Ch. 7-Dermal & Subcutaneous Growths

Question 1

What is helpful with distinguishing features of dermal & subcutaneous growths?

Answer 1

color & consistency

Question 2

an area of focal dermal fibrosis, often accompanied by overlying epidermal thickening & hyperpigmentation.

Answer 2

dermatofibroma

Question 3

Dermatofibromas are common and most often seen in ____.

Answer 3

young adults

Question 4

Dermatofibromas are symptomatic/asymptomatic.

Answer 4

asymptomatic

Question 5

What is a helpful diagnostic test used to determine dermatofibromas?

Answer 5

‘dimple sign’

Question 6

Where is the most common locations where dermatofibromas occur?

Answer 6

thighs and legs

Question 7

How does dermatofibroma appear clinically?

Answer 7

a brown papule or small nodule, often more indurated than elevated

Question 8

a low-grade malignant fibrous tumor that grows slowly but persistently, and rarely metastasizes; it is distinguished from a dermatofibroma by its larger size, irregular shape, and continued growth.

Answer 8

dermatofibrosarcoma protuberans

Question 9

What may be an initiating factor for some of dermatofibroma lesions?

Answer 9

trauma

Question 10

a cyst derived from the upper portion of the epithelial lining of a hair follicle and is located in the mid and lower dermis

Answer 10

epidermal inclusion cyst

Question 11

T/F: epidermal inclusion cysts are usually asymptomatic, slow growing, and most frequently are found incidentally by either the patient or the examining physician

Answer 11

TRUE

Question 12

How do epidermal inclusion cysts present clinically?

Answer 12

flesh-colored, firm but malleable, solitary nodule in the skin

Question 13

What are the key diagnostic features of epidermal inclusion cysts?

Answer 13

a central pore and cheesy, foul-smelling discharge

Question 14

T/F: to prevent recurrence of epidermal inclusion cysts, the entire cyst, with its lining, should be removed

Answer 14

TRUE

Question 15

What is the range in size of epidermal inclusion cysts?

Answer 15

0.5 - 5 cm

Question 16

What are multiple epidermal inclusion cysts a feature of?

Answer 16

Gardner syndrome

Question 17

an uncommon, autosomal dominant, heritable disorder manifested by multiple epidermal cysts, fibromas, osteomas, and intestinal polyp.

Answer 17

Gardner syndrome

Question 18

a benign proliferation of blood vessels in the dermis and subcutis.

Answer 18

hemangioma

Question 19

What is the most common soft tissue tumor of infancy, occurring more frequently in premature, white females.

Answer 19

hemangioma

Question 20

What are the types of hemangiomas?

Answer 20

1. superficial
2. subcutaneous
3. mixed

Question 21

How do superficial hemangiomas appear clinically?

Answer 21

a lesion of bright red color

Question 22

How do subcutaneous hemangiomas appear clinically?

Answer 22

a lesion with a bluish hue

Question 23

How do mixed hemangiomas appear clinically?

Answer 23

bright red, dome-shaped nodules

Question 24

What is a diagnostic feature found in many (but not all) hemangiomas?

Answer 24

blanchability

Question 25

T/F: Most hemangiomas continually increase in size.

Answer 25

FASLE (most involute spontaneously during childhood)

Question 26

A malignant vascular tumor derived from endothelial cells

Answer 26

Kaposi's sarcoma

Question 27

What are the 3 types of Kaposi's sarcoma?

Answer 27

1. classic 2. lymphadenopathic 3. AIDS-associated

Question 28

Which form of Kaposi's sarcoma occurs primarily in elderly men of Eastern European descent?

Answer 28

Classic Kaposi's sarcoma

Question 29

Which form of Kaposi's sarcoma is an aggressive form that primarily occurs in equatorial Africa, where it accounts for approximately 9% of all cancers?

Answer 29

Lymphadenopathic Kaposi's sarcoma

Question 30

T/F: You should test for HIV in patients who are newly diagnosed with Kaposi's sarcoma.

