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
