CK Flashcards
1
Q
skin cancer - types and MC
A
- basal cell carcinoma (BCC) (MC)
- Squamous cell carcinoma
- Melanoma
2
Q
basal cell carcinoma (BCC) of the skin is found in (area of the body and classic location) / behavior
A
sun exposed areas / classic location: upper lip
- locally invasive
- RARELY metastasizes
3
Q
basal cell carcinoma (BCC) of the skin - macroscopic appearance
A
- PINK, pearly nobules, commonly with telengectasias, rolled borders, central crusting or ulceration
- nonhealing ulcer with infiltrating growth or as a scaling plaque (superficial BCC)
4
Q
basal cell carcinoma (BCC) of the skin - Histology
A
clusters of darkly staining basaloid cells with a palisade
5
Q
Squamous cells carcinoma (SCC) of the skin is associated with (risk factors)
A
- excessive exposure to sunlight
- immunosuppression
- arsenic exposure
6
Q
Squamous cells carcinoma (SCC) of the skin commonly appears on
A
- face 2. lower lip 3. ears 4. hands
7
Q
Squamous cells carcinoma (SCC) of the skin - behavioural
A
- locally invasive
- may spread to lymph nodes
- metastasize: uncommon
8
Q
Squamous cells carcinoma (SCC) of the skin - macroscopic appearance / associated with
A
ulcerative red lesions with frequent scale.
- chronic drainage sinus
9
Q
Squamous cells carcinoma (SCC) of the skin - precursor lesion and appearance
A
Actinic keratosis
scaly plaque, hyperkeratotic
(small, rough, erythematous or brownish papules or plaques)
10
Q
keratoacanthoma - definition
A
keratoacanthoma is a variant (well differentiated squamous cell carcinoma that develops rapidly (4-6 weeks) and may regress spontaneously over months
11
Q
keratoacanthoma - present as a
A
cap-shaped tumor filled with keratin debris
12
Q
melanoma - risk factors
A
- sunlight exposure
2. fair-skinned persons are at high risk
13
Q
melanoma - some subtypes (MC?)
A
- superficial spreading (MC)
- nodular
- lentigo maligna
- acral lentiginous
14
Q
superficial spreading melanoma - growth / prognosis
A
radial
good prognosis
15
Q
lentigo maligna melanoma - prognosis / growth
A
good prognosis
radial growth
16
Q
nodular melanoma - growth / prognosis
A
early vertical
poor prognosis
17
Q
acral lentiginous melanoma - special feature
A
it is not related with UV light exposure
PALMS AND SOLES
18
Q
Basal vs squamous cell carcinoma according area of the lips
A
SCC -> lower lip
BCC –> upper lip
19
Q
skin layers:
A
- epidermis
- dermis
- subcutaneous fat (hypodermis or subcutis )
20
Q
epidermis layers - from surface to base (only the names)
A
- stratum corneum
- stratum lucidum
- stratum granulosum
- stratum spinosum
- statum basale
21
Q
hyperkeratosis - definition + example
A
increased thickness of stratum corneum
psoriasis / calluses
22
Q
parakeratosis - definition / examplie
A
hyperkeratosis with retention of nuclei in stratum corneum
psoriasis
23
Q
spongiosis - definition / example
A
epidermal accumulation of edematous fluid in inter-cellular spaces
eczematous dermatitis
24
Q
acantholysis - definition
hypergranoulosis - definition
A
acantholysis: seperation of epidermal cells
hypergranoulosis: increased thickness of stratum granulosum
25
acantholysis example
| hypergranoulosis - example
acantholysis: pemphigus vulgaris
hypergranoulosis: liches planus
26
acanthosis - definition
epidermal hyperplasia (increased spinosum)
27
patch - definition
flat lesion with well-circumscribed change in skin color, more than 1 cm (macule but more than 1cm)
28
macule -definition
flat lesion with well-circumscribed change in skin color less than 1 cm
29
papule - definition
elevated solid skin lesion
30
plaque - definition
elevated solid skin lesion more than 1cm (papule but more than 1cm)
31
vesicle - definition
small fluid containing blister less than 1 cm
32
bulla - definition
large fluid containing blister more than 1cm
33
wheal - definition
transient smooth papule or plaque
34
pustule - definition
vesicle containing pus
35
scale - definition
flaking off of stratum corneum
36
pigmented skin disorders - types
1. Albinism
2. Melasma
3. Vitiligo
37
albinism - mechanism
normal melanocyte number with decreased production of melanin
1. decreased tyrosinase activity
2. defective tyrosine transport
3. failure of neural crest cell migration during development
38
vitiligo is caused by
autoimmune destruction of melanocytes
39
vascular tumors - types
1. angiosarcoma 2 kaposi 3. bacillary angiomatosis
