Dermatology Lecture

Question 1

Melanoma - incidence?

Answer 1

5th most common cancer in the UK

Question 2

Melanoma - pathogenesis

Answer 2

Melanocytic naevi (normal) ——dysplasia——-> In situ melanoma (99% survival) –> superficial spreading melanoma —> nodular melanoma

Question 3

What’s a halo naevus?

Answer 3

Skin paler around naevus because lymphocytes attack it

Question 4

Melanoma - what’s it

Answer 4

Superficial spreading melanoma, typical…non-pigmenting melanoma is very difficult

Question 5

Lentigo Maligna - what is it?

Answer 5

Lentigo simplex is v common in elderly - maligna is its change

Question 6

What are acral lentiginous and amelanotic nodular melanoma?

Answer 6

Nr 1 under the nail - differ from trauma (trauma isn’t as straight and grows out, is sudden onset)

Nr 2 looks like very round reddish wart

Question 7

Risk Factors of melanoma

Answer 7

Sun, genetic

Question 8

What symptoms should cause referrals

Answer 8

Any uncertainty regarding dx.

Changes: colour, itching, size, pain, regularity..

Question 9

Basal cell carcinoma

Answer 9

Presentation?

Question 10

Squamous cell carcinoma - Presentation

Answer 10

Hyperkeratotic, it ulcerates (bleeds etc), nodular

Question 11

Actinic keratosis (Solar keratoses)

Answer 11

pre-malignant, need excision to make sure its not SCC

Question 12

Bowens disease

Answer 12

Intraepidermal squamous cell carcinoma - pre-malignant.

Question 13

Cutaneous T-cell carcinoma

Answer 13

Patch stage mycpsos gungoides… gets confused with psoriasis and eczema - often missed

Question 14

Cutaneous B cell lymphoma

Answer 14

is also very rare.. nodules, sometimes skin-coloured

Question 15

Skin metastases

Answer 15

Are v important - hx of cancer?

Question 16

Other systems affected?

Answer 16

Psychiatric link - brain inflammation - directly alter neurotransmitter such as blocking serotonin. Can cause suicide and depression

Question 17

Alopecia areata - LOOK UP EXAMINABLE

Answer 17

Vitiligo, pernicious anaemia, diabetes, immune thrombocytopenia, addisons

Question 18

Scarring alopecia

Answer 18

SLE associated

Question 19

Leg ulcers

Answer 19

Important - warfarin induced necrosis.

Penicillin rash- can turn life threatening