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BLOCK F > Benign and Malignant Lumps and Bumps > Flashcards

Benign and Malignant Lumps and Bumps Flashcards

1
Q

Biggest risk factors for skin cancer (2)

A

Age and sun exposure (lifetime or intermittent)

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2
Q

Most common location for non-melanoma skin cancer in general

A

head and neck

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3
Q

Most common location for melanoma in females

A

legs

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4
Q

Most common location for squamous cell carcinoma in females

A

legs

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5
Q

most common location for melanoma in males

A

back

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6
Q

Name 3 benign skin lesions

A
  1. Seborrheic keratosis
  2. Cherry angioma
  3. Solar lentigo
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7
Q

Describe seborrheic keratosis

A
  • Papule or plaque with “warty” appearance
  • Appears in adulthood
  • Can grow and change color if irritated
  • Benign, no risk of malignancy
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8
Q

Describe cherry angioma

A
  • Red or violaceous purple
  • Occurs at any age
  • Number increases with age
  • Benign, no treatment needed
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9
Q

Describe solar lentigo

A
  • Flat macule or patch
  • Well-circumscribed
  • Benign melanocytic proliferation
  • No treatment needed
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10
Q

Even though solar lentigo is benign, we need to be more alert because…

A

It is a sign of sun exposure, making the patient more at risk for skin cancer!

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11
Q

Malignant form of solar lentigo

A

Lentigo maligna or lentigo maligna melanoma (blotchy, darker, less defined)

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12
Q

2 types of non-melanoma skin cancer

A

Basal cell carcinoma
Squamous cell carcinoma

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13
Q

Most common skin in North America

A

Basal cell carcinoma

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14
Q

Second most common skin cancer in North America

A

Squamous cell carcinoma

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15
Q

Main risk factor for BCC vs SCC

A

BCC: intermittent sun exposure
SCC: lifetime sun exposure

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16
Q

BCC appearance

A
  • Pearly, rolled up border
  • Arborizing vessels
  • Crusts
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17
Q

SCC appearance

A
  • Scaly, erythematous plaque
  • Thick keratin
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18
Q

BCC vs SCC progression and prognosis

A

BCC: locally invasive, rarely metastatic
SCC: has metastatic potential!

SCC has a worse prognosis than BCC (but overall they both have a good prognosis, especially if caught early)

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19
Q

4 types of BCC

A
  1. Nodular (most common)
  2. Superficial (2nd most common): pink or red scaly area
  3. Morpheiform (yellow, scar like)
  4. Pigmented
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20
Q

Describe the spectrum of SCC

A
  1. Acitinic keratosis (pink, thin, rough plaque)
  2. Bowen’s disease (SCC in situ)
  3. Well-differentiated SCC (more overt tumour)
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21
Q

How can we diagnose NMSC (3)

A
  1. Shaving biopsy
  2. Punch biopsy
  3. Elliptical biopsy
22
Q

NMSC management

A

Best option is surgical removal or Mohs micrographic surgery

23
Q

3 types of nevi

A
  1. Congenital melanocytic nevus
  2. Acquired melanocytic nevus
  3. Dysplastic nevus syndrome
24
Q

Congenital melanocytic nevus - key features

A
  • Present at birth or during first few weeks of life
  • Melanoma transformation risk is proportional to size (<1cm: low but >20 cm high)
  • Monitor
25
Acquired melanocytic nevus - key features
- Mole or beauty spot - Usually acquired between the ages of 1-40 - Predisposing factors: genetics, sun exposure -
26
Average number of acquired melanocytic nevi in adults
30
27
Acquired melanocytic nevi distribution in males vs females
Males: upper body Females: arms, back
28
Acquired melanocytic nevi morphology
- Uniform (color, shape) - <6mm
29
3 types of acquired melanocytic nevi
1. Junctional 2. Intradermal 3. Compound
30
Junctional nevus
In the junction between epidermis and dermis. Dark and flat
31
Intradermal nevus
In the dermis. Raised and pale
32
Compound nevus
Both intradermal and junctional components. Raised and somewhat paler.
33
Dysplastic nevi key features
- Clinical atypical - Strong family history - > 50 nevi - >5-6mm - Highly variable morphology - Increased risk of melanoma
34
Dysplastic nevus syndrome management
Monitor, protect from sun, biopsy/excision if suspicious of melanoma
35
Name some risk factors for melanoma
1. Phenotype (blond/red hair, pale skin, freckles) 2. Number of nevi (more than 100 nevi, more than 5 dysplastic) 3. Sun exposure (both intermittent and cumulative, esp. sunburns in youth) 4. Family history 5. Previous skin cancer 6. Immunosuppression
36
Most common type of melanoma
Superficial spreading melanoma
37
5 types of melanoma
1. Superficial spreading melanoma 2. Nodular melanoma 3. Lentigo maligna melanoma 4. Acral lentiginous melanoma 5. Amelanotic/hypomelanotic melanoma
38
Describe superficial spreading melanoma
Spreads horizontally/radially (flat), then vertically (papule). Hypo- or depigmented areas mark regions of tumour regression, where the immune system is attacking the tumour.
39
Nodular melanoma location
trunk, head, neck
40
Nodular melanoma affects more ... than ..
affects more men than women
41
Describe nodular melanoma
- Blue to black (or pink/red) nodule +/- bleeding/ulceration - Vertical growth - Fast-growing tumour causing deep invasion (poor prognosis)
42
Lentigo maligna melanoma location
Face (cheeks, nose)
43
Lentigo maligna melanoma precursor
Lentigo maligna (in situ) (only 5% progress to LMM)
44
Describe lentigo maligna melanoma
- Slowly evolving brown/black macule/patch - Irregular, variable color - Indented border
45
Acral lentiginous melanoma location
Palms, soles, nails
46
Describe acral lentiginous melanoma
- Asymmetric brown/black macule - Variable color - Ill-defined border - Grows wider
47
Classic sign of acral lentiginous melanoma
Hutchinson's sign (spreads to proximal nail fold)
48
Pearly red melanoma similar in appearance to BCC
Amelanotic/hypomelanotic melanoma
49
Melanoma physical exam (ABCDE)
A: Asymmetry B: Border irregularity C: Colour variation D: Diameter >5mm E: Evolution
50
What is the gold standard for melanoma diagnosis?
Excisional biopsy
51
Most important determinant of melanoma prognosis
Tumour thickness >1mm (Breslow) is associated with worse prognosis

BLOCK F (27 decks)

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