4. Cystic hygroma 5. Glomus tumor 6. Pyogenic granuloma 7. Strawberry hemangioma
8. Cherry hemangioma
40
angiosarcoma - typical occurs in (areas) / age
SUN EXPOSED AREAS: head, neck, breast
| usually in elderly
41
angiosarcoma is associated with
radiation therapy
| chronic postmastectomy lymphadema
42
hepatic angiosarcoma is associated with
1. vinyl chloride
| 2. arsenic exposures
43
angiosarcoma - course
very aggressive and and difficult to resect due to delay in diagnosis
44
Bacillary angiomatosis - definition / RF / caused by
Bening CAPILLARY skin papules found in AIDS patiens
Bartonella henselae
AIDS patients
45
Cherry hemangioma - definition / natural history
bening CAPILLARY hemangioma of the elderly
do not regress
increased freq with age
46
cystic hygroma - definition / RF
CARVENOUS lymphangioma of the neck
| Turner
47
Glomus tumor / definition / area / arises from
Benign, painful, red blue tumor under fingernails
| - modified SMCs of the thermoregulatory glomus bodies
48
Bacillary angiomatosis vs kaposi sarcoma
Bacillary angiomatosis has neutrophilic infiltrate
| Kaposi sarcoma has lymphocytic infiltrate
49
Pyogenic granuloma
polipoid lobulated CAPILLARY hemangioma that can ulcerate and bleed
50
Pyogenic granuloma is associated with
trauma and pregnancy
51
Strawberry hemangioma
bening capillary hemangioma of infancy
52
Strawberry hemangioma- age (when appears) / frequency
infancy
appears in first few weeks of life
1/200 births
53
Strawberry hemangioma natural history
appears in first few weeks of life
| grows rapidly and regress spontaneously by 5-8 years old
54
vascular tumors from capillaries
1. Bacillary angiomatosis
2. Cherry hemangiomas
3. Pyogenic granuloma
4. Straberry hemangioma
55
acne - found in / treatment
face and trunk
| treatment: treatment: retinoids, benzoyl peroxide, antibiotics
56
atopic dermatitis (eczema) - appearance / area of the body / often associated with
pruritic eruption / skin flexures
| other atopic diseases (asthma, allergic rhinitis, food alergies)
57
```
atopic dermatitis (eczema) usually starts ....
thereafter
```
on the face in infancy and often appears in antecubital fossae thereafter
58
Melanocytic nevus - course
benign, but melanoma can arise in congenital or atypical moles
59
Melanocytic nevus - types according location (and where)
- junctional nevus (junction between the epidermis and dermis) --> flat
- intradermal nevi (in the dermis) --> papular
60
psoriasis appearance / area
papules and plaques with silvery scaling
| - knees and elbows
61
Auspitz sign? (and when)
psoriasis - pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off
62
rosacea - macroscopic appearance
erythematous papules and pustules, but no comedones
63
rosacea is an .... disorder
inflammatory FACIAL skin disorder
64
rosacea may be associated with
facial flushing in response to external stimuli (eg. alcohol, heat)
65
rosacea - chronic inflammatory changes may result in
rhinophyma
66
varrucae (warts) on genitals
condyloma acuminatum
67
Seborrheic keratosis - cyst?
keratin filled cysts (horn cysts)
68
Leser-Trelat sign
sudden appearance of multiple Seborrheic keratosis,
69
skin infections are divided to
1. bacterial skin infections
| 2. viral skin infections
70
viral skin infections - types
1. herpes
2. molluscum contagiosum
3. varicella zoster virus
4. hairy leukoplakia
5. verrucae (warts)
71
herpes include (types)
1. herpes labialis (lip)
2. herpes genitalis
3. herpes whitlow (finger)
72
Molluscum contagiosum is caused by / appearance / ages
- poxvirus
- umbilicated (depressed) papules
- frequently in children
- it may be sexually transmitted in adults
73
Hairy leukoplakia - appearance / caused by
- irregular, white painless plaques on tongue that cannot be scrapped off
- its EBV mediated
occurs in HIV + or organ transplant recipients
74
hairy leukoplakia vs thrush
thrush is scrapable
75
hairy leukoplakia vs oral leukoplakia
oral leukoplakia is precancerous
76
bacterial skin infections - types
1. impetigo
2. cellulitis
3. erysipelas
4. abscess
5. Necrotizing fascitis
6. staphylococcal scalded skin syndrome
77
impetigo? caused by / appearance
- very superficial skin (bacterial) infection
- usually S. aureus or S. pyogenes
- honey colored crusting
- it is highly contagious
78
cellulitis? caused by
- acute, painful, spreading infection of deeper dermis and subcutaneous tissues
