Ch. 36 Recently Changed Skin Lesion

Question 1

What risk factor for skin cancer is common to SCC, BCC, and Melanoma?

Answer 1

UV light exposure

Question 2

ABCDEs of Melanoma

Answer 2

• Asymmetry of lesion
• Border irregularity
• Color variegation (different colors)
• Diameter > 6 mm
• Evolution (changing lesion)

Question 3

What genetic condition is associated with an increased risk of skin cancer?

Answer 3

Xeroderma pigmentosum = rare autosomal recessive condition that leads to photosensitivity due to deficient repair of DNA damaged by UV radiation

Leads to very high rate of melanoma, BCC, and SCC at an early age

Question 4

How does hair growth help differentiate benign vs. malignant?

Answer 4

Hair growth on a skin lesion suggests benign nevus.

Melanomas destroy hair follicles.

Question 5

Why is it important to inqure about and examine areas of chronic skin inflammation?

Answer 5

Chronic skin inflammation = known risk factor for SCC

Can develop in:

• chronic open burn wounds (marjolin’s ulcer),
• chronic venous ulcers, and
• longstanding skin infections (hidradenitis suppurativa and HPV)

Question 6

Most common skin cancer? Which skin cancer is associated with the greatest number of deaths?

Answer 6

BCC, Melanoma

Question 7

What is the most common precancerous skin lesion?

Answer 7

Actinic keratosis = rough scaly epidermal lesion that occurs in an area of body subjected to chronic sun exposure

Question 8

Answer 8

Bowen’s Disease

• SCC in situ
• Well-defined erythematous plaque covered by an adherent scaly yellow crust
• No potential for metastasis

Question 9

What is the most common metastasis to the small bowel?

Answer 9

Melanoma

Question 10

How is melanoma of the fingernail managed?

Answer 10

Amputation through the joint, just proximal to the lesion

Acral-lentiginous melanoma is found beneath the nail, on the palm of the hand, or on the sole of the foot