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Gen Med: Dermatology > Malignant Neoplasms of the skin > Flashcards

Malignant Neoplasms of the skin Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the malignant neoplasms of the skin?

A
  1. Actinic Keratosis
  2. Basal Cell Carcinoma
  3. Squamous Cell Carcinoma
  4. Dysplastic Melanocytic Nevi
  5. Malignant Melanoma
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2
Q

What % of skin cancers occurs on the head and neck?

A

80%

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3
Q

What is actinic keratosis?

A
  1. Sun induced Premalignancy
  2. Seen in older adult pt’s
  3. Erythematous scaling papules or plaques
    A. Feels like sandpaper
  4. Located on sun exposed skin
    Face, Neck, Dorsal hands/arms
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4
Q

How is actinic keratosis dx?

A

Clinical, Bx if unsure

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5
Q

How is actinic keratosis treated?

A

Cryo, ED&C, Topical 5FU

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6
Q

What is basal cell carcinoma most common in?

A
  1. MC form of primary cutaneous malignancy
  2. MC in older adults >40yo to sun-exposed skin
  3. MC in fair skin pt’s (skin types I & II)
  4. MC on face/scalp/ears/neck, trunk/extr’s
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7
Q

What are the sxs of basal cell carcinoma?

A

Persisting lesion, enlarging, painful/bleed/itch

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8
Q

What are risk factors for BCC?

A

High Cumulative UVR, ionizing rad.

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9
Q

What are the severe clinical variants of BCC?

A
  1. Nodular, Pigmented, and Micronodular (infiltrative) BCC

2. Superficial BCC and Morpheaform BCC

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10
Q

What is the prognosis for BCC?

A

95% cure rate if detected early, Metastases extremely rare

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11
Q

What is the tx for BCC?

A

Surg Exc., ED&C, Moh’s Surgery

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12
Q

How is BCC prevented?

A

Annual FBE and Educate pt on MoSSE and Sun Prot

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13
Q

What are the MC’s for SCC?

A
  1. 2nd MC form of primary cutaneous malignancy
  2. MC in older adults >40yo to sun-exposed skin
    May arise from AK’s or KA’s or arise de novo
  3. MC in fair skin pt’s (skin types I & II)
  4. MC on face/scalp/ears/neck, trunk/extr’s
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14
Q

What are the sxs of SCC?

A

Persisting lesion, enlarging, painful/bleed/itch

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15
Q

What are the risk factors of SCC?

A

High Cumulative UVR, ionizing rad.

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16
Q

What are the clinical variants of SCC?

A
  1. Clinical Variants depend on depth of invasion
    A. SCC in situ (Bowens Disease) – Confined with in epidermis
    B. SCC invasive – dermoepidermermal junction is breached
17
Q

What is the prognosis for SCC?

A
  1. Surg exc nonmetastatic SCC PX is excellent

2. Metastatic rate for SCC is 2-6% (check LN’s!)

18
Q

What is the tx for SCC?

A

Surg Exc., ED&C, Moh’s Surgery

19
Q

How can SCC be prevented?

A

Annual FBE and Educate pt on MoSSE and Sun Prot

20
Q

What is dysplastic malanocytic nevi?

A
  1. Atypical Nevi considered to be part of a spectrum between benign nevi and melanoma
  2. Believed to have incr risk for malignancy depending on the severity of the atypia
    A. Controversy around the exact incidence (1-40%)
21
Q

How are dysplastic melanocytic nevi managed?

A
  1. Recommended to Bx Atypical appearing lesions

A. Surg Exc (2mm margins) if shows signs of dysplasia

22
Q

What are the ABCDEs for dysplastic melanocytic nevi?

A 
A = Asymmetry
B = Border Irregularity
C = Color variation
D = Diameter >6mm
E = Enlarging/Evolving
23
Q

define melanoma

A

Malignancy of Melanocytes and nevus cells

24
Q

What are the risk factors for melanoma?

A
  1. Fair complexion (skin types I & II)
  2. Numerous Atypical Nevi (>50)
  3. Large Congenital Nevi
  4. PMHx or immediate FAMHx of Melanoma
25
Q

Where is MM found on the body?

A
  1. MM can arise on any part of the body
    A. MC on trunk for men
    B. MC on lower extr for women
26
Q

What are the types of MM?

A
  1. Superficial Spreading MM – MC form of MM in lighter skin
  2. Nodular MM – Pigmented slowly enlarging ulcerative nodule
  3. Acral Lentiginous MM – MC form of MM in darker skin types, hands and feet involvement
  4. Lentigo Maligna MM – MC form in elderly, sun exposed areas
  5. Amelanotic MM – nonpigment producing variant of MM
27
Q

How is MM dx?

A
  1. Biopsy recommended for any suspicious lesion
    A. Excisional Bx method of choice (Punch if necessary)
    B. Do not Shave Bx a suspected MM (miss the vertical)
28
Q

What is MM tx based on?

A
  1. Tx decisions (Margins/SLN Bx) and Prognosis
    A. Based off of depth of MM invasion
    -Clark’s Levels or Breslow’s Depth
    B. Based off of TNM system
29
Q

How is MM followed up?

A
  1. Routine f/u depends on stage of MM
    A. FBE with LN evaluation q 3, 6, 12 Mo’s
    B. Labs for CBC and LFT’s
    C. CXR

Gen Med: Dermatology (10 decks)

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