Answer 30

TRUE

Question 31

How does Kaposi's sarcoma present clinically?

Answer 31

the lesions may appear as macules, papules, dermal plaques, or nodules that are purple.

Question 32

excessive proliferation of collagen (scar tissue) after trauma to the skin

Answer 32

keloid

Question 33

How do keloids present clincally?

Answer 33

as elevated, firm, protuberant nodules or plaques pink or dark-brown in color

Question 34

Who is keloids most common in?

Answer 34

black people 10 - 30 years old

Question 35

What regions of the body are more common locations for keloids?

Answer 35

earlobes, shoulders, upper chest, and back

Question 36

What does histologic examination of keloids show?

Answer 36

whorls and nodules of highly compacted hyalinized bands of collagen

Question 37

a benign tumor of subcutaneous fat

Answer 37

lipoma

Question 38

How does a lipoma present clinically?

Answer 38

as a rubbery nodule that appears only slightly elevated above the skin's surface but is easily palpable deep in the skin

Question 39

What is the size range of lipomas and where are they most often found?

Answer 39

- range from 1-10cm | - found on the trunk, neck, and upper extremities

Question 40

T/F: A lipoma is usually shallower, more stable, and less rubbery than an epidermal inclusion cyst.

Answer 40

FALSE (deeper, more freely movable, and more rubbery)

Question 41

How does a lipoma appear histologically?

Answer 41

as an encapsulated collection of normal fat cells

Question 42

What represents a focal proliferation of nerual tissue within the dermis?

Answer 42

neurofibroma

Question 43

What two ways may a neurofibroma appear clinically?

Answer 43

1. soft, protruding papules and nodules (most often) | 2. deep, firm, subcutaneous nodules (less often)

Question 44

a dominantly inherited neurocutaneous disorder with prominent skin, skeletal, and nervous system abnormalities

Answer 44

von Recklinghausen's disease (neurofibromatosis 1)

Question 45

Ophthalmologic examination of ___ is useful in diagnosing neurofibromatosis 1.

Answer 45

Lisch nodules

Question 46

What is a characteristic sign of soft papules and nodules of neurofibroma?

Answer 46

'buttonhole' sign

Question 47

What is neurofibromatosis 1 caused by?

Answer 47

an abnormal gene, NF-1, on chromosome 17

Question 48

What represents a focal collection of lipid-laden histiocytes in the dermis or tendons?

Answer 48

xanthoma

Question 49

How do xanthomas located in the dermis appear clinically?

Answer 49

yellowish papules, plaques, and nodules

Question 50

How do tendon xanthomas appear clinically?

Answer 50

deep, flesh-colored, hard nodules located within peripheral tendons

Question 51

What are the most frequently encountered xanthomas?

Answer 51

flat xanthomas on the eyelids

Question 52

A type of xanthoma that presents as yellowish plaques on the eyelids & is the only type that is not accompanied by an increase in either plasma cholesterol or triglyceride concentration.

Answer 52

xanthelasma

Question 53

A type of xanthoma that presents as reddish-yellowish papules & plaques on the extensor surfaces of patients with markedly raised triglyceride levels

Answer 53

Eruptive xanthomas

Question 54

A type of xanthoma that presents as stony hard nodules occurring on tendons, most often the Achilles tendon & the extensor tendons of the fingers in patients with severe hypercholesterolemia

Answer 54

Tendon xanthomas

Question 55

A type of xanthoma that presents as yellowish 'potato-like' papules and nodules most often found on the elbows & buttocks in patients with increased serum triglyceride or cholesterol levels

Answer 55

Tuberous xanthomas

Question 56

What are the major causes of the yellow color in skin papules of xanthoma?

Answer 56

1. sebaceous glands 2. lipid deposits 3. granulomas

Question 57

What is the suggested therapy for a patient with xanthoma?

Answer 57

lowering the abnormal lipid levels with diet or meds

Question 58

T/F: Eruptive xanthomas usually resolve when triglyceride levels are lowered.

Answer 58

TRUE