Cutaneous Neoplasms Flashcards
WHat are the relevant epithelial (epidermal) tumors?
- Seborrheic keratoses
- actinic keratosis
- squamous cell carcinoma
- keratoacanthoma
- basal cell carcinoma
What is seborrheic keratosis/what does it look like? who gets it? where is it most common?
- very common cutaneous neoplasm
- common in middle age or older patients
- brown or tan waxy papules and plaques with a “stuck on” or warty appearance
- most common on face, trunk, and upper extremeties
- Leser-Trelat sign
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What is the Leser-Trelat sign?
sudden onset of multiple seborrheic kertoses associated with internal malignancy (usually stomach cancer)
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what is visible on this histology slide?
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seborrheic keratoses
What is actinic keratoses? what is it also known as? what is it a result of?
who gets it? what d they look like?
- aka solar keratosis
- common lesiosn that develop as a result of chronic sundamage
- predilection for sun-exposed areas
- middle-age to elderly
- red tan-brown macules with “gritty” sandpaper like scale
- may regress or remain stable
- .1-10% become malignant
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what is seen on this histology slide?
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Actinic Keratosis
retention of nuclei in the corneum and loss of granular layer. lower 1/3 of epidermis is very irregular.
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who gets squamous cell carinoma and what are predisposing factors?
- common neoplas in older individulas, 20% of all skin cancers
- UV radiation is most common cause (DNA damage)
- also chronic ulcers, old burn scars, HPV, radiation, arsenic, immunosuppression
How does SCC in situ present? How does Invasice SCC present?
WHat is the risk of metastasis of insitu?
- SCC in situ presents as red scaly plaque
- Invasive SCC lesions are nodular and may ulcerate
- 5% of insitu become invasive, and risk of metastasis is 2-4%, but even higher if immunosuppressed
- likelihood of metastasis is related to location and degree of invasion
What is this?
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SCC in situ
full thikness (thicker) basal layer to top and you lose the granular layer
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what is this?
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Invasive SCC
no longer is contained to the epidermis it is almost down to the fat in this image
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What is a Keratoacanthoma? How does it grow? what causes it?
- variant of squamous cell carcinoma with pink papule or nodule with a central keratin plug
- grows rapidly over 2-10 weeks
- usually occurs due to sun damage and may resolve spontaneously, but treatment is usually advocated bc can cause extensive local destruction
- in immunosuppresed patients, mulitple lesions may be present
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What is shown on this histology slide?
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Keratoacanthoma
WHat is the most comon human cancer?
Basal Cell Carcinoma
What causes basal cell carcinoma? How does it grow? What is it associated with?
- secondary to chronic sun exposure/UV radiation
- can be locally destructive, and is slow growing/rarely metastasizes
- When it metastasizes, patient is often immunocompromised
- associated with dysregulation of sonic hedgehog or PTCH pathway (30-40%)
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What do basal cell carcinomas look like?
pink, pearly papules with prominent arborizing subepidermal blood vessels (telangiectasia). Ulceration and erosion are common
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What doe sit mean to say that a basal cell carcinoma has retracted?
it broke away from surrounding stroma
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What are the common melanocyti tumors?
- melanocytic nevi
- acquired melanocytic nevus
- congenital melanocytic nevus
- dysplastic nevi
- melanoma
Where are melanocytes usually seen and what do they increase with? WHat are the 3 classifications melanocytic nevi can be histologically?
- melanocytes are normally seen in epidermis, and increase with sun exposure (acquired nevi), also present aat birth (congenital nevi)
- histologically melanocytic nevi can be:
- junctional (dermal epidermal junction)
- compound (epidermis and dermis)
- intradermal (in dermis only)
What do acquired melaocytic nevi usually look like?
- pink, tan or brown uniformly pigmented papules and macules
- small (usually < .5cm) well-defined, smooth borders
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