Plastic and Reconstructive Surgery

TEST TAKING TIPS

SKIN

What type of UV radiation is linked with skin cancer?

• UVB

What is the most common skin malignancy in the United States?

• Basal cell carcinoma

What are the classic physical findings of basal cell carcinoma?

• Pearly appearance with rolled edges, +/− telangiectasia

What type of basal cell carcinoma is the most aggressive?

• Morpheaform type (produces collagenase)

What margins are appropriate for basal cell?

• 3 mm margins are acceptable and frozen section can be used intraoperatively.

What is the most common physical finding of squamous cell carcinoma?

• Scaly appearance, papulonodular, ulceration

What is the name of the cancer associated with a previous burn injury?

• Marjolin ulcer; can also develop in areas of chronic inflammation, that is, enteric fistula.

What are appropriate margins for squamous cell carcinoma?

• 0.5 to 1.0 cm margins

What are risk factors for the development of squamous cell carcinoma?

• Actinic keratosis, arsenics, atrophic dermatitis, Bowen disease, chlorophenols, fair skin, HPV, immunosuppression, nitrates, previous skin cancer, radiation exposure, sun exposure, xeroderma pigmentosum

What is the natural history of squamous cell carcinoma?

• Actinic keratosis, Bowen disease (squamous cell carcinoma in situ), squamous cell carcinoma

Aside from sun exposure, what is classically a risk factor for squamous cell carcinoma?

• History of organ transplantation, or any other immunocompromised state

Can squamous cell carcinoma metastasize?

• Yes, it is uncommon, but it can metastasize to lymph nodes. Regional adenectomy should be performed.

When can Mohs surgery be used for basal cell or squamous cell carcinoma?

• Delicate areas that include perioral, perioccular, perinasal, ears, hands, and genitalia

What is the most common melanoma site on the skin in men? In women?

• Men—back

• Women—legs

What is the most common location for distant melanoma metastasis?

• The lung (surgery can help relieve pain caused by metastatic melanoma to the lung, but is not a cure)

What is the most common metastasis to the small bowel?

• Melanoma

What margins are recommended for a melanoma skin lesion with thickness of 1 mm?

• 1 cm margins ...