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malignant lesions Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the most common skin CA?

A

BCC

slow growing and locally destructive

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2
Q

where is BCC most common?

A

face, scalp, ears, neck

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3
Q

what are RF for BCC?

A

sun, white, sunburns before age 14, arsenic ingestion

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4
Q

subtypes of BCC

A

superficial, pigmented, morpheaform, ulcerating, sclerosing

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5
Q

most common variant of BCC?

A

pearly white or pink, translucent, dome-shaped papule w. overlying radom telangiectasias

the center eventually flattens or ulcerates, borders bcome raised or rolled, bleed, and develop crust/scale

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6
Q

tx of BCC

A

ED&C, excision, MMS for recurrent or high risk lesion

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7
Q

Superficial BCC

A

least aggressive variant

trunk/extremities,

resembles o Usually erythematous and scaly papules or plaques, but may or may not have the rolled border
o May resemble psoriasis, eczema, seborrheic keratosis, Bowen’s Disease, or tinea corporis

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8
Q

Pigmented BCC

A

resemble melanoma, contain melanen

thick hard area of variegated pigmentation

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9
Q

Morpheaform

A

least common and most subtle

white to yellow w/ poorly defined borders

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10
Q

ulcerated BCC

A

ulcer with a rolled border, often covered with a crust

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11
Q

sclerosing

A

inflitrating carcinoma, white sclerotic patch with ill defined border

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12
Q

SCC

A

potentially invasive, primary cutaneous malignancy of keratinocytes in the skin
or mucous membranes

20% of all skin cancers

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13
Q

SCC most common place

A

face, scalp, neck , and hands of older pts

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14
Q

SCC causes

A

UV, chemicals (arsenic and hydrocarbons), tobacco, chronic infx, chronic inflammation, HPV infxn

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15
Q

what does SCC look like?

A

flesh-colored, pink, yellowish, or red-colored indurated papules, plaques or nodues w. scale

+/- ulceration or erosion

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16
Q

SCC lymphnode metastisis?

A

palplate regional lymph nodes! (ear, scalp, lips, temples)

17
Q

tx of SCC?

A

ED&C, excision, or MMS

18
Q

Bowen’s Disease?

A

SCC in situ

presents as a slow-growin, slightly raised, red plaque w/ scale

19
Q

Erythroplasia of Queyrat’s

A

SCC in situ of the penis

20
Q

tx of Bowens?

A

5-FU, cryotherapy, ED&C, excision, MMS

21
Q

Kaposi’s Sarcoma

A

indolent sarcoma due to HV 8 (think immunocompromised)

22
Q

Kaposi’s sarcoma presentation

A

painless, pigmented nodules, usually on LE, diffuse pulmonary infiltrates, lymphedema

23
Q

Kaposi’s tx

A

many lesions resolve after ART, systemic chemo can cause remission in many pts with symptomatic visceral dz

interferon, radiation, chem

24
Q

melanoma

A

malignancy of melanocytes

most commonly develop as a new growth, but 30% arise w/in a preexisting mole

25
Q

Melanoma appearance

A

flat, raise, nodular or uclerated, color is variable

usually black or dark brown, but can be fleshed colored
** should be in ddx for any new mole presenting in adulthood or any mole changing in size, shape, or color

26
Q

Breslow Depth

A

*most important prognostic indicator

depth of lesion measured in mm

best to do a punch bx

27
Q

Clark level

A

level of anatomic invasion!

important in areas w/ thinner skin like eyelids, ears, and genitals

28
Q

most common cancer?

A

Females age 25-29 yo

29
Q

melanoma RF

A

PMH or FMH of melanoma or atypical nevus, fair skin, blue eyes, blonde or red hair, UV exposure, many moles, hx of blistering sunburns

30
Q

what should a skin exam always inclue?

A

LYMPH NODE CHECK

31
Q

what is the most common cause of death from melanoma

A

CNS mets

32
Q

types of melanoma

A

lentigo maligna, superficial spreading malignant, nodular malignant, acral lentiginous (palms, soles, nail beds)

33
Q

most common type of melanoma

A

superficial spreading

34
Q

what is best treatment?

A

prevention!!!

35
Q

melanoma on nails

A

dark brown or black pigmentation at proximal nail fold aka (Hutchison’s sign)

36
Q

pigmented streaks in nail beds?

A

longitudinal melanonychia- common in AA, may be sign of melanoma in caucasias

Derm (10 decks)

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