Flashcards in Dermatologic Surgery Deck (30)
Most common cancer in the US
Skin Cancer, 80% of which are BCC (basal cell carcinoma)
Which skin cancer is responsible for the most fatalities?
-only 4% of new cancer diagnoses, but are the most lethal
Is BCC or SCC more likely to metastasize?
BCCs basically never metastasize => SCC can
What is the mortality from nonmelanoma skin cancers?
Super low- like 1-2% (most of which are from metastatic SCC)
> 95% cure rate if BCC/SCC are detected and treated early
Distinguish cumulative skin exposure vs. sun bursts and which skin cancer they're associated with?
Cumulative skin exposure = accumulation over time (so older pts) w/ tons of sun exposure is associated w/ BCC
While sun bursts = short time in the sun causing blistering sun burn is associated w/ MM (malignant melanoma)
What are the 3 most common locations for NMSC?
Nonmelanoma skin cancers (BCC and SCC) most commonly on sun-exposed areas
>80% on upper limbs, head, and neck
Risk factors for all skin cancers besides sun exposure
Fair complexion, light hair, light eyes
Why are BCCs removed?
Basal cell carinomas won't metastasize, but can be very locally invasive and disfiguring => remove while they're small
What environmental factor is responsible for a peak in deaths from BCC in young women
Describe the appearance of a BCC
Basal cell carcinoma: pearly white papule w/ slightly elevated border and indented center
Hallmark/buzz word for basal cell carcinoma
Hallmark/buzz word for squamous cell carcinoma
What is a subtype of BCC that is more invasive than pearly ulcerated lesions?
Morpheaform = 'scar like' basal cell carcinomas
-poorly defined borders
-less frequent, but are usually more aggressive/deeper
What are the
most common cutaneous malignancies
Most common cutaneous malignancies
(a) 1st = BCC (basal cell carcinoma)
(b) 2nd = SCC (squamous cell carcinoma)
What is the name for precancerous skin lesions?
Actinic Keratoses (AK)
What does presence of actinic keratoses indicate?
Identifies high risk pts that are predisposed to other skin cancers (ex: SCC and BCC)
-often marker of sun exposure
What percent of actinic keratoses transform into malignancy?
8% of actinic keratoses progress to SCC
Prognosis of actinic keratoses
99% cure rate w/ cryosurgery (liquid nitrogen )
-often use photodynamic or laser therapy for a more systemic form of treatment
Why is it so important to catch malignant melanomas quickly?
Once it's spreads it's not very responsive to chemo or radiation, so once it metastasizes => dismal prognosis
-if caught early: can be caught out easily under local anesthesia
5 year prognosis
-99% if detected and treated before spreading
What epidemiological factor separates malignant melanomas from the other most common causes of cancer in the US?
Malignant melanoma = 6th most common cancer in the US
-only one of the 7 most common that is increasing incidence
Dysplastic nevi increase risk of which skin cancer?
Dysplastic nevi are a risk factor unique to melanoma
-tons of atypical moles (dysplastic nevi) = risk factor for malignant melanoma
-nevi themselves can become melanoma or the skin in general is at an increased risk
What clinical feature is the best prognostic indicator for malignant melanoma?
Prognosis is directly proportional to thickness of melanoma
ABCDEs of malignant melanoma
A = asymmetrical
B = border irregularity
C = color variability
D = diameter (not really used anymore)
E = evolution
Where do African Americans commonly get melanomas?
Between toes or on soles of feet
What is a nodular melanoma?
(b) Distinguishing features
Nodular melanoma = black nodule
-tend to be very deep and invasive, high rate for metastasis
What is cryosurgery
What is Mohs surgery?
skin cancer surgery: remove skin cancer w/ about 1 cm margin, do margin to see if margins are clear, then reconstruct
What is selective photothermolysis?
Laser therapy: brief irradiation w/ laser light pulse
Indications for laser therapy
-benign pigmented lesions: birthmarks, freckles
-vascular lesions: hemangiomas, telangectasias