- usually S. aureus or S. pyogenes
- with a break in skin from trauma or another infection
79
erysipelas is caused by / appearance
S. pyogenus
| well-defined demarcation between infected and normal skin
80
skin abscess - is caused by
almost always S. aureus which is frequently methcillin resistant
81
necrotizing fascitis - definition and causes / appearance
- deeper tissue injury, usually from anaerobic bacteria or - S. pyogenes
- bullae and purple color to the skin
- CREPITUS
82
staphylococcal scalded skin syndrome - mechanism / symptoms
exotoxin (exofliative) destroys keratinocytes attachments in stratum granulosum ONLY
symptoms: 1. fever
2. generalized erythematous rash with sloughing of the upper layers of the epidermis that heals completely
83
staphylococcal scalded skin syndrome - seen in
1. newborns
2. children
3. adults with renal insufficiency
84
toxic dermal necrolysis vs staphylococcal scalded skin syndrome according mechanism
staphylococcal scalded skin syndrome --> exotoxin destroys keratinocytes attachments in stratum granulosum
toxic dermal necrolysis --> destroys epidermal dermal junction
85
blistering skin disorders - types
1. pemphigus vulgaris
2. Bullous pemphigoid
3. dermatitis herpetiformis
4. Erythema multiforme
5. Steven-Johnson syndrome
86
pemphigus vulgaris - appearance
Flaccid intraepidermal bullae caused by acantholysis
| ORAL MUCOSA ALSO INVOLVED
87
pemphigus vulgaris - sign
Nikolsky sign + : separation of epidermis upon manual stroking of skin
88
bullous pemphigoid - appearance
tense bilsters (CONTAINING
89
bullous pemphigoid - Nikolsky sign
negative
90
pemphigus vulgaris vs bullous pemphigoid - immunofluorescense
pemphigus vulgaris --> reticular (net like)
| bullous pemphigoid --> linear pattern
91
dermatitis herpetiformis - appearance / - associated with / mechanism
pruritic papules, vesicles and bullae (often found on elbows)
- celiac disease
- deposits of IgA at tips of dermal papillae (associated with celiac disease)
92
pemphigus vulgaris vs bullous pemphigoid - according course
pemphigus vulgaris --> potentially fatal
| bullous pemphigoid --> less severe
93
pemphigus vulgaris vs bullous pemphigoid - according mechanism
pemphigus vulgaris --> IgG against desmoglein
| bullous pemphigoid --> IgG against hemidesmosomes
94
Erythema multiforme is associated with
1. infection 2. drugs 3. cancers 4. autoimmune diseases
95
Erythema multiforme - infections?
1. Mycoplasma pneumoniae
| 2. HSV
96
Erythema multiforme - drugs?
1. sulfa drugs
2. β-lactams
3. phenyntoin
97
Erythema multiforme - target lesions?
look like targets with multiple rings and dusky center showing epithelial disruption
98
Steven - Johnson syndrome is symptoms
1. fever 2. bullae formation 3. necrosis
| 4. sloughing of skin 5. targetoid lesions may appear
99
Steven - Johnson syndrome - skin manifestations
1. bullae formation 2. necrosis
| 3. sloughing of skin 4. targetoid lesions may appear
100
toxic epidermal necrolysis - characteristic
more severe form of Steven - Johnson syndrome
| >30% of the body surface
101
Steven - Johnson syndrome with 10%-30% of the body surface
Steven - Johnson syndrome-toxic epidermal necrolysis
102
Actinic keratosis appearance
scaly plaque, hyperkeratotic
| small, rough, erythematous or brownish papules or plaques
103
causes of Erythema nodosum
1. idiopathic 2. sarcoidosis 3. coccidioidomycosis 4. histoplasmosis 5. TB 6. streptococcal infections 7. leprosy 7. Inflammatory bowel disease
104
sunburn can lead to
1. impetigo
| 2. skin cancers
105
pityriasis rosea - skin manifestations
Herald patch followed days later by other scaly erythematous plaques, often in a Christmas tree distributions
Multiple plaques with collarette scale
106
pityriasis rosea - treatment
self-resolving in 6-8 weeks
107
Lichen planus - skin manifestation / associated with
mneominc 6Ps
1. Pruritic 2. Purple
3. Polygonal Planar Papules 4. Plaques
HCV
108
Liches Planus - histology
Sawtooth infiltrate of lymphocytes at dermal - epidermal junction
109
Liches Planus - mucosa involvement as
Wickham striae (reticular white lines)
110
dermatitis herpetiformis - treatment
1. gluten free diet
| 2. dapsone
111
strawberry hemangioma - complications (and treatment of complications)
1. ulceration / scarring
2. vision impairment if near eye
3. life-threatening if near airway
propranolol --> to constrict vessels
