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