P&P Skin Cancer Quiz
Use to protect teeth and gums
lead shield
Most common sites of melanomas
legs of women and trunk and face of men
Difference in skin color is due to the amount of
melanin that the melanocytes produce
Skin cancers in order from most common to rare
-Basal cell -Squamous cell -Melanoma and Merkel cell
Functions of skin
-regulates body temperature -acts as a barrier -participates in production of Viatmin D -provides receptors for external stimulus
Signs of skin cancer
-sore that takes longer than 3 weeks to heal -recurrent red patch -wart that bleeds or scabs -new growth -change in existing nevus
Tanning beds is listed as a group ______ carcinogen
1
early non-melanoma lesions are almost ________ curable
100%
Have one or more of the clinical features of melanoma
Dysplastic Nevi
Risk factors for Melanoma
Dysplastic Nevi, having multiple moles, family hystory, Hormones and birth control, and melanocytic nevi
Risk factors for squamous cell
HPV, thermal or electric burns, scars, hydrocarbons, areas of chronic drainage, smoking
Which individuals are more likely to develop skin cancer?
Individuals with fair complexions
SMall, well-circumscribed, dome-shaped lesions that range from flesh to brown color. May contain excess hair
Intradermal Melanocytic Nevi
Usually small, well-circumscribed, flat lesions with smooth surfaces.
Junctioinal Melanocytic Nevi
Usually occur sin chronically exposed skin of usually older white people, especially females. May stay in radial growth pahse for years before becoming raised
Lentigo maligna
Responsible for differences in skin color
Melanin
Where do melanomas arise from?
Melanocytes in the stratum basale layer
Risk of ____________ increases after 4 or more blisterning sunburns during adolescence
Melanoma
One of the more lethal forms of skin cancer
Melanomas
Second lethal skin cancer
Melanomas
Are melanoma rates higher in men or women?
Men
High rate of recurrence after surgical incision
Merkel Cell
Most lethal skin cancer
Merkel Cell
Frequently involves regional lymph nodes and distant metastasis
Merkel Cell Carcinoma
A more precise type of surgery where tissue is removed one layer at a time and examined under a microscope
Mohs surgery
Are people who were previously diagnosed with skin cancer more or less likely to get it again?
More; primary skin cancer increases odds of another primary later
twice as common in men, tend to be raised on skin, do not have a radial growth phase making it harder to diagnose early, invade early, frequently show ulceration when advanced
Nodular
Is radiation therapy done for melanoma?
Palliative, melanomas tend to be more radioresistant
Detection and diagnosis
Self exams, biopsy of lesion, physical exam
Contains melanocytes, stem cells capable of producing keratinocytes, Merkel cells
Stratum Basale
Contains nerves, blood vessels, adipose tissue, and areolar connective tissue
Subcutaneous layer
Layer that lies beneath the dermis
Subcutaneous layer
70% of melanomas are this subtype and start of as a preexisting lesion that changes start off growing radially but as more time goes by it might grow vertically
Superficial spreading (radial spreading)
Tanning beds produce _______ rays
UVA
Damage DNA and its repair system, leading to mutations and also suppress T-cell function
UVB rays
Do not tend to metastasize but are capable of extensive local invasion and destruction
basal cell carcinoma
Most prevelant skin cancer
basal cell carcinoma
Why are electrons used
because most tumors are located superficially (lips, nose, eyelids, face, ears)
What is used when treating ear?
bolus to flatten surface or get rid of ear gap
Spread for melanoma in following order:
direct extension, regional lymphatics, distant skin and subcutaneous tissues, lung, liver, bone, and brain
Covering a lead lip shield in wax prevents
electron backscatter, reducing dose to buccal muscosa
Radiation therapy side effects
erythema, pigment changes, dry and moist desquamation, temporary hair loss, decreased function of glands
When treating eyelids, use ____________ to protect lens and cornea
eye shield
4 main categories of etiology for skin cancer
geographic location, skin type, multiplicity, and gender
About 80% of basal cell carcinoma occurs on
head and neck
Squamous cell carcinoma car arise anywhere on the body but more commonly on:
head, neck, face, arms, and hands (sun-exposed areas)
Melanocyte-stimulating hormone is released by the
pituitary
Approximately 70% of melanomas occur as a result of a change in
preexisting nevus
Does basal cell carcinoma metastasize?
rarely
Appearance of squamous cell carcinoma
scaly, crusty, slightly elevated lesion that may have a cutaneous horn
Most commonly diagnosed malignancy
skin cancer
appearance of basal cell carcinoma
smooth, red, milky lumps with pearly border, shiny, and pale
Arises from mature keratinocytes of the upper layers of the epidermis
squamous cell carcinoma
faster growing that basal cell
squamous cell carcinoma
horny layer of skin
stratum corneum
found in areas where the thick skin is present such as soles of feet and palms
stratum lucidum
4 categories of melanoma
superficial spreading 70%, nodular 15%, lentigo maligna 5%, and acral lentiginous 10%
The only current form of curative therapy for melanoma
surgery
Treatment for squamous cell and basal cell carcinomas
surgery
People who live near _______________ have higher risk of skin cancer
the equator
Which type of melanoma tumors have poorer prognosis
thicker tumors
What makes for a poor prognosis for melanoma
thicker tumors, older age, deeper level of penetration
Melanomas can also occur in:
uvea of eye, mucosal surfaces of aerodigestive and genitourinary tracts
What is used when treating nose?
wax coated lead strip to protect nasal septum
Rare disease of the skin starIng in childhood and marked by disseminated pigment discoloraIons, ulcers, cutaneous and muscular atrophy, and death.
xeroderma pidmentosum
A - for melanoma
Asymmetry - tend to be asymmetric
A,B,C,D, Es of Melanoma
Asymmetry, Border, Color, Diameter, Evolution
If melanoma metastasizes, women have a _________% survival advantage over men
22
______ higher rates in men than women for squamous cell and basal cell carcinoma
3x
How many layers of the epidermis are there
4-5
Most skin cancers appear after age
50
Found mainly on palsm, soles, nail beds, or mucous membrances. Most common subtype in black and asian populations. Tan or brown flat stain on palms or soles. When located under the nail bed, often mistaken for a fungal infection
Acral Lentiginous
Most common type of skin cancer
Basal cell carcinoma
Slow growing skin cancer
Basal cell carcinoma
B - for melanoma
Border - tend to have notched uneven borders
Staging system based on tumor thickness from the top of the granular layer of the epidermis
Breslow
How is Merkel Cell carcinoma often treated
Chemo and radiation
Staging system based on level of invasion through the epidermis and layers of dermis
Clark
Staging systems for melanoma
Clark, Breslow, and TNM
C- for melanoma
Color - Contain different shades of black, brown, or tan
Contain melanocyte clusters in the dermis and epidermis. Small, well-circumscribed, slightly raise papules that often contain hair
Compound Melanocytic Nevi
Used to collimate treatment field using custom cutouts
Cone
Contains blood and lymphatic vessels, nerves and nerve endings, sweat glands and hair follicles
Dermis
D - for melanoma
Diameter-Most are more than 6mm