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Dermatology > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

Basal cell carcinoma is named for?

A

It appears blue (basophilic) like the basal layer because it is packed with proteins. Most likely arises from hair follicles and areas around them.

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2
Q

Squamous cell carcinoma resembles

A

spinous layer

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3
Q

Melanoma comes from

A

melanocytes

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4
Q

What is teh risk in the US of nonmelanoma skin cancer

A

1 in 5

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5
Q

Most common invasive neoplasm in US is

A

Basal Cell Carcinoma

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6
Q

What mutation is most common in BCC

A

PTCH (patch) present in 30% of sporadic tumors.

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7
Q

What the hell is the PTCH gene

A

its a tumor suppressor, regulates basal epidermal cell proliferation

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8
Q

Basal cell carcinoma histology

A

Basophilic, pleomorphic, hyperchromatic cells that form nodules which often extend from the epidermis
Look for the “palisade” at the periphery
Tumor nodules are set in a mucinous stroma

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9
Q

Basal cell nevus syndrome

A

Also called Gorlin syndrome. It is autosomal dominant and rare. A mutation of the PTCH1 tumor suppressor gene. You have your first basal cell carcinoma in your early 20s. Increased risk of other malignancues like medulloblastoma and fibrosarcoma. Jaw cysts and musculoskeletal disorder.

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10
Q

Be familiar with the sonic hedgehog pathway and the role that the pTCH gene plays in preventing SMO binding to SHH ligand.

A

ok

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11
Q

Metastasis in basal cell carcinoma is

A

RARE>

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12
Q

Treatment options for basal cell

A 
excision is the main option
electrodessication and curretage
cryosurgery
radiation
topical treatment
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13
Q

What defines squamous cell carcinoma in situ

A

Full thickness epidermal atypia confined above the basement membrane.
Other names for SCC in situ: Bowen’s disease
Erythroplasia of Querat- on the glans penis

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14
Q

Minimal atypia (not full epidermal thickness) is called?

A

actinic keratosis

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15
Q

Three biggest risk factors for squamous cell carcinoma>

A

UV, HPV, Immunosuppression

Also:
Inflammation
Burn scars
Chemical Exposure
Radiation Exposure
Leukoplakia
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16
Q

Risk of metastasis for cutaneous squamous cell carcinoma is based on

A

size of the tumor, depth of invasion into the dermis, anatomic site, host immune status

Larger than 2cm = greater risk
Greater than 4mm in depth= Greater risk
lips and ears= greater risk

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17
Q

What is the metastasis rate of SCC

A

less than 5%

18
Q

What clinical scenarios often lead to higher rates of metastasis for SCC

A

Actinic induced on the lip
Marjolin’s ulcers
vulvar, perineal, pineal HPV induced
Leukoplakia- chewing tobacco

19
Q

Highest risk for melanoma?

A

white men over 50

20
Q

second most common age group for melanoma

A

25-29 yo

21
Q

Most melanoma develops..

A

de novo

22
Q

Melanoma has to be where in order to metastasize

A

has to be in the dermis

23
Q

Three types of nevi (moles)

A

Junctional, Compound, Intradermal

24
Q

Junctional nevi are what?

A

confined to the epidermis.

Remember than any nevi is a nest of melanocytes and 3 melanocytes make a nest.

25
Q

Compound Nevi

A

Both in epidermis and dermis

26
Q

Intradermal nevi

A

Nests in dermis only

27
Q

What are some genetic predispositions to melanoma

A

CDNK2 and BRAF mutations

28
Q

Melanoma risk factors?

A 
Large number of common nevi
Giant congenital nevi
Atypical Nevi
History of blistering sunburns
Family History of melanoma
Light complexion
Underlying immune dysfunction
29
Q

What is Acral Lentiginous melanoma

A

melanoma located on palmar and plantar surfaces.

Most common in pts with darker skin

30
Q

Lentigo maligna>

A

Melanoma on the face. slow growing, usually shows up on old sun damaged skin

31
Q

When lentigo maligna melanoma develops a nodule, thats a sign that….

A

it is invasive and not in situ

32
Q

Nodular melanoma

A

usually appears on sun exposed skin.

No preceding radial growth

33
Q

Superficial spreading melanoma

A

asymmetrical, irregular borders, wide variation in color, diameter over 6mm
red, white, and blue

34
Q

melanomoa most commonly metastasizes to where>

A

skin…often via the lymphatics

35
Q

Most common cause of death in melanoma

A

CNS involvement

36
Q

Single most important prognostic factor for melanoma?

A

Lymph node involvement

37
Q

What is the most important histologic prognostic factor for melanoma

A

Breslow thickness and ulceration

38
Q

What is the breslow thickness

A

distance of involvement from the stratum granulosum to the deepest tumor cell

39
Q

What drug is a small molecule molecular inhibitor of BRAF

A

Vemurafinib…
Approved for unresectable of metastatic melanoma
Provides modest survival benefit
Initially it works very well, but the melanoma adapts and can come up with alternative proliferation pathways
New trials are focused on combo therapy with ipilimumab

40
Q

Xeroderma pigmentosum has what type of inheritance patter

A

Autosomal recessive

Dermatology (17 decks)

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