COMMON SKIN TUMORS

Question 1

Cherry Hemangiomas epidmiology

Answer 1

Typically arise in middle age
Most common vascular tumor in adults
Generally no association with underlying disease

Question 2

Cherry Hemangiomas clinical

Answer 2

truncal distribution. Endothelial Vascular Tumor. bright red, smooth topped papules, poss’ly pedunculated.

Question 3

Cherry hemangiomas Tx

Answer 3

Burn, shave, liquid nitrogen, poss local anethesia, lasers.

Question 4

Infantile hemangioma

Answer 4

Strawberry (capillary) tumor appearing <=2mo, some @ birth. Grow rapidly over 1st yr, then diminish ~10%/yr→ 90% resolved by 9yo.

Question 5

Infantile hemangioma Tx

Answer 5

can use B-blockers among other things

Question 6

What is port wine stain

Answer 6

Endothelial Vascular Malformation, poss’ly assoc’d w systemic defects (IE: Sturge Weber Syndrome, SWS w ocular/neuro defects).

Question 7

port wine stain Tx

Answer 7

Pulsed laser

Question 8

Nevus Sebacceous

Answer 8

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).

Question 9

Sebaceous Hyperplasia

Answer 9

Sebocyte tumor of Sebacceous gland. Distrib’n: face > trunk > extremities. 1o lesion: 1-6 mm, yellowish-white papule
(globules, NOT pigmented) w central dell.

Question 10

Acrochordon

Answer 10

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).

Question 11

Dermatofibroma

Answer 11

Benign tumor of fibroblasts.in adults, tan-brown, firm papules, 3-10mm, acquired, common on legs, (+) dimple sign.

Question 11

Dermatofibroma

Answer 11

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).

Question 12

Composition of Keloid

Answer 12

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.

Question 13

SignofLeser-Trélat

Answer 13

– Rapid increase in size or number

– Associated with internal malignancies, especially adenocarcinoma of the stomach (60%)

Question 14

SignofLeser-Trélat

Answer 14

– Rapid increase in size or number

– Associated with internal malignancies, especially adenocarcinoma of the stomach (60%)

Question 15

Intradermal nevus

Answer 15

Melanocyte nests are only in dermis. Tan to light brown. <6mm Papule or nodule. Head & neck most common.

Question 16

Compound Nevi

Answer 16

Melanocyte nests are @ dermal-epidermal junction AND in dermis. Tan-Black. <6mm Papule or nodule. Trunk & proximal extremitie

Question 17

junctional Nevi

Answer 17

Melanocyte nests are @ dermal-epidermal junction above BM. Tan-Black, 1-5mm, macules/papule. Anywhere, but common on plantar/palmar surfaces.

Question 18

Appropriate Nevi treatment

Answer 18

– Shave biopsy
– Punch biopsy
– Excision biopsy
anything else is baaad

Question 19

Blue Nevus

Answer 19

Melanocyte proliferation that produces abundant melanin. Blue color- optical effect where longer wavelengths are absorbed and shorter wavelengths are reflected back (Tyndall effect).

Question 20

Dysplastic Nevi

Answer 20

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.

Question 21

T or F: risk of melanoma approaches 100% in FAMM

Answer 21

True

Question 22

T or F: risk of melanoma approaches 100% in FAMM

Answer 22

True

Question 23

Criteria for FAMM

Answer 23

• 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

Question 24

Melanoma Mutations

Answer 24

CDK2NA mapped to 9p21
– CDK4 mapped to 12q14
– CMM1 mapped to 1p.

Question 25

Neurofibromatosis

Answer 25

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

Question 26

Cafe-Au-Lait spots

Answer 26

Subtle increase in number of melanocytes with increased melanin production
Multiple lesions associated with NF
– prepubertal child- 6 or more > 5 mm