Block 1- PPT 4 Neoplasms, Cancers, Nevi Flashcards
Seborrheic Keratosis is common in what age groups?
middle age and elderly
appearance of Seborrheic Keratosis
waxy, crumbly, warty plaques that appear “stuck on”
Treatment for Seborrheic Keratosis
although unnecessary, treatment is cryosurgery or shave + curette treatment
why do patients want Seborrheic Keratosis removed?
cosmetic reasons
African American variant of Seborrheic Keratosis
Dermatosis Papulosa Nigrans
what type of tumor is Seborrheic Keratosis
benign keratocytic tumor
keratoacanthoma is a rapidly developing _______.
neoplasm
keratoacanthoma clinically and histologically mimics ____.
squamous cell carcinoma
how should keratoacanthoma be biopsied?
deeply and curette base
keratoacanthoma is found more in patients over what age?
over 50
is keratoacanthoma more common in males or females?
males
where is keratoacanthoma often found?
on sun-exposed skin- ears, nose, cheeks, and dorsal of hand
appearance of keratoacanthoma
dome shaped nodule, central keratin filled plug (stakes in a pit)
why should keratoacanthoma be biopsied?
there may be SCC at base
what type of tumor is keratoacanthoma?
benign keratocytic tumor
actinic keratosis is what type of lesion?
pre-malignant keratinocytic lesion
actinic keratosis may cause excess keratin build up resulting in ____.
cutaneous horn
is actinic keratosis cancerous or pre-cancerous?
pre-cancerous
appearance of actinic keratosis
ill defines, scaly plaque,
tan, pink, or skin colored,
found on sun exposed areas of skin
how is actinic keratosis diagnosed?
by touch- feels sand papery
can differentiate from SK because SK is rubbery/crusty
percentage of actinic keratosis that progresses to malignance
1-5%
thin actinic keratosis evolves to hypertrophic actinic keratosis, which can then evolve into ___.
Squamous Cell Carcinoma
treatment for actinic keratosis
topical therapy: 5-florouracil, imiquimod, ingenol mebutate
photodynamic therapy
destruction (cryotherapy)
3 types of malignant keratinocytes tumors
squamous cell carcinoma in-situ (Bowes’s disease)
invasive squamous cell carcinoma
basal cell carcinoma
predisposing factors for squamous cell carcinoma
decades of sun damage, smoking, HPV, industrial carcinogens, chronic ulcers, old burn scars, arsenic, ionizing radiation, tobacco chewing
signs and symptoms of SCC
non healing ulcer or abnormal growth in sun exposed areas
painful- invasive SCC
may bleed, lesion doesn’t heal
can be found on lower lip, ear, pre auricular area, forehead and scalp
in the mouth can be found on floor, tongue, anterior tonsillar pillar and soft palate
genital variant of SCC
bowenoid papulosis
treatment for SCC
surgery- most cases
Moh’s surgery if on face or high risk tumor
basal cell carcinoma is more common in younger or older pts?
younger
what does BCC look like?
pearly papule with telangiectasia
Where does BCC tend to occur?
on sun exposed skin
a nevi is a ___.
mole
a nevi is a congenital or acquired ______.
melanocytic neoplasm
colors of nevi
fleshy to any shade of brown, uniformly pigmented
usually size of nevi
less than 5 mm
are nevi macular or papular?
they can be BOTH
are melanocytic nevi benign?
yes
size of melanocytic nevi
less than 6mm
appearance of melanocytic nevi
small, macule or papule, well-defined border, homogeneous beige or pink to dark brown pigment
early in life, moles are often flat, small, brown lesions called _____.
junctional nevi (located near dermal junction)
overtime, moles enlarge and become raised and are called ______.
compound nevus
what can happen to moles during pregnancy?
they can darken and grow
normal moles should have what features?
well demarcated
symmetric
uniform in contour and color
this type of nevus is much deeper in dermis, circular, and raised
dermal nevus
this type of nevus looks like conventional nevi, may have hair, is present at birth, and can be associated with an increased risk for melanoma
congenital nevus
appearance of blue nevi
small, slightly elevated, blue-black lesions
blue nevi favor what area of the body?
dorsal hands
what ethnic group are blue nevi commonly found in?
asians
differential diagnosis for blue nevi
melanoma
traumatic tattoo
when should blue nevi be monitored?
if there are blue-black papule that are new or growing. important to rule out nodular melanoma
spitz nevus appearance
RED-PINK NODULE
spitz nevus are usually benign or malignant?
benign
spits nevus is most common in what age group?
kids
spits nevus may be confused clinically with ____.
vascular lesion
This type of nevus is a host immune response to nevocellular cells and adjacent melanocytes
halo nevus
why is there a ring around halo nevus?
body will attack mole, forms white depigmented ring
Do dysplastic/clark’s nevus have “ABCD” features?
yes but not malignant
where Do dysplastic/clark’s nevus tend to appear?
sun-exposed and non sun-exposed skin
Does having dysplastic/clark’s nevus increase your risk for melanoma?
yes
dysplastic/clark’s nevus are common in pts with a family history of ____.
Melanoma
appearance of dysplastic/clark’s nevus
irregular border and pigmentation
Risk factors of melanoma
Dysplastic nevi Large congenital nevi Past history of melanoma (900x) Family history of melanoma (8x) Fair skin – regardless of sunburn history Severe sunburns in childhood Brief, intermittent, intense UV exposure, especially during 10 –24 yr of age Use of UV sunbeds Xeroderma pigmentosa (1000x) Immune suppression History of breast cancer
Chronic UV exposure increases risk of _____.
squamous cell and basal cell carcinoma
In the “ABCDE” for diagnosing melanoma, what does it stand for?
A - asymmetry B - border irregularity C - color change D - diameter >6mm E - evolution
if you suspect BCC or SCC, you should do a ___.
shave biopsy
what is Karposi’s sarcoma?
a spindle-cell tumor thought to be derived from endothelial cell lineage
4 types of Karposi’s sarcoma
AIDS-related*- most common form, AGGRESIVE
Immunocompromised- 100x > in transplant pts
Classic, or sporadic
Endemic (African)
in Karposi’s sarcoma, lesions may involve ?
skin- most present w/ skin disease Extremities, head and neck oral mucosa Mucous membranes -palate, gingiva, conjunctiva common lymph nodes visceral organs
