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Derm 1 > Malignant Vs Benign Lesions > Flashcards

Malignant Vs Benign Lesions Flashcards

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Dermatology Board Prep flashcards
1
Q

Benign or malignant? Symmetrical shape, slow growing, rarely ulcerated, rarely friable, uniform color

A

Clinical clues for benign lesion

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2
Q

Benign or malignant? Irregular contours, slow or rapid growth, may ulcerate and bleed, often friable, variation in color

A

Clinical clues for malignant lesion

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3
Q

Most common human form of skin cancer

A

Basal cell carcinoma

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4
Q

What is the 1st and 2nd most common types of BCC?

A

1 - Nodular BCC 2 - Superficial BCC

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5
Q

Actinic keratosis (AK) left untreated can develop into what?

A

Squamous cell carcinoma (SCC)

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6
Q

Least common/most dangerous form of skin cancer?

A

Malignant melanoma

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7
Q

ABCDE “red flags” of melanoma

A

Asymmetry Borders (irregular) Color (variation) Diameter (>6 mm) Elevation/enlargement/evolving

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8
Q

What skin condition is pictured here? It is characterized by a papule/nodule, telangectasia and often described as pearly?

A

nodular basal cell carcioma

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9
Q

What skin condition is pictured here? It is characterized by threadlike borders and central crust, often with superficial plaques?

A

superficial basal cell carcinoma

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10
Q

What skin condition is pictured here? It is characterized by a papule/nodule that can be pigmented/necrotic and telangectasia?

A

ulceratvie basal cell carcinoma

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11
Q

What skin condition (pictured here) is often described as the “sore that won’t heal” and is more common in males than females?

A

actinic keratosis (AK)

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12
Q

What are the risk factors for basal cell