Epidermal Tumours Flashcards by Emma Feechan

example of a benign epidermal tumour

seborrheic keratosis (basal cell papilloma)

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examples of precancerous dysplasia

Bowen’s disease
actinic keratosis
viral lesions

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examples of invasive malignancies

basal cell carcinoma

squamous cell carcinoma

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define seborrheic keratosis

benign proliferation of epidermal keratinocytes

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where is seborrheic keratosis usually located

face

trunk

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appearance of seborrheic keratosis

well-defined
small cysts/ depressions
warty
stuck on apperance
greasy hyperkeratotic surface

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define leser-trelat sign

abrupt eruptive onset of multiple seborrheic keratoses (paraneoplastic syndrome)

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management of seborrheic keratosis

reassurance

cryotherapy if troublesome

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define Bowen’s disease

full thickness dysplasia of epidermal keratinocytes

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diagnosis of Bowen’s disease

biopsy

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management of Bowen’s disease

non-surgical is imiquimod cream

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where is Bowen’s disease usually located?

legs

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appearance of Bowen’s disease

scaly patch/plaque
irregular border
can mimic inflammatory conditions

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where is actinic keratosis usually found

head

neck

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what is a common precursor of invasive SCC

actinic keratosis

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where is actinic keratosis usually found?

sun-exposed sites

presentation of actinic keratosis

scaly with no signs of progression (can become SCC- more common in immunosuppressed)

where are viral lesions found?

anogenital skin

causes of viral lesions

HPV16

management of precancerous dysplasias

cryotherapy
5-fluorouracil cream
imiquimod
PDT

genetics of basal cell carcinoma

mutations in PTCH1 (hedgehog signalling pathway)

where is basal cell carcinoma often located?

sun exposed sites

appearance of BCC

slow growing
painless
picket fence pearly border

three subtypes of BCC

nodular (pearly with blood vessels)
superficial (plaque with pearly whipcord margin)
infiltrative (waxy, scar-like plaque with indistinct borders)

diagnosis of epidermal tumours

skin biopsy

management of epidermal tumours

vismodegib excision imiquimod, PDT or cryotherapy

who does squamous cell carcinoma arise in?

elderly | immunosuppressed

where are SCC usually located?

sun-exposed sites chronic leg ulcers burns chronic lupus vulgaris

rare associations with SCC

xeroderma pigmentosum | dystrophic variant epidermolysis bullosa

presentation of SCC

hyperkeratotic warty or crusted lump or ulcer fast growth painful bleeds

management of SCC

excision

who does Kaposi's sarcoma arise in?

HIV | immunosuppressed (transplant)

appearance of Kaposi's sarcoma

purple lesions (herpes)

risk factors for development of skin cancer

- sun exposure - genetic predisposition - immunosuppression - environmental carcinogens - phototoxic drugs

examples of genetic predispositions to skin cancer

xeroderma pigmentosum albinism (congenital absence of melanin AR) Gorlin's syndrome recessive dystrophic epidermolysis bullosa

describe albinism

congenital absence of melanin (AR), absence or defect of tyrosine, lack on retina leads to visual problems e.g. photophobia, nystagmus and amblyobia

describe Gorlin's syndrome

AD condition with multiple BCC's (naevoid basal cell carcinoma)

examples of phototoxic drugs

``` voriconazole thiazide diuretics NSAIDs anti-TNF azathioprine ```