Question 11

Describe Clark levels

Answer 11

• Describes how far a melanoma has penetrated into skin, as opposed to thickness
• Looks more at layers of skin
• Not a true indicator of prognosis

I: Epidermis
II: Papillary dermis
III: Mid-dermis
IV: Reticular dermis
V: SubQ fat

Question 12

What are the methods of skin cancer prevention?

Answer 12

• Wear sunscreen
• Wear sunglasses
• Get to new genes

Question 13

What are the risk factors for skin cancer in transplant patients?

Answer 13

• Age, skin type, UV exposure
• Genetic factors
• HPV
• Level of immunosuppression (CD4 count, medications)
• Type of transplant

Question 14

What are the ABCDE guidelines for malignant melanoma?

Answer 14

A: asymmetry
B: border irregularity
C: color variation
D: Diameter >6mm
E: Evolution (has it changed?)

Question 15

What is Kaposi’s Sarcoma

Answer 15

• Endothelial malignancy
• Triggered by HHV-8
• Slowly progressive
• 0.05 in 100K pop’n

Three types:

1) Classic: in E. European, Mediterranean men, legs
2) Lymphadenopathic: equatorial Africa, young men, rapidly fatal
3) AIDS-associated: declining w/ anti-retroviral therapy against HIV