Chapter 5 - Epidermal Growths Flashcards
neoplasms of the epidermis are derived from a proliferation of ___ or ____
basal cells or keratinocytes
epidermal growths are recognized clinically by a localized thickening of the epidermis that often is accompanied by thickening of the stratum _____, which is called hyperkeratosis or scale
corneum
large, indurated, rapidly growing, crusted or ulcerated tumors suggest a ____ process and should undergo a biopsy
malignant
benign neoplasms caused by infection of epidermal cells with papillomaviruses
wart
thickening of the epidermis with scaling and an upward extension of the _____ containing prominent capillaries give warts their “warty” or verrucous appearance
dermal papillae
most common sexually transmitted disease
HPV
what type of occupations have a higher incidence of common warts?
butchers and meat cutters
EWWW
___ affect sexually active individuals, and their occurrence in children should raise suspicions of sexual abuse
Anogential warts (condylomata acuminata)
Call stabler and bension
flesh colored firm papule or nodule that has a corrugated or hyperkeratotic surface, interrupts the normal skin lines and is studded with black puncta, linear fashion from autoinoculation
common wart or verrua vulgaris
__ variant of verrucca vulagaris occurs on the head and neck
filiform
subtle appearance, flesh colored or reddish brown, slightly raised, flat surfaced 2-5 mm, well marginated papulae
flat wart
a single, painful papule on the plantar aspect of the foot, covered by a thick callus
plantar wart
__ involves the rectum, perineal region, inguinal folds, external genitalia and occasionally urethra and vagina, soft moist papule and plaque that may be sessile or pedunculated
condyloma acuminatum - venereal wart
soaking the genital area for 5 minutes with 3-5% ____ causes warts to turn white
acetic acid
Diff Diagnosis of a wart
Callus Squamous cell carcinoma Comedo lichen planus corns Secondary syphilis Seborrheic keratoses Bowenoid papulosis
an uncommon disorder characterized by erythematous, sometimes pigmented, papulae occuring in the genital region of sexually active young adults
bowenoid papulosis
treatment for warts
cryotherapy with liquid nitrogen
electrodesiccation and curettage
surgical excision
laser therapy
most common initial mode of treatment, uses either a cotton tipped stick or a cryospray unit for application of the liquid nitrogen onto the verrua
cryotherapy with liquid nitrogen
a potent blistering agent derived from the blister beetle, an alternative office treatment that is applied to common warts and covered with tape
Cantharidin
cytotoxic agent that resulted in renal toxicity, polyneuritis, and shock
podophyillin
a chemically pure ligand derived from podophyillin is available as topical solution or gel, for patient self treatment of external genital warts
Podofilox
t/f warts are contagious
True
if they weren’t, sexual partners wouldn’t share them and the book says some guy in the 1800s Jadassohn inoculated normal skin with wart material and warts grew about 2- 3 months after
a localized thickening of epidermis secondary to chronic pressure or friction
corn (clavus or heloma)
white gray or yellow brown, well circumscribed, horny papules or nodules
corn
diff dx of a corn
plantar wart - if skin lines are present its a corn
tx for a corn
paring down with scalpel, mediplast or reduction of trauma (new shoes) or surgery (correction of deformity)
a __ will persist unless friction and pressure are relieved.
corn
a benign neoplasms of epidermal cells that clinically appears as a scaling, “pasted on” papule or plaque, autosomal dominant inherited trait
seborrheic keratosis
vary is size from 2mm to 2cm and slightly to markedly elevated, color ranges from flesh to tan/brown and occasionally black, oval to round, greasy appearing, sharply marginated growths
seborrheic keratosis
diff dx of seborrheic keratosis
wart, actinic keratosis, nevus, pigmented basal cell carcinoma, malignant melanoma
what type of biopsy confirms the clinical impression of seborrheic keratosis?
excisional or shaved
leser-trelat, the rapid increase in size and number of seborrheic keratoses is accompanied by _____
pruritus
acrochordon is another name for ___
skin tag
a benign fleshy tumor that is frequently acquired in adult life, slightly hyperplastic epithelium covering a dermal connective tissue stalk, pedunculated, flesh colored growth
skin tag
soft, tan to flesh colored, 1-10 mm, pedunculated, fleshy papule, has a smooth or folded surface and frequently appears boggy of filiform
skin tag
t/f large or necrotic skin tags should be sent to pathology
true!
purple box on page 59!
caused by a DNA poxvirus that infects epidermal cells, lesions appear smooth, dome-shaped papules that often are umbilicated
molluscum contagiosum
papules are 2-5 mm wide, hard, smooth, dome shaped and flesh colored or translucent, central umbilication from which a cheesy core can be expressed, singly or in groups
molluscum contagiosum
precancerous neoplasm of the epidermis caused by the UV portion of sunlight
actinic keratosis
1-10 mm, reddish, ill-marginated patches and papules that have a rough, yellowish brown, adherent scale
actinic keratosis
a malignant neoplasm of keratinocytes, locally invasive and has the potential to metastasize, scaling, indurated plaque or nodule that sometimes bleeds or ulcerates
squamous cell carcinoma
second most common skin cancer
squamous cell carcinoma
chronic, nonhealing, bleeding growth or ulcer should arouse suspicion of ___
squamous cell carcinoma
squamous cell carcinoma in situ of the skin, erythematous, scaling, crusted, well marginated patch
Bowen’s disease
Squamous cell carcinoma is situ of the glans penis is referred to as ___ , red, velvety, moist patch
erythroplasia of Queyrat
rapidly growing neoplasma of the epithelium that is biologically benign but histologically resembles a squamous cell carcinoma, round, flesh colored nodule that characteristically grows rapidly (within 4-6 weeks) and has a central keratin filled crater
Keratoacanthoma
Exposure to what carcinogens leads to squamous cell carcinoma?
arsenic and soot, UV, X-irradiation, and viruses
a rare genetic disorder, develop hundreds of flat warts caused by HPV and prone to transform into squamous cell carcinoma
epidermodysplasia verruciformis
a malignant neoplasm arising from the basal cells of the epidermis, rarely metastasize, types include: nodular, pigmented, superficial and scarring
basal cell carcinoma
most common human malignant disease
basal cell carcinoma
which TYPE of basal cell carcinoma is most common?
nodular, has a pearly, semitranslucent papule or nodule that often has a central depression or crater, telangiectasia and a rolled waxy border.
a shiny, blue-black papule, nodule or plaque, which type of basal cell is this?
pigmented basal cell carcinoma
type of basal cell carcinoma that occurs on the thorax, red, slightly scaling, well demarcated, eczematous appearing patch, may become slightly eroded and crusted, subsequently leaving an atrophic, slightly depressed center
superficial basal cell carcinoma
atrophic, white, slightly eroded or crusted plaque that often looks like a scar
scarring basal cell carcinoma
rare malignant tumor that usually occurs as a solitary nodule on the head and neck of elderly patients
merkel cell carcinoma
treatment of ___ includes local excision, sentinel lymph node biopsy and radiotherapy
merkel cell carcinoma
hamartoma of the sebaceous glands and other cutaneous structures appears at birth as a thin yellowish plaque with alopecia
nevus sebaceus
plaque becomes verrucous and both benign and malignant tumors may develop, excision is recommended, may be associated with neurologic or skeletal abnormalities
nevus sebaceus
benign tumor of the hair follicle, solidary or multiple firm, smooth, flesh-colored papules or nodules, inherited as an autosomal dominant condition
trichoepithelioma
