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Dermatology > Benign and Malignant Neoplasms of the Skin > Flashcards

Benign and Malignant Neoplasms of the Skin Flashcards

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Dermatology Board Prep flashcards
1
Q

Nevi?

A

pigmented skin lesion that is usually benign. Commonly called moles, usually involve epidermis and dermis but rarely may involve the subcutaneous tissue as well.

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2
Q

Junctional Melanocytic Nevus

A

macule, tan to black, round with smooth borders. epidermis. Usually appear in early childhood

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3
Q

Compund Melanocytic Nevus

A

Papule or nodule, light to black but usually dark brown, Surface may be smooth or cobblestone, defined borders, always <1 cm. Involves both dermis and epidermis. Appear in childhood

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4
Q

Dermal Melanocytic Nevus

A

Papule or nodule, smooth, dome shaped. From dermis, possible hairs. Appear in adults

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5
Q

Halo Nevus

A

Halo of depigmentated skin around a junctional or compound nevus. Nevus will regress, leaving white spot which will repigment. May also occur around melanoma

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6
Q

Blue Nevus

A

Papule or nodule, firm, dark blue to black. Very small. Appear in children and young adults, if large biopsy for confirmation

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7
Q

Nevus spilus

A

Many dark brown macules or papules scattered throughout a pigmented background Junctional and compound nevi are scattered in a defined area of increased melanocytes

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8
Q

Spitz Nevus

A

Nodule, dome-shaped, hairless, ,1cm, epidermis only, reddish. Appear in children and adults under 40. Develop relatively abruptly which makes diagnosis confusing

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9
Q

Mongolian spot

A

Macule, gray-blue, usually in lumbosacral area. Congenital, seen in Asians and Native Americans, may fade and disappear

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10
Q

Nevus of Ota

A

Macule, area dusky blue/brown. Distributed around the trigeminal nerve, including mucous memb. and sclera. Not hereditary, but most common in Asians. Will not fade or disappear. Lasers can help

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11
Q

Dysplastic Nevi

A

atypical nevus and potential precursor to melanoma. Irregular border, indistinct margins, mixed coloration. The “ugly duckling” sign

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12
Q

Management of Dysplastic Nevi

A

Excision NOT recommended, only remove if lesion has changed or cant be followed. Follow up with pt every 12 months if family history or large # or every 3-6 months if not

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13
Q

Congenital Melanocytic Nevus (CMN)

A

Precursor to melanoma, present at birth but fades in.
<15 cm= low risk
Surgical excision may be necessary for large lesions
small lesion removal can be delayed

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14
Q

What is ABCDE Rule?

A 
Used to detect whether melanoma has developed. 
A= Asymmetry
B=Border
C=Color
D=Diameter
E=Elevation and Enlargement
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15
Q

Melanoma

A

A malignancy of melanocytes that occur in skin, eyes, ear, GI tract, oral and genital mucous membranes. One of the most dangerous tumors. Leading cause of skin disease

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16
Q

Risk Factors for Melanoma

A

Dysplastic nevus >5, congenital nevus, large # of benign moles, family history of DN or melanoma, red hair, fair skin, sever sunburn before 14, previous non melanoma or melanoma skin cancer

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17
Q

Management of suspicious lesions

A

Recognize melanoma at earliest stage
Use ABCDE rule
excise suspicious lesion when possible, document size
A punch biopsy is appropriate when suspicion is low or lesion is too large

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18
Q

Management of Melanoma

A

REFER
Treatment is excision, lesion thickness is most important factor determining prognosis. Entire nodal basin is dissected if spread to lymph. Radiation is not helpful and chemotherapy is limited.

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19
Q

Squamous Cell Carcinoma

A

A slow growing malignant tumor of squamous epithelium that can (rarely) metastasize to other areas

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20
Q

Actinic Keratosis

A

considered pre-cancerous skin lesion to squamous cell carcinoma, dry, hard, scaly papules in sun exposed areas of skin on face, scalp, forearms. Painful and tender to scrape but doesn’t cause bleeding

21
Q

Treatment of Actinic Keratosis

A

Cryosurgery - single treatment for 10-15 sec freeze time

can use topical preparations but not as effective because pt. doesn’t use them consistently

22
Q

What is Squamous Cell Carcinoma caused by?

A

UVR or human papilloma virus, begins on skin but can become invasive through lymph node, then organ involvement (Bowen’s cancer)

23
Q

Symptoms of Squamous Cell Carcinoma

A

Lesions may be thick or thin, adherent scale with erythematous base, may have cutaneous horn

24
Q

Where can Squamous Cell Carcinoma be found?

A

most common distribution is on scalp, dorsal hands, helix of ear, may also be found on mouth, tongue, soft palate, pharynx, larynx

25
Q

How do you manage Squamous Cell Carcinoma?

