Podcast
Questions and Answers
Which of the following is a characteristic of basal cell carcinoma?
Which of the following is a characteristic of basal cell carcinoma?
What is the purpose of dermoscopy in the evaluation of skin lesions?
What is the purpose of dermoscopy in the evaluation of skin lesions?
Which of the following dermoscopic criteria would suggest malignancy in a pigmented lesion?
Which of the following dermoscopic criteria would suggest malignancy in a pigmented lesion?
What distinguishes excisional biopsies from other types of skin biopsies?
What distinguishes excisional biopsies from other types of skin biopsies?
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What type of skin cancer is primarily associated with cells in the stratum basale?
What type of skin cancer is primarily associated with cells in the stratum basale?
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What is the recommended surgical margin for excising an in situ melanoma?
What is the recommended surgical margin for excising an in situ melanoma?
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Which type of therapy is suggested for individuals with a single microscopic lymph node involvement in melanoma?
Which type of therapy is suggested for individuals with a single microscopic lymph node involvement in melanoma?
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What size of melanoma should warrant lymphatic mapping and sentinel lymph node biopsy?
What size of melanoma should warrant lymphatic mapping and sentinel lymph node biopsy?
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Which mutation analysis should be performed if the BRAF V600 mutation is negative?
Which mutation analysis should be performed if the BRAF V600 mutation is negative?
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Which of the following features of a melanoma lesion does NOT represent a worrisome sign according to the ABCDE mnemonic?
Which of the following features of a melanoma lesion does NOT represent a worrisome sign according to the ABCDE mnemonic?
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What is the primary disadvantage of surgical excision when treating basal cell carcinoma?
What is the primary disadvantage of surgical excision when treating basal cell carcinoma?
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Which treatment method involves the immediate examination of excised tumor margins under a microscope?
Which treatment method involves the immediate examination of excised tumor margins under a microscope?
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What is the most accurate statement about Bowen’s disease in relation to squamous cell carcinoma?
What is the most accurate statement about Bowen’s disease in relation to squamous cell carcinoma?
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Which treatment option is least likely to be used for basal cell carcinoma due to its high recurrence risk?
Which treatment option is least likely to be used for basal cell carcinoma due to its high recurrence risk?
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In the management of actinic keratosis, which treatment method is typically used?
In the management of actinic keratosis, which treatment method is typically used?
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Study Notes
Skin Cancer
- Skin cancer types determined by the type of skin cell involved
- Basal cell carcinoma: Cells in the stratum basale, slow-growing, rarely metastasize, but locally invasive.
- Squamous cell carcinoma: Squamous keratinocytes, can metastasize to lymph nodes or distant areas.
- Melanoma: Melanocytes, most aggressive type, metastasizes quickly.
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Diagnosis:
- Begins with visual examination and patient history
- Dermoscopy: non-invasive technique to visualize subsurface skin structures
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Biopsy: Definitive diagnosis, shows cell type
- Shave biopsy: superficial skin removal
- Punch biopsy: core-shaped tissue removal
- Excisional biopsy: entire lesion and surrounding skin removal
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Basal cell carcinoma:
- Appearance: Well-circumscribed, pearly, waxy, or shiny elevation with small blood vessels.
- Biopsy: Palisading pattern of tumor cells.
- Treatment:
- Surgery: Excisional surgery, Mohs Micrographic Surgery
- Other: Cryotherapy, Curettage and electrodesiccation, Photodynamic therapy
- Medications: Fluorouracil, Imiquimod
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Squamous cell carcinoma:
- Stages: Actinic keratosis (precancerous), Bowen's disease (early stage), Invasive squamous cell carcinoma
- Treatment:
- Actinic keratosis: Cryotherapy, topical fluorouracil or imiquimod, photodynamic therapy
- Bowen's disease and Invasive SCC: Surgical excision, Mohs surgery
- Adjuvant radiotherapy: Extensive perineural involvement, positive surgical margins, single positive lymph node.
- Second line: Curettage and electrodesiccation, cryotherapy, photodynamic therapy, radiotherapy.
- Medications: Fluorouracil, imiquimod, Systemic chemotherapeutic agents (cisplatin, capecitabine, methotrexate, cetuximab, bleomycin, doxorubicin, cemiplimab)
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Melanoma:
- Precancerous: Melanocytic nevus (mole)
- Growth: Horizontal (within epidermis) and vertical (invading dermis)
- Signs: ABCDE (Asymmetry, Borders irregular, Color varies, Diameter > 6mm, Evolution rapid)
- Biopsy: Full-thickness excisional biopsy to determine thickness and cell characteristics.
- Treatment:
- Surgical excision: Width dependent on tumor thickness (0.5 - 2 cm)
- Adjuvant radiotherapy: For high-risk recurrence (tumors > 4 mm, ulceration)
- Lymphatic mapping and sentinel lymph node biopsy: For tumors ≥ 0.8 mm or smaller tumors with ulceration.
- Adjuvant immunotherapy: Microscopic involvement of a single lymph node (nivolumab, pembrolizumab)
- Targeted therapy: BRAF V600 mutation (dabrafenib + trametinib)
- Palliative treatment for metastatic melanoma: Surgical metastasectomy, radiotherapy, or systemic medications (immunotherapy, targeted therapy, chemotherapy)
Follow up for all skin cancer patients:
- At least once a year
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Description
This quiz covers the different types of skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma. It discusses their characteristics, diagnosis methods such as dermoscopy and biopsy, and treatment options. Test your knowledge on skin cancer and its various aspects.
