GP Vivas · dermatological-presentations
Melanoma and keratinocyte skin cancer detection — structured viva
Structured oral on skin cancer detection: defending excision rules against the shave-biopsy shortcut, quoting dermoscopy and sunscreen trial numbers, managing keratinocyte cancer by subtype, and building surveillance for high-risk patients.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A colleague freezes every suspicious spot and shaves the rest, and tells patients sunscreen is a scam. Take me through what you will change.' The viva branches through biopsy rules, dermoscopy evidence, keratinocyte cancer management, prevention evidence and referral pathways.
Stem
You are the GP. The practice nurse says: "Dr X just cryotherapies anything pink or brown and shaves everything else — it's quicker." [3]
References8ShowHide
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- [2]Vestergaard ME, Macaskill P, Holt PE, Menzies SW Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. British Journal of Dermatology, 2008.PMID 18616769
- [3]Hayes AJ, Maynard L, Coombes G, et al. Wide versus narrow excision margins for high-risk, primary cutaneous melanomas: long-term follow-up of survival in a randomised trial. Lancet Oncology, 2016.PMID 26790922
- [4]Wheatley K, Wilson JS, Gaunt P, et al. Surgical excision margins in primary cutaneous melanoma: A meta-analysis and Bayesian probability evaluation. Cancer Treatment Reviews, 2016.PMID 26563920
- [5]Daudén E Effectiveness and satisfaction with imiquimod for the treatment of superficial basal cell carcinoma in daily dermatological practice. Journal of the European Academy of Dermatology and Venereology, 2011.PMID 21348896
- [6]Skulsky SL, O'Sullivan B, McArdle O, et al. Review of high-risk features of cutaneous squamous cell carcinoma and discrepancies between the American Joint Committee on Cancer and NCCN. Head and Neck, 2017.PMID 27882625
- [7]Stratigos A, Garbe C, Lebbe C, et al. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. European Journal of Cancer, 2015.PMID 26219687
- [8]Betti R, Vergani R, Tolomio E, et al. Factors of delay in the diagnosis of melanoma. European Journal of Dermatology, 2003.PMID 12695136