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MS Week 1 > Derm/Path > Flashcards

Derm/Path Flashcards

1
Q

Pigmented lesions caused by increase in melanocytes?

A

Melanocyte hyper plasmia (lentigo simplex) or melanocytic neoplasmia (nevi, melanoma)

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2
Q

What causes a solar lentigo?

A

Increased melanin, normal number of melanocytes, due to chronic sun exposure!

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3
Q

What is lentigo simplex?

A

An increase in the NUMBER of melanocytes, not sun related.

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4
Q

What is a neoplasm?

A

Unregulated cell growth- cells originating from one cell that does not obey the laws of cell growth. These come from stem cells and differentiate to look like a specific type of cell.

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5
Q

Melanocytic neoplasm

A

A neoplasm of the melanocytes

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6
Q

Stromal neoplasm

A

A neoplasm of the dermis- mesenchymal cells

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7
Q

Hematopoietic neoplasm

A

T/B cells

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8
Q

Metastasis/non cutaneous origin neoplasm

A

From visceral cell type

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9
Q

How is benign neoplasm different from a malignant one?

A

Benign has NO CAPABILITY TO METASTASIZE, whereas malignant HAS THE CAPACITY TO METASTASIZE.

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10
Q

How are epithelial neoplasms classified?

A

By the presence/absence of invasion bast the basement membrane into foreign tissue, must get to dermis to get to the blood

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11
Q

What do you call a benign vs malignant melanocytic neoplasm?

A

Nevi vs melanoma

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12
Q

What do you call a benign vs malignant epithelial neoplasm?

A

adenomas vs carcinoma

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13
Q

What do you call a nevus that is difficult to characterize? Why are they clinically important?

A

Spitz- ALL SHOULD BE EXCISED may have significant histologic overlap with melanoma.

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14
Q

If a nevus is raised what layer is it in?

A

DERMIS

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15
Q

What is a blue nevus?

A

A nevus that starts in the dermis (unlike most in epidermis)

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16
Q

Why are dysplastic nevus clinically significant?

A

They serve as a marker for risk of melanoma- hereditary significant higher risk in your lifetime if you have many dysplastic nevi.

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17
Q

What does melanoma arise from?

A

Nevi (dysplastic) or can occur randomly

18
Q

Evaluation for melanoma is based on (ABCD):

A 
symptoms: itchy, changing mole
A- asymmetry
B- border
C- color
D- diameter
19
Q

How to differentiate between melanoma in situ and malignant melanoma?

A

Depth- if below BM then it is melanoma malignant, if above in situ

20
Q

What is significant about desmoplastic melanoma?

A

Spindle cell morphology, with LESS RISK OF METASTASIS. Though it is deep it is unlikely to metastasize leading to a good pronosis

21
Q

How can we estimate the probability of metastasis of melanoma?

A

BRESLOW DEPTH measures in mm is our best prognostic indicator!
If >1mm do a sentinel lymph node biopsy

22
Q

What factors influence melanoma staging?

A

breslow depth, ulcerations (bad- tell us these behave more poorly than other melanomas of same depth) and mitotic figures

23
Q

What is a seborrheic keratosis?

A

A benign, squamous proliferation caused by increased melanin– stuck on appearance of papule

24
Q

What is a skin tag?

A

A non-neoplastic cutaneous lesion- could be melanoma though so send to lab. Increased with pregnancy, diabetes and obesity

25
Q

What is actinic keratosis (AK)?**

A

A benign, squamous neoplasm that is a PRECURSOR to squamous cell carcinoma

  • Induced by sunlight
  • looks like red, scaly plaques
  • Located in EPIDERMIS- shave biopsy
26
Q

Squamous cell carcinoma of the skin

A

Red, scaly plaques on sun-exposed skin

  • LOW metastatic risk!
  • often raised
  • depth here doesn’t matter! shave is OK
27
Q

What is the most common human malignancy?

A

Basal cell carcinoma, RARELY metastasize but locally destructive! CUT OUT.

  • risk due to sun exposure and fair complexion
  • named because it can resemble the basal layer of the epidermis
28
Q

What are the most common types of basal cell carcinoma? Are they likely to metastasize?

A

Superficial (plaque- often scaly and red- shave biospsy) and nodular BCC, NO!

29
Q

What are the adnexal proliferations/neoplasms that are associated with hereditary tumor syndromes?

A

Cowden syndrome and

Muir torre syndrome

30
Q

What are the key features of cowden syndrome

A
  • AD
  • Multiple trichilemmomas (face, cobblestone tongue)– a hair follicle like benign tumor
  • Often have a visceral carcinoma like BREAST
  • Mutation in the PTEN gene (a tumor suppressor)
31
Q

What is clinically significant about sebaceous carcinoma?

A

It is malignant, metastasis is not common but you need to get this out- lower part tells that it is cancer CANNOT SHAVE.

32
Q

What are they key features of muir torre syndrome

A
  • Hereditary germline mutation in DNA mismatch repair proteins, MLH1, MSH2, MSH6 and PMS2
  • Lead to multiple sebaceous adenoma and carcinomas (extraocular!)
  • Often have an internal colorectal cancer!
33
Q

What are merkel cell carcinomas clinically significant?

A

They are a rare, aggressive epithelial neoplasm that are caused by polyomaVIRUS.

34
Q

What is a dermatofibroma?

A

A benign, fibrous dermal proliferation common to the legs- possibly neoplastic
PUNCH BIOPSY

35
Q

What is a hemangioma?

A

A solitary purple/red papule, congenital or acquired –> shave is fine

36
Q

What is kaposi sarcoma?

A

A malignant vascular neoplasm caused by HHV-8, found often in immunosuppresed

37
Q

What is angiosarcoma?

A

An aggressive malignant vascular neoplasm- head/neck of elderly- or post radiation

38
Q

Cutaneous T-cell lymphoma? What is one important type

A

A slowly progressive disease
NON-SUN EXPOSED skin –> bathing suit distribution
If cells circulate in blood –> sezary sydrome (red all over)

-Mtcisus fungoides, most common CTCL of neoplastic CD4+ T cell. Infiltrate the epidermis leading to redness! PUNCH.

39
Q

Cutaneous B cell lymphoma?

A

A few solitary nodules, rather than multiple like CTCL. Head or face often (sun exposed!) involving the deep dermis (vs epidermis in CTCL). PUNCH BIOPSY.

40
Q

Benefits of shave biopsy? Used for?

A

Better cosmetics, fast, no sutures

Used for BCC, AK, SCC in situ, pigmented macules

41
Q

Benefits of punch biopsy? Used for?

A

Bigger sample but requires sutures

Used for nodular BCC, SCC, melanoma and most rashes

MS Week 1 (11 decks)

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