COMMON SKIN TUMORS Flashcards
Cherry Hemangiomas epidmiology
Typically arise in middle age
Most common vascular tumor in adults
Generally no association with underlying disease
Cherry Hemangiomas clinical
truncal distribution. Endothelial Vascular Tumor. bright red, smooth topped papules, poss’ly pedunculated.
Cherry hemangiomas Tx
Burn, shave, liquid nitrogen, poss local anethesia, lasers.
Infantile hemangioma
Strawberry (capillary) tumor appearing <=2mo, some @ birth. Grow rapidly over 1st yr, then diminish ~10%/yr→ 90% resolved by 9yo.
Infantile hemangioma Tx
can use B-blockers among other things
What is port wine stain
Endothelial Vascular Malformation, poss’ly assoc’d w systemic defects (IE: Sturge Weber Syndrome, SWS w ocular/neuro defects).
port wine stain Tx
Pulsed laser
Nevus Sebacceous
Sebacceous gland tumor. Rapid growth occurs @ puberty w sebacceous gl enlg’mt & epidermal hyperplasia. Complic’ns: Epidemal Nevus Syndrome (neuro defects) & Epithelial neoplasms (BCC & syringocystadenoma).
Sebaceous Hyperplasia
Sebocyte tumor of Sebacceous gland. Distrib’n: face > trunk > extremities. 1o lesion: 1-6 mm, yellowish-white papule
(globules, NOT pigmented) w central dell.
Acrochordon
skin tags; fibroepithelial polyps. In areas of rubbing (neck, axilla, infra-mammary area). Solitary or multiple. Soft, flesh-colored tan to brown exophytic papule (1-4 mm).
Dermatofibroma
Benign tumor of fibroblasts.in adults, tan-brown, firm papules, 3-10mm, acquired, common on legs, (+) dimple sign.
Dermatofibroma
Benign tumor of fibroblasts.in adults, tan-brown, firm papules, 3-10mm, acquired, common on legs, (+) dimple sign. Enlarging lesions=dermatofibrosarcoma protuberans or BCC (rare).
Composition of Keloid
composed of mainly either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1.
SignofLeser-Trélat
– Rapid increase in size or number
– Associated with internal malignancies, especially adenocarcinoma of the stomach (60%)
SignofLeser-Trélat
– Rapid increase in size or number
– Associated with internal malignancies, especially adenocarcinoma of the stomach (60%)
Intradermal nevus
Melanocyte nests are only in dermis. Tan to light brown. <6mm Papule or nodule. Head & neck most common.
Compound Nevi
Melanocyte nests are @ dermal-epidermal junction AND in dermis. Tan-Black. <6mm Papule or nodule. Trunk & proximal extremitie
junctional Nevi
Melanocyte nests are @ dermal-epidermal junction above BM. Tan-Black, 1-5mm, macules/papule. Anywhere, but common on plantar/palmar surfaces.
Appropriate Nevi treatment
– Shave biopsy
– Punch biopsy
– Excision biopsy
anything else is baaad
Blue Nevus
Melanocyte proliferation that produces abundant melanin. Blue color- optical effect where longer wavelengths are absorbed and shorter wavelengths are reflected back (Tyndall effect).
Dysplastic Nevi
Irregular outline, pigment’n, or borders. >6mm. “fried egg” appearance (central brown papular dome, surrounded by flat tan pigment). W FHx of melanoma (FAM), ↑ed risk. W malignancy, upper dermis shows fibrosis & lymphocytes.
T or F: risk of melanoma approaches 100% in FAMM
True
T or F: risk of melanoma approaches 100% in FAMM
True
Criteria for FAMM
- The occurrence of malignant melanoma in 1 or more first- or second-degree relatives
- The presence of numerous (often >50) melanocytic nevi, some of which are clinically atypical
- Many of the associated nevi showing certain histologic features
Melanoma Mutations
CDK2NA mapped to 9p21
– CDK4 mapped to 12q14
– CMM1 mapped to 1p.
Neurofibromatosis
AD inheritance with variable expression
• 50% of cases due to spontaneous mutations
• Defect in neurofibromin gene, a tumor suppressor, on chromosome 17 for NF-1
-“button hole sign” papules
Cafe-Au-Lait spots
Subtle increase in number of melanocytes with increased melanin production
Multiple lesions associated with NF
– prepubertal child- 6 or more > 5 mm
