7- Skin malignancies Flashcards
Normal progression of a nevi
form pigments at epidermis/dermis junction, aggregates, moves to dermis, shrinks and matures. Gives pigment to skin
Bad progression
Forms > aggregates > moves to dermis > no maturation > forms melanoma
ABCDE of detecting melanoma
A- assymetry B- borders uneven C- color (multicolored) D- diameter (larger than 1/4 inch) E- Evolving
Melanoma growth
When do they become malignant usually?
Melanocyte > nevi > dysplastic nevus > RGP melanoma (radial, grows laterally) > VGP melanoma (grows vertically)
Lateral growth- not usually malignant
Vertical growth- Bad
When does it become an invasive tumor?
What is Breslows level of staging?
When it breaks through to dermis
how far it goes down into tissues. >1 mm is potentially bad
What is the prognosis related to?**
Depth of invasion**
What does loss of p16 do to the cell cycle in melanocytes?
Treatment for melanomas?
Loss of p16 speeds it up.
Drugs can inhibit cell cycle. Put it on pause mode
What does Ras do to the cell cycle?
Speed it up
What are the risk factors for melanoma?
Blistering sunburn at early age. The think teens and early 20s is when melanocytes develop
What is sentinel lymph node?
The first lymph node seen by the draining tumor stuff. Very important to prognosis if this is positive or not. Inject dye by tumor then find the lymph node that way.
dye with HMB 45 (brownish) to see if metastisis for melanoma is found in lymph node
Squamous pearls, what type of malignancy is this involved with?
What appearance are the lesions?
What usually causes this type?
What protein is usually mutated in this type?
Treatment?
Whirls in dermis (invasive tumor) means squamous cell carcinoma
Lesions are usually poking out. white parts (keratin)
usually evolved from sun exposure, damage DNA, smoking drinking is also risk factors
p53- mutated so it can’t inhibit like it should
Treatment is usually surgery
What color do basal cell carcinomas stain?
What appearance are the lesions
What is the deletion in basal cell carcinomas?
Are you going to stimulate or inhibit this bad boy?
Blue
Can have pearly white top of lesion
Hedgehog has deletion, usually inactive, now active all the time. Things growing all the time
Drug should inhibit!
How does Aldara work to treat basal cell carcinoma lesions?
Stimulates cytotoxic T cells to wipe out lesions.
Also stimulates apoptosis
For basal cell carcinoma
prognosis (best to worst) of three skin malignancies
Basal cell, squamous, melanoma
appearance of: basal cell, squamous cell, melanoma
basal: pearly
Squamous- raised, white stuff
Melanoma- ABCDEs
