Skin Cancers

basal cell carcinoma is a slow grower, it _____ but does not _____

invades metastasize

MM can present with

itching tendernes pain bleeding oozing

malignant melanoma is the ______ common skin cancer but most _____

least deadly

where is MM MC found in women?

legs

>3 cm flat and tan slow growing face rarely metastizes

lentigo maligna melanoma

what are the risk factors of BCC?

light colored skin blue/green eyes blonde or red hair Scandinavian

BCC is most commonly found on the face, when it invades the eye area what can it cause?

loss of vision

what are the major complications that can occur with BCC

loss of vision loss of nerve function infection cosmetic issues

MM mets is commonly seen in the

lungs liver brain

____ ____ is tumorous melanocytes that are malignant

malignant melanoma

MM originates in the _____ cells

melanocyte

______ are pigmented cells that arise from neural crest tissue during baryonic development and migrate by the 6th week to a variety of sites within the embryo

melanocytes

a brown black pigment produced by the epidermal cells known as _____ provide protection against UV induced mutations in the skin

melanocytes

what is the time span between the initial mutation and clinical onsent of BCC

2-5 DECADES

if patient has significant lymphadenopathy what does this indicate?

MM has spread to lymph nodes

to determine mets to the brain?

MRI

______ results in the best long term cure rates of BCC and is used on a tumor with thin margins on normal skin

Moh's Technique

is it necessary to run labs and CXR to determine the diagnosis of BCC?

NO BCC DOES NOT METASTASIZE

what is the number one risk of basal cell carcinoma?

UV radiation/sun exposure

_____ is an autosomal recessive disease that predisposes sun exposed skin to rapid aging and pigmentary changes and progression to skin cancer

XP

palms and soles beneath the nails >3 cm common in AA

acral lentiginous melanoma

what is the precursor of squamous cell carcinoma?

actinic keratonsis

melanoma cells secrete ______ factors that stimulate new blood vessel formation

angiogenic

what is another risk factor for BCC?

arsenic exposure

diagnose subtype on a _____

biopsy

how do you identify the bcc subtype?

biopsy

how does MM travel to metastasize?

blood stream

growth of melanoma cell is what color?

blue

basic fibroblast growth factor is thought to be an important mediator in ____ ____

cell division

you treat MM with ____ it has spread to the lymph or the blood

chemo

where can you find arsenic?

contaminated well water

____ uses a looped blade to scrape tumor from the skin

curretage

blue gray center is filled with mucus gelatin like center

cystic BCC

________ is a cytotoxic drug that is believed to exert anti timor effect by alkylating DNA in treatment of melanoma

dacarbazine

where do melanocytes reside the ______ junction

epidermal junction

the cell of origin is a basal cell that resides deep within the _____

epidermis

risk factors of MM

exposure to UVA and UVB fair skinned (commonly freckle) light eyes blistering sunburns FAMMS immuosupppressed PUVA treatment tanning salons

melanoma of the ______ has the best prognosis

extremities

melanocytes are located in the?

eyes meninges respiratory tract gallbladder

where is basal cell carcinoma most common found on the body?

face

*what is the single most important reason for evaluation of MM?*

history of a changing mole

who is most likely to get bcc?

men because they work outside more often

if patient is coughing up blood what might this indicate?

mets to lung

less prone to ulceration yellow and white when stretched *firm to touch*

micronodular BCC

resembles a scar white or yellow in color waxy

morpheaform BCC

basal cell carcinoma is the ____ ____ type of skin cancer

most common (80%)

african americans find melanoma on their

mucous membranes palms/soles nail beds

______ BCC syndrome is autosomal dominant condition in which multiple BCC occur early in life

nevoid

MC smooth translucent pink raised dilated blood vessels ulcerates centrally face

nodular BCC

raised and dome shaped *resembles blood blister* men invades deep into vein symmetric

nodular melanoma (MN:BB)

radiation and cyrotherapy can also be used for _____ ____ types of BCC

non aggressive

UV induced mutations in ____ tumor suppressor genes on chromosome 17 can cause BCC

p53

BCC is the result of selective mutations in ____ _____

photo oncogens

brown black translucent raised borders dilated blood vessels *seen in dark skinned people*

pigmented BCC

in BCC the tumor is believed to arise from ____________ cells within a layer of the epidermis

pluripotential

what is FAAMS

positive family history of melanoma and over 50 moles

what do you use PUVA treatment in?

psorasis

how do you diagnose MM?

punch biopsy

you treat cancer with ____ if its on one spot

radiation

melanoma will first enter a _____ growth phase then a _____ growth phase

radical vertical

common presentation of BCC

raised pearly border flesh/skin colored translucent central ulcerations telenangiectasia slow grower, occasional bleeding

inflammation in response to the foreign cancerous tissue is ____

red

_____ lymph nodes are the first to receive lymphatic drainage from MM and develop mets first

sentinel

a skin lesion that does not heal well or bleeds with minimal trauma suggests ____ ____

skin cancer

where is squamous skin cancer most commonly found?

skin of arms and legs *extremities exposed to skin*

caucasians find melanoma on ____ ____ regions

sun exposed

red well defined *whitish scale* resembles psorasis or eczema seen on the chest and back *indicates arsenic posioning*

superficial BCC

MC people who sunburn easily exposure to UV women *begins as macule*

superficial spreading melanoma

MM that is localized can often be cured with

surgical excision

where is MM MC found in men?

trunk head neck arms

single most important prognosis of MM is

tumor thickness

_____ _____ _____ ____secreted by melanoma cells promotes new blood cell formation

vascular endothelial growth factor

during the _______ growth phase tumor cells also metastasize to regional lymph nodes through lymphatic vessel and to distant sides of the body

vertical

repair and healing by scar tissue formation subsequent to inflammation is _____

white

ABCDE of moles

Asymmetry Border irregular Color changing Diameter >6 mm Evolution

what is the probabilty that a patient with BCC will develop it again in 5 years

50%

what is the age range for BCC?

55-75

average age of diagnosis of melanoma is

57

what labs would you perform to see if MM has mets to the bone?

ALK phosphate calcium

what labs would you perform to determine if MM has mets to liver?

ALT AST

what labs would you perform to determine if it spread to the kidney?

BUN Creatinin

________ also facilities movement of melanoma cells through the body by regulating the synthesis of enzymes

Basic Fibrobast Growth Factor

to determine mets to the lung?

CXR