Dermatology II

Question 1

T or F

Benign or malignant neoplasms can arise from any component of the skin

Answer 1

T

epidermis, dermis, adnexal

Question 2

What are the 2 types of neoplasma that arise from the dermis?

Answer 2

squamos

melanocytic

Question 3

Is seborhhaic keratosis malignant or benign?

Answer 3

Benign!

Question 4

Describe seborrhaic keratosis?

Answer 4

waxy, stuck on appearance, common in the elderly

Question 5

Sudden onset of multiple seborrheic keratosis can be a sign of (blank)

Answer 5

carcinoma of the GI tract (perineoplastic syndrome)

Question 6

What can you find in sebhorreic keratosis?

Answer 6

horn cysts

Question 7

What are horn cysts?

Answer 7

invaginations of epidermis

Question 8

What is this:

loose stroma, surrounded by epidermis. No malignant potential. Can infarct at stalk.

Answer 8

skin tags

Question 9

Are skin tags malignant or benign epithelial tumors?

Answer 9

benign

Question 10

How do you get hypertrophic scars/keloids and are the malignant or benign?

Answer 10

too much deposition of collagen.
often seen in black population, often due to trauma
Benign

Question 11

What is this:
invagination of epidermis into the dermis with subsequent keratinization- can rupture into surrounding tissue causing inflammatory response

Answer 11

Epidermal inclusion cyst

Question 12

Is an epidermal incusion cyst benign or malignant?

Answer 12

benign

Question 13

What is this:

scaly plaque, feels like sandpaper, can be scraped off and it will grow again.

Answer 13

Actinic keratosis

Question 14

Is actinic keratosis malignant or benign?

Answer 14

premalignant

Question 15

What does the histo of actinic keratosis look like?

Answer 15

hyperkeratosis

Question 16

What is this:

dyskeratosis that doesn’t extend the whole thickness of the epidermis

Answer 16

Actinic keratosis

Question 17

What is this:
extend through all layers of the epidermis and is called bowen’s if its in the genital region
Is this malignant or benign?

Answer 17

Squamos cell carcinoma in situ

Malignant

Question 18

Squamos cell carcinoma invades through (blank)

Answer 18

basement membrane

Question 19

What is this:
pink, pearl-like papule
elevated nodule w/ centra ulcerated center
Is it malignant or benign?

Answer 19

Basal cell carcinoma

Malignant

Question 20

What will the histo look like of basal cell carcinoma?

Answer 20

peripheral pallisading

Question 21

Freckles and cafe au lait spots are examples of (blank) patterns of growth and are melanocytic neoplasms

Answer 21

lentiginous

Question 22

T or F

Melanocytic neoplasms are on a spectrum from benign to malignant

Answer 22

T

Question 23

What are the three types of melanocytic neoplasms?

Answer 23

Nevus
Dysplastic nevus
Melanoma

Question 24

Nevas are common benign neoplasms that are acquired by activating mutation in the (blank) signaling pathway

Answer 24

Ras

Question 25

Nevi progress through a series of morphologic changes over time... what are they?

Answer 25

Junctional nevus Compound nevus Intradermal nevus

Question 26

What is a junctional nevus?

Answer 26

Found only in epidermis It is flat Most common nevus in children

Question 27

What is a compound nevus?

Answer 27

Raised, found in epidermis and dermis

Question 28

What is an intradermal nevus?

Answer 28

Junctional component is lost, now only in the dermis. Most common nevus in adults

Question 29

What is this: - may be direct precursors of melanoma - vast majority are stable and never progress - Have acquired activating mutations in NRAS and BRAF genes

Answer 29

Dysplastic nevus

Question 30

What 2 activating mutationsa are found in dysplastic nevi?

Answer 30

NRAS and BRAF

Question 31

When looking at a dysplatic nevus what should you be thinking about?

Answer 31

ABCDE

Question 32

Greater than (blank) mm in a dysplastic nevus is bad

Answer 32

6

Question 33

What is thsi: | most deadly of all skin cancers, but can be cured if detected in its early stages.

Answer 33

Melanoma

Question 34

Where do you find melanoma?

Answer 34

mostly occurs on skin but can occur within the mucosa

Question 35

if you get melanoma autosomal dominantly (10-15%) what kind of syndrom got you here?

Answer 35

dysplastic nevus syndrome

Question 36

Where does melanoma occur?

Answer 36

mostly occurs on the skin but can occur within the mucosa

Question 37

What is another cause besides autosomal dominant inheritance of dysplastic nevus syndrome that causes melanoma?

Answer 37

Sporadic due to UV radiation damage to DNA

Question 38

What does UV radiation mess with causing melanoma?

Answer 38

- cell cycle control genes - activate pro-growth signaling pathways - activate telomerase

Question 39

In melonma, the (blank) checkpoint is no longer functional.

Answer 39

P16

Question 40

What are the 4 subtypes of melanoma?

Answer 40

- superficial spreading - lentigo maligna melanoma - nodular - acral lentiginous

Question 41

What is the most common type of melanoma?:

Answer 41

superficial spreading

Question 42

``` What is this: Occurs on chronically sun-damaged skin More common in elderly Slow progression Growth of tumor is horizontal Good prognosis ```

Answer 42

lentigo maligna melanoma

Question 43

``` What is this: Most common type Involves back in men Involves back and legs in women Growth of tumor is primarily horizontal rather than down into the dermis ```

Answer 43

Superficial spreading melanoma

Question 44

What is this: | rapid growth, growth is vertical, giving tumor an increased Breslow's depth

Answer 44

Nodular

Question 45

What is this: more common in people with darker skin color (Asians and persons of African ancestry) Diagnosis is often delayed so lesions tend to be many centimeters in diameter.

Answer 45

Acral lentiginous

Question 46

What is this: morphological appearance is variable. Clinical appearance of pigment is subtle or often absent. Often confused with a variety of benign lesions such as psoriasis or dermatitis. Also confused with a variety of malignant lesions such as SCC in situ or basal cell carcinoma.

Answer 46

Amelanotic

Question 47

What kind of neoplasm is a pilar (hair) cyst?

Answer 47

an adnexal neoplasm | hair and calcification rolled in one

Question 48

Dermatofibroma sarcoma protuberans is (blank)

Answer 48

malignant

Question 49

Dermatofibroma is (blank)

Answer 49

benign fibrous histiocytoma