Cutaneous Malignancies

Question 1

Basal cell carcinoma is the most common what?
What is the most common presenting complaint of BCC?
It rarely does what?
How does it advance?

Answer 1

Invasive malignant cutaneous neoplasm
Bleeding or scabbing sore that heals and recurs
Rarely metastasizes

Question 2

Main risk factor for BCC and patient population?

Answer 2

UVB radiation exposure

Elderly population

Question 3

What is the mechanism of UVB and its effect?

How does BCC grow?

Answer 3

DNA damager and its repair system. Alters immune system

Direct extension

Question 4

85% of BCC appear where?

Where is the most common site?

Answer 4

Head and neck, upper lip

Nose alone

Question 5

What is the most common form of BCC?

Answer 5

Nodular BCC

Question 6

What is the second most common cancer among whites people?

What is a big difference between BCC and skin SCC?

Answer 6

Metastasis is very rare in BCC and SCC has much higher risk of metastasis

Question 7

What are the two major groups of SCC based on malignant potential?

Answer 7

Those arising from prior radiation or thermal injury, chronic draining sinuses or chronic ulcers (more aggressive)

Originating in actinically damaged skin (less aggressive)

Question 8

3 common sites on the body that we find SCC but that is rare for BCC?

Answer 8

Scalp, backs of hands, superior surface of the pinna

Question 9

What is a precursor lesion to SCC and how does that precursor lesion present?

Answer 9

Actinic keratosis

Red, inflamed, hyperkeratotic scaly lesion

Question 10

4 things to remember about melanoma:

Answer 10

Most dangerous and deadly
High metastatic potential
Poor prognosis with metastasis
UV light

Question 11

4 types of melanoma and describe each one?

Answer 11

Superficial spreading, most common, radial growth
Lentigo maligna melanoma, radial growth, most common in elderly
Nodular, early vertical growth, poor prognosis.
Acral lentiginous, not UV related, arises in dark skinned peeps on palms and soles

Question 12

How do we distinguish melanoma clinically?

What are two late clinical signs of melanoma?

Answer 12

ABCD

Ulceration and bleeding

Question 13

What are 3 common colors of melanoma and 2 others in addition but not as common?

Answer 13

Red white and blue

Brown and black

Question 14

What must be referred to specialist in regards to melanoma?
What is the most important prognostic factor of melanoma?
Diagnosis of melanoma is by what?

Answer 14

Diagnosis, biopsy and excision

Depth of invasion

Excisional biopsy

Question 15

How to perform diagnostic excisional biopsy of melanoma lesion?

Answer 15

Must contain 1-2 mm of normal skin and normal subcutaneous fat

Question 16

5 skin procedures when dealing with lesions that we can perform?
Which one is most common?

Answer 16

Shave biopsy, most common
Punch biopsy
Excision and invision/wedge biopsy
Electrosurgery devices 
Destructive techniques like freezing it off

Question 17

What 3 cancers is prutitus a manifestation of?

Answer 17

Lymphoma, leukemia, and CNS tumors

Question 18

What cancer is acanthosis nigricans highly associated with?

Answer 18

Gastric cancer

Question 19

What cancer can vitiligo be associated with?

Answer 19

Malignant melanoma

Question 20

What 3 tumors can pemphigus occur with?

Answer 20

Lymphoma, Kaposi’s sarcoma, thymic tumors

Question 21

What disease and cancer is dermatitis herpetiformis associated with?

Answer 21

Celiac disease and gastrointestinal lymphoma

Question 22

How do we best characterize actinic keratosis and what patient population does it most commonly occur in?

Answer 22

Scaly, erythematous macule or patch not he skin and usually develops in the sun exposed areas of elderly and fair skinned individuals.

Question 23

What is Bowen’s disease and what can we also call it and what is the main sign of it?

Answer 23

Very early form of skin cancer
Squamous cell carcinoma in situ. This is confined to the epidermis.
Red, scaly patch on skin.

Question 24

What is erythroplasia of Queyrat and what is it associated with?

Answer 24

In situ SCC affecting the glans penis or vulva

HOV infection