SM_260a: Nonmelanoma Skin Cancer / Photobiology Flashcards Preview

MSK/Derm > SM_260a: Nonmelanoma Skin Cancer / Photobiology > Flashcards

Flashcards in SM_260a: Nonmelanoma Skin Cancer / Photobiology Deck (42)
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1

UVA is responsible for ____

 

 

UVA is responsible for aging

 

 

(photoaging, smoking also plays a role, also tanning)

2

UVB is responsible for ____

UVB is responsible for burning

3

UVC is most ____

UVC is most carcinogenic

4

Photoaging is influenced by ____ exposure and ____

Photoaging is influenced by UVA exposure and smoking

 

 

(clinical signs of photoaging: spotty hyperpigmentation and hypopigmentation, rhytids (wrinkles), telangiectasias, skin thickening, and loss of elasticity)

5

Photocarcinogenesis involves ____ and ____

Photocarcinogenesis involves UV-mediated DNA damage and mutation formation

 

  • Direct damage: thymine dimer formation
  • Indirect damage: ROS formation
  • Mutation formation: inactviation of tumor suppressors, activation of oncogenees, evasion of apoptosis, and limitless replicative potential

6

UVB is important first step of ____ metabolism

UVB is important first step of Vitamin D metabolism

7

Nonmelanoma skin cancer means ____ carcinomas, which include ____ and ____

Nonmelanoma skin cancer means keratinocyte carcinomas, which include basal cell carcinoma and squamous cell carcinoma

 

 

(risk factors: environmental exposures, skin type, genetic predisposition, predisposing skin conditions, and immunosuppression)

8

Shave biopsy is the most ____ biopsy, has ____ bleeding, requires ____, and is less likely to ____

Shave is the most superficial biopsy, has minimal bleeding, requires no sutures, and is less likely to scar (dyschromia, hypopigmentation)

9

Punch biopsy is a commonly used diangostic biopsy technique for ___ and ___, provides ___ for histology, and involves using ___ to close

Punch biopsy is a commonly used diagnostic biopsy technique for pigmented lesions (nevi) or deeper lesions (dermal / fat), provides full thickness clean edged specimens for histology, and involves using suture to close

10

Describe basal cell carcinoma

Basal cell carcinoma

  • Most common skin cancer
  • Locally destructive
  • Metastasis is very rare
  • Increased risk for developing other keratinocyte carcinomas
  • Recommend skin checks at regular intervals (every 6 months)
  • Usually occur on the head and neck
  • Diagnosis by biopsy
  • Treatment depends on clinical and histological features but is often surgical

11

This is ____

This is basal cell carcinoma

12

Diagnosis is ____

Diagnosis is basal cell carcinoma

13

Basal cell carcinoma is treated with ____

Basal cell carcinoma is treated with surgical removal

14

Describe management of basal cell carcinoma

Basal cell carcinoma management

  • Surgical excision with 4-5 mm margins
  • Mohs micrographic surgery in certain cases
  • Photoprotection
  • Regular total body skin examination
  • Monthly self-skin exams

15

Nodular basal cell carcinoma is a ____ and is most frequently found on the ____ and ____

Nodular basal cell carcinoma is a pearly papule or nodule with rolled border and telangiectasias and is most frequently found on the head and neck

 

(most common subtype)

16

Superficial basal cell carcinoma is ____ and ____

Superficial basal cell carcinoma is pink / translucent in color with telangiectasia and a slightly rolled border and a patch / thin plaque that may be scaly 

 

(differential diagnosis includes squamous cell carcinoma in situ / Bowman's disease or actinic keratosis)

17

Ulcerated basal cell carcinoma is ____

Ulcerated basal cell carcinoma is translucent color with telangiectasia, rolled border, and ulceration and crusting (scab)

18

Pigmented basal cell carcinoma is ____ and commonly found in ____

Pigmented basal cell carcinoma is pearly papules with telangiectasias and globules of dark pigment within and commonly found in persons of color

 

(differential diagnosis may include malignant melanoma, over 50% of basal cell carcinomas in persons of color are pigmented)

19

Morpheaform basal cell carcinoma is ____ with a plaque that ____

Morpheaform basal cell carcinoma is translucent with telangiectasia and rolled border with a plaque that appears white or bound down in scar-like areas

20

Diagnosis is ____

Diagnosis is squamous cell carcinoma

21

Next step in management is ____

Next step in management is shave biopsy

22

Diagnosis is ____

Diagnosis is squamous cell carcinoma

23

Squamous cell carcinoma involves ____, regular ____, monthly ____, and ____

Squamous cell carcinoma management involves surgical excision with 5 mm margins, regular total body skin examinations, monthly self-examinations, and photoprotection

24

Squamous cell carcinoma is most common in people with ____ skin, is found on ____ areas, and has increased mortality compared to basal cell carcinoma due to ____

Squamous cell carcinoma is most common in people with white/fair skin, is found on sun-exposed areas, and has increased mortality compared to basal cell carcinoma due to higher rate of metastasis

25

Squamous cell carcinoma cell of origin is ____ and is common under conditions of ____

Squamous cell carcinoma cell of origin is keratinocytes and is common under conditions of immunosuppression (s/p transplant)

26

Describe clinical manifestations of squamous cell carcinoma

Squamous cell carcinoma clinical manifestations

  • Variable morphologies: papule / plaque / nodule, pink / red / skin-colored, scale, exophytic (grows outward), indurated, may present as cutaneous horn
  • Friable: may bleed with minimal trauma
  • Asymptomatic, painful, or pruritic

27

Squamous cell carcinoma in situ is called ___ and involves keratinocyte atypia that is ___ and does not ___

Squamous cell carcinoma in situ is called Bowen's disease and involves keratinocyte atypia that is confined to the epidermis and does not invade past the dermal-epidermal junction

 

(circumscribed pink / red patch or thin plaque with scaly or rough surface)

28

Squamous cell carcinoma has higher rates of metastasis if on the ____ or in ____ patients

Squamous cell carcinoma has higher rates of metastasis if on the lips (smoking) or in immunosuppressed patients (s/p transplant)

29

Skin cancer treatment is ____

Skin cancer treatment is complete elimination of the tumor with best cosmetic result

30

Standard excision of basal cell carcinoma or squamous cell carcinoma is ____

Standard excision of basal cell carcinoma or squamous cell carcinoma is elliptical excision with layered suture closure and 4-5 mm margins

Decks in MSK/Derm Class (49):