Case 3: Carcinomas

Question 1

Where do basal cell carcinomas develop a malignancy?

Answer 1

Basal layer of epidermis

Question 2

What do BCC look like?

Answer 2

Shiny, firm, pearly nodule w/ superficial telangiectasia, “rodent ulcer”

Question 3

Where is BCC most commonly located?

Answer 3

Lower eyelid or medial canthus

Question 4

What is the most common type of skin cancer in the US?

Answer 4

BCC

Question 5

What is the MC type of eyelid malignancy?

Answer 5

BCC

Question 6

Do BCC commonly metastasize?

Answer 6

No

Question 7

SCCs are a malignancy of what layer of the epidermis?

Answer 7

Spinosum

Question 8

What do SCCs look like?

Answer 8

Erythematous plaque that appears rough, scaly, and/or ulcerated, may be flat or elevated, commonly located on lower eyelid or eyelid margin

Question 9

Sebaceous gland carcinomas are malignancies of what?

Answer 9

Sebaceous glands (meibomian glands or glands of Zeis)

Question 10

What do sebaceous gland carcinomas look like?

Answer 10

Yellow, hard tumor on the upper eyelid that causes madarosis & thickened red eyelid margins

Question 11

Eyelid lesions > ____ cm are assoc w/ 60% mortality rate

Answer 11

2

Question 12

Eyelid lesions > ____ mo sx are assoc w/ 38% mortality rate

Answer 12

6

Question 13

Malignant melanomas have what 3 things?

Answer 13

1. irregular borders 2. uneven pigment 3. rapid growth

Question 14

SCC & BCC are both assoc w/ chronic exposure to what?

Answer 14

UV light esp UV B

Question 15

25% of cases of actinic keratosis develop into _____

Answer 15

SCC

Question 16

Eyelid malignancies can metastasize to nearby organs by passing thru what lymph nodes?

Answer 16

Preauricular and/or submandibular

Question 17

What are 4 early signs of keratoconus?

Answer 17

1. Fleischer’s ring (iron deposits w/i the cornea at the base of the cone) 2. scissors reflex on ret 3. irregular mires on keratometry 4. inf steepening of cornea on corneal topo

Question 18

What are 3 late signs of keratoconus?

Answer 18

1. Vogt’s striae (vertical lines w/i deep corneal stroma) 2. Munson’s sugn (protrusion of the lower eyelid on down gaze) 3. Hydrops (corneal epithelial edema due to tears in Descemet’s membrane)