Block 1- PPT 4 Neoplasms, Cancers, Nevi

Question 1

Seborrheic Keratosis is common in what age groups?

Answer 1

middle age and elderly

Question 2

appearance of Seborrheic Keratosis

Answer 2

waxy, crumbly, warty plaques that appear “stuck on”

Question 3

Treatment for Seborrheic Keratosis

Answer 3

although unnecessary, treatment is cryosurgery or shave + curette treatment

Question 4

why do patients want Seborrheic Keratosis removed?

Answer 4

cosmetic reasons

Question 5

African American variant of Seborrheic Keratosis

Answer 5

Dermatosis Papulosa Nigrans

Question 6

what type of tumor is Seborrheic Keratosis

Answer 6

benign keratocytic tumor

Question 7

keratoacanthoma is a rapidly developing _______.

Answer 7

neoplasm

Question 8

keratoacanthoma clinically and histologically mimics ____.

Answer 8

squamous cell carcinoma

Question 9

how should keratoacanthoma be biopsied?

Answer 9

deeply and curette base

Question 10

keratoacanthoma is found more in patients over what age?

Answer 10

over 50

Question 11

is keratoacanthoma more common in males or females?

Answer 11

males

Question 12

where is keratoacanthoma often found?

Answer 12

on sun-exposed skin- ears, nose, cheeks, and dorsal of hand

Question 13

appearance of keratoacanthoma

Answer 13

dome shaped nodule, central keratin filled plug (stakes in a pit)

Question 14

why should keratoacanthoma be biopsied?

Answer 14

there may be SCC at base

Question 15

what type of tumor is keratoacanthoma?

Answer 15

benign keratocytic tumor

Question 16

actinic keratosis is what type of lesion?

Answer 16

pre-malignant keratinocytic lesion

Question 17

actinic keratosis may cause excess keratin build up resulting in ____.

Answer 17

cutaneous horn

Question 18

is actinic keratosis cancerous or pre-cancerous?

Answer 18

pre-cancerous

Question 19

appearance of actinic keratosis

Answer 19

ill defines, scaly plaque,
tan, pink, or skin colored,
found on sun exposed areas of skin

Question 20

how is actinic keratosis diagnosed?

Answer 20

by touch- feels sand papery

can differentiate from SK because SK is rubbery/crusty

Question 21

percentage of actinic keratosis that progresses to malignance

Answer 21

1-5%

Question 22

thin actinic keratosis evolves to hypertrophic actinic keratosis, which can then evolve into ___.

Answer 22

Squamous Cell Carcinoma

Question 23

treatment for actinic keratosis

Answer 23

topical therapy: 5-florouracil, imiquimod, ingenol mebutate

photodynamic therapy

destruction (cryotherapy)

Question 24

3 types of malignant keratinocytes tumors

Answer 24

squamous cell carcinoma in-situ (Bowes’s disease)
invasive squamous cell carcinoma
basal cell carcinoma

Question 25

predisposing factors for squamous cell carcinoma

Answer 25

decades of sun damage, smoking, HPV, industrial carcinogens, chronic ulcers, old burn scars, arsenic, ionizing radiation, tobacco chewing

Question 26

signs and symptoms of SCC

Answer 26

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

Question 27

genital variant of SCC

Answer 27

bowenoid papulosis

Question 28

treatment for SCC

Answer 28

surgery- most cases | Moh's surgery if on face or high risk tumor

Question 29

basal cell carcinoma is more common in younger or older pts?

Answer 29

younger

Question 30

what does BCC look like?

Answer 30

pearly papule with telangiectasia

Question 31

Where does BCC tend to occur?

Answer 31

on sun exposed skin

Question 32

a nevi is a ___.

Answer 32

mole

Question 33

a nevi is a congenital or acquired ______.

Answer 33

melanocytic neoplasm

Question 34

colors of nevi

Answer 34

fleshy to any shade of brown, uniformly pigmented

Question 35

usually size of nevi

Answer 35

less than 5 mm

Question 36

are nevi macular or papular?

Answer 36

they can be BOTH

Question 37

are melanocytic nevi benign?

Answer 37

yes

Question 38

size of melanocytic nevi

Answer 38

less than 6mm

Question 39

appearance of melanocytic nevi

Answer 39

small, macule or papule, well-defined border, homogeneous beige or pink to dark brown pigment

Question 40

early in life, moles are often flat, small, brown lesions called _____.

Answer 40

junctional nevi (located near dermal junction)

Question 41

overtime, moles enlarge and become raised and are called ______.

Answer 41

compound nevus

Question 42

what can happen to moles during pregnancy?

Answer 42

they can darken and grow

Question 43

normal moles should have what features?

Answer 43

well demarcated symmetric uniform in contour and color

Question 44

this type of nevus is much deeper in dermis, circular, and raised

Answer 44

dermal nevus

Question 45

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

Answer 45

congenital nevus

Question 46

appearance of blue nevi

Answer 46

small, slightly elevated, blue-black lesions

Question 47

blue nevi favor what area of the body?

Answer 47

dorsal hands

Question 48

what ethnic group are blue nevi commonly found in?

Answer 48

asians

Question 49

differential diagnosis for blue nevi

Answer 49

melanoma | traumatic tattoo

Question 50

when should blue nevi be monitored?

Answer 50

if there are blue-black papule that are new or growing. important to rule out nodular melanoma

Question 51

spitz nevus appearance

Answer 51

RED-PINK NODULE

Question 52

spitz nevus are usually benign or malignant?

Answer 52

benign

Question 53

spits nevus is most common in what age group?

Answer 53

kids

Question 54

spits nevus may be confused clinically with ____.

Answer 54

vascular lesion

Question 55

This type of nevus is a host immune response to nevocellular cells and adjacent melanocytes

Answer 55

halo nevus

Question 56

why is there a ring around halo nevus?

Answer 56

body will attack mole, forms white depigmented ring

Question 57

Do dysplastic/clark's nevus have "ABCD" features?

Answer 57

yes but not malignant

Question 58

where Do dysplastic/clark's nevus tend to appear?

Answer 58

sun-exposed and non sun-exposed skin

Question 59

Does having dysplastic/clark's nevus increase your risk for melanoma?

Answer 59

yes

Question 60

dysplastic/clark's nevus are common in pts with a family history of ____.

Answer 60

Melanoma

Question 61

appearance of dysplastic/clark's nevus

Answer 61

irregular border and pigmentation

Question 62

Risk factors of melanoma

Answer 62

``` 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 ```

Question 63

Chronic UV exposure increases risk of _____.

Answer 63

squamous cell and basal cell carcinoma

Question 64

In the "ABCDE" for diagnosing melanoma, what does it stand for?

Answer 64

``` A - asymmetry B - border irregularity C - color change D - diameter >6mm E - evolution ```

Question 65

if you suspect BCC or SCC, you should do a ___.

Answer 65

shave biopsy

Question 66

what is Karposi's sarcoma?

Answer 66

a spindle-cell tumor thought to be derived from endothelial cell lineage

Question 67

4 types of Karposi's sarcoma

Answer 67

AIDS-related*- most common form, AGGRESIVE Immunocompromised- 100x > in transplant pts Classic, or sporadic Endemic (African)

Question 68

in Karposi's sarcoma, lesions may involve ?

Answer 68

``` skin- most present w/ skin disease Extremities, head and neck oral mucosa Mucous membranes -palate, gingiva, conjunctiva common lymph nodes visceral organs ```