Benign Cutaneous Neoplasms CH109 Bologna

Question 1

Dermoscopy of lichenoid keratosis

Answer 1

Overlapping pinkish areas in keeping with lichenoid inflammation
Light brown pseudonetworks due to residual solar lentigo
Annular granular structures and gray pseudonetworks in the early regressing stage
Blue-gray dots or globules in late regressing stage

Question 2

List types of actinic keratoses

Answer 2

Hypertrophic (hyperkeratotic)
Pigmented
Lichenoid
Atrophic

Question 3

Types of KA’s

Answer 3

Solitary
Multiple
Grouped
Keratoacanthoma centrifugum marginatum
Giant
Subungal
Palmoplantar
Intraoral
Multiple spontaneously regressing (Ferguson-Smith)
Multiple non regressing and generalised eruptive (Grzybowski)

Question 4

Keratoacanthoma centrifugum marginatum may reach several centimetres in diameter, persist for months before resolution and heal without scarring

Answer 4

F, heal with prominent scarring

Question 5

KA’s never metastasise

Answer 5

F, rare reports of metastases

Question 6

Multiple KAs of Grzybowski present as thousands of papules resembling milia or early eruptive xanthomas .

Answer 6

T

Question 7

Patients with Grzybowski KA’s often have scarring, ectropion and mask-like facies

Answer 7

T

Question 8

PUVA lentigines often contain BRAF mutations

Answer 8

T

Question 9

Stucco keratosis have PIK3CA somatic activating mutations

Answer 9

T

Question 10

Invasive and in-situ SCC , cutaneous melanoma, BCC, and KA have all been associated with sebK’s

Answer 10

T (may represent coincidental neoplasm developing in adjacent skin but is possible that various cell types in Seb K can develop into their respective neoplasms)

Question 11

What is the sign of Leser Trelat

Answer 11

Rare cutaneous marker of internal malignancy, in particular gastric or colonic adenocarcinoma, breast carcinoma and lymphoma

Question 12

Leser trelat associated features

Answer 12

• abrupt and striking increase in number or size of SK’s
• associated pruritus has been documented
  Majority of lesions occur on back, followed by extremities, face and abdomen

Question 13

Malignancy acanthosis nigricans May appear at the same time or shortly after the sign of Leser trelat in approx 20% of patients

Answer 13

T

Question 14

List types of Seb K

Answer 14

Acanthotic
Hyperkeratotic
Reticulated/adenoid
Inflated/irritated
Clonal

Question 15

Changes of solar lentigo or macular Seb K are often present at periphery of lichenoid keratosis specimens

Answer 15

T

Question 16

DSAP has highest risk of malignant change

Answer 16

F, lowest

Question 17

Flegel disease has diffuse Lichoid infiltrate

Answer 17

F, patchy lichenoid infiltrate

Question 18

Development of BCC or SCC in an epidermoid cyst is possible

Answer 18

T - rare event

Question 19

Milia in newborns are called Bohn nodules when on hard palate

Answer 19

T

Question 20

Milia in newborns on the gum margin are Epstein pearls

Answer 20

T

Question 21

Milia can be seen in which syndromes:

Answer 21

Rombo, Bazex-Dupre-Christol, Loeys-Dietz, and a subset of Brooke-Spiegler (Rasmussen syndrome - This autosomal dominant condition consists of multiple cylindromas, trichoepitheliomas, and milia.)