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Flashcards in Dermatologic Surgery Deck (30):
1

Most common cancer in the US

Skin Cancer, 80% of which are BCC (basal cell carcinoma)

2

Which skin cancer is responsible for the most fatalities?

Myeloma
-only 4% of new cancer diagnoses, but are the most lethal

3

Is BCC or SCC more likely to metastasize?

BCCs basically never metastasize => SCC can

4

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

5

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)

6

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

7

Risk factors for all skin cancers besides sun exposure

Fair complexion, light hair, light eyes

8

Why are BCCs removed?

Basal cell carinomas won't metastasize, but can be very locally invasive and disfiguring => remove while they're small

9

What environmental factor is responsible for a peak in deaths from BCC in young women

Tanning beds

10

Describe the appearance of a BCC

Basal cell carcinoma: pearly white papule w/ slightly elevated border and indented center
-telangectases

11

Pearly white

Hallmark/buzz word for basal cell carcinoma

12

Hyperkeratinized

Hallmark/buzz word for squamous cell carcinoma

13

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

14

What are the

(a) 1st
(b) 2nd

most common cutaneous malignancies

Most common cutaneous malignancies

(a) 1st = BCC (basal cell carcinoma)
(b) 2nd = SCC (squamous cell carcinoma)

15

What is the name for precancerous skin lesions?

Actinic Keratoses (AK)

16

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

17

What percent of actinic keratoses transform into malignancy?

8% of actinic keratoses progress to SCC

18

Prognosis of actinic keratoses

99% cure rate w/ cryosurgery (liquid nitrogen )
-often use photodynamic or laser therapy for a more systemic form of treatment

19

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

20

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

21

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

22

What clinical feature is the best prognostic indicator for malignant melanoma?

Prognosis is directly proportional to thickness of melanoma

23

ABCDEs of malignant melanoma

A = asymmetrical
B = border irregularity
C = color variability
D = diameter (not really used anymore)
E = evolution

24

Where do African Americans commonly get melanomas?

Between toes or on soles of feet

25

What is a nodular melanoma?

(a) Appearance
(b) Distinguishing features

Nodular melanoma = black nodule

-tend to be very deep and invasive, high rate for metastasis

26

What is cryosurgery

Liquid nitrogen

27

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

28

What is selective photothermolysis?

Laser therapy: brief irradiation w/ laser light pulse

29

Indications for laser therapy

-benign pigmented lesions: birthmarks, freckles
-vascular lesions: hemangiomas, telangectasias
-tattoo removal
-wart ablation
-hair removal
-photorejuvenation/acne scaring

30

Indications for botox

Wrinkles, sweating, migraines