Derm Cancers 1 Flashcards
Mast cells, basophils
Type 1 immunology
skin colored, erythematous or yellowish
Squamous Cell Carcinoma (SCC)
Type 1 Immunology
- IgE (ER)
- Mast cells, basophils
- e.g. Hives
cytotoxic
Type II immunology
Immune complex
Type III immunology
Type III imm
- immune (antigen-ab) complex
- platelet damage, vascular permiability
- vasculitis
cell-mediated immunity
Type IV
poison ive
blistering diseases
defect in Basement Membrane Zone (BMZ)
what affects mucous membrane and causes pustules?
candida
SK Tx
- reassure
- cosmetic:cryotherapy, curettage with electo…., shave
- excisional biopsy
- greasy
- stuck on
- tan to black
- 2mm-3cm
- trunk but anywhere
Seborrheic Keratosis (SK)
- tan to black papule
- irregular but well-circumscribed
- 2mm-3cm
Seborrheic Keratosis (SK)
- suddenly many SK
- with many skin tags
Lesler-Trelat sign
- sign of internal malignancy
- many skin tags
- suddenly many SK
Lesler-Trelat sign
- rapid growth (4-6 wks)
- biologically Benign but histologically SQUAMOUS CELL melanoma
- resolves on its own within 6 months
- round flesh colored nodule
keratoacanthoma
flesh colored, round nodule
rapid
keratoacanthoma
keratoacanthoma
- flesh colored, round nodule
- rapid (4-6 wks)
- resolves within 6 months
- resembles SCC
- benign but often precursor to SCC
- <1 mm - several cm
- skin colored, white or light (can be pink)
- scale or rough patch
- FELT more easily
Actinic Keratosis (AK)
Actinic Keratosis (AK) Tx
5-FU cream/imiquimod
cosmetic: cryotherapy, curettage, shave, biopsy
chem peels
benign precursor to SCC
sun exposure
Actinic Keratosis (AK)
- firm/hard nodule/papule, often depressed center
- “Pearly” “waxy”, rolled borders
- teleangiectasias
- few mm-1 cm
- pink/red, pale yellow, translucent
Basal Cell Carcinoma (BCC)
Basal Cell Tx
- biopsy if ? ab Dx
- refer to derm for any skin cancer
- cosm: cryotherapy, curettage/electrodessication, excisional biopsy
- MOHS
- 5 FU, Imiquimod
- HEAD and FACE lesions most likely to metastasize
- low risk for met
SCC
What condition can often lead to SCC
Actinic Keratosis (AK)
SCC Tx
- surgical resection (cure >90%)
- MOHS if > 2cm and recurrent
- Cosm: cryotherapy, curettage/electro
- If metastasized: radiation, chemo
Melanoma Tx
- wide surgical excision with margins
- elective lymph node dissection
- Chemo: DTIC Dacarbazine
- Immuno: interferon-alpha
- Gene therapy
- F/u q 3 months
dermis
- contains vessels, nerves, appendages
- 1mm-4 mm
- collagen, elastic fibers, ground substance
- 1st as flat/slightly raised discolored patch
- IRREGULAR borders (vs. nodular is more regular)
- tan, brown, red, blue white
- RADIAL before VERTICAL
- in previously benign mole
Superficial Spreading Melanoma
- long horizontal growth, then RAPID vertical
- flat or mildly raised, mottles (spots)
- older ppl, sun-exp
- in situ turned invasive
- shades of brown
- subtype of MM
Lentigo Maligna
- rapid vertical growth (wks to months)
- little/no radial growth
- inflamed/friable nodule
- black or any color
- looks like superficial spreading melanoma
Nodular Melanoma
most aggressive form of melanoma
nodular melanoma
what looks like Superficial Spreading Melanoma?
Nodular Melanoma
rapid vertical growth (wks to months)
Nodular melanoma
ABCDs of melanoma
- assymetry
- border, irregular
- color, uneven
- diameter >6 mm
- other: color spreads into surrounding skin, new nodule, inflammation beyond mole, tender, itch, bleeding, oozing
sampling of melanoma
!!! ALWAYS require a FULL thickness biopsy!!!
!!! do NOT cauterize or shave !!!
- localized erythematous PATCH or plaque on TRUNK > 5 cm
- itchy
- Sezary cells later
- Tx: refer to oncology/derm
Mycosis Fungoides (AKA Cutanious T Cell Lymphoma)
- may appear in previously benign mole
- horizontal before vertical invasion
- irregular borders
Superficial Spreading Melanoma
Felt easier than seen
Actinic Keratosis
Scale or dry rough patch