A

Referral is a good option
Small lesions with cryosurgery
Larger lesions should be excised
If advanced disease radiotherapy and chemotherapy are options

26
Q

Basal Cell Carcinoma

A

malignant epithelial cell tumor that arises from the basal layer of the epidermis and does not metastasize
Most common cancer in humans, caused by UVR
Is locally invasive

27
Q

Symptoms of Basal Cell Carcinoma

A

Occurs in many different clinical forms

  1. Nodular- peary, firm, dome shaped, most common
  2. Ulcerated(cystic)-pearly, firm, bumpy border, ulcer in middle
  3. Sclerosing-waxy, firm, flat to slightly raised “scar like”
  4. Superficital- think scaling plaque that bleeds when scraped, looks like actinic keratosis
  5. Pigmented- similar to nodular form, but with pigment
28
Q

Diagnosis of Basal Cell Carcinoma

A

Biopsy must be done before management is chosen. Shave biopsy is often preferred, but punch sometimes

29
Q

Management of Basal Cell Carcinoma

A 
Non-aggressive lesions <3mm deep and not on scalp are excised or (cryosurgery/electrocautery)
Topical creams possible but will have to be a long time so not recommended
Mohs surgery(histology at time of surgery) is used for difficult area
30
Q

Nevus Sebacious

A

present at birth(2/3rd) develops in infants (1/3rd), may rarely undergo malignant transformation into basal cell carcinoma in adulthood
hairless or linear plaque with orange color and pebbly surface

31
Q

Cutaneous Lymphomas

A

many types of cutaneous T-cell and B-cell lymphomas,

initially extranodal proliferations of T or B cells, but eventually LN and internal organs are involved

32
Q

What is the most common cutaneous lymphoma?

A

Mycosis Fungoides
T cell involved in older adults
treatment is by stage: PUVA, interferon electron beam therapy

33
Q

Kaposi Sarcoma

A

Human herpes virus type 8, localized or generalized, purple brownish macules. If systemic mainly in GI tract. common in HIV males, diagnose through biopsy, refer, treat with radiation and chemotherapy

34
Q

Merkel Cell Carcinoma

A

Pts. carry the polyomavirus which mutates from UV
nodule that is pink or reddish brown
exposure, nodules grow rapidly and metastasize quickly to LN
mortality 40%
found on white skin only
AEIOU rule

35
Q

AEIOU Rule

A 
Asymptomatic
Expand rapidly
Immune compromised pts more common
Older than 50
Ultraviolet-exposed areas of skin
36
Q

Treatment of Merkel Cell Carcinoma?

A

Excision or Mohs surgery, sentinel node biopsy, radiation, plus one chemotherapy med (avelumab)

37
Q

Inherited Cancer Susceptibility Syndromes (ICSS)

A

caused by inherited genetic mutations that place pts at increased risk of cancer
autosomal dominant pattern with the ones discussed

38
Q

Neurofibromatosis Type 1

A

(ICSS)
cafe-au-lait macules, nerofibromas, axillary and inguinal freckling
tumor type-malignant peripheral nerve sheath tumors

39
Q

Hereditary Multiple Melanoma

A

5% of pts. diagnosed with melanoma have this, increases pancreatic cancer risk, family members may have large # of benign and dysplastic nevi

40
Q

Peutz-Jeghers Syndrome

A

associated with various GI cancers and breast cancer risk

dark macules on lips and buccal mucosa during infancy or childhood

41
Q

Seborrheic Keratosis

A

most common benign cutaneous neoplasm
hereditary
small papules to plaques that apppear stuck on the skin
appear during middle age and then grow with age
no treatment required

42
Q

Dermatofibroma

A

button like dermal nodule, usually solitary lesion on lower legs
may develop in response to trauma
“dimple sign”
no treatment unless cosmetic

43
Q

Keloids

A

abnormally large scar that extends beyond margins of injury
appears soft to firm tuberous papule or nodule that grows slowly
may be pruritic or tender, appears more in blacks
no treatment is high effective

44
Q

Lipoma

A

common benign fatty tumors (subcutaneous) that usually are asymptomatic
freely mobile, soft mass under skin
no treatment is necessary but may be surgically excised if larger than 5 cm cosmetic or symptomatic

45
Q

Sebaceous Cyst (Epidermal/Epidermoid Cyst)

A

epidermal cells go down into the dermis
cyst that forms in dermis and is lined with epithelial cells that produce keratin
has sm opening to surface called punctum
treatment is excision (pull out pouch)

46
Q

Syringoma

A

Benign tumors of eccrine glands commonly around eyes
very small, flest to light colored papules, usually multiple symmetrically near both eyes
no treatment, but may be removed for cosmetic purposes

47
Q

Xanthelasma

A

asymptomatic, yellow-orange papules near eyelids.
develop over months to years
usually in pts >50 yrs but if seen in children or young adults associated with familial hyperlipidemia
can be excised, elctrodessicated, or removed with TCA

48
Q

Pyogenic Granuloma

A

common benign vascular lesion that evolves quickly over a period of weeks
solitary glistening red papule or nodule that is prone to ulceration
occurs in children and young adults at the side of minor trauma
treatment is excision with electrodessication

Dermatology (5 decks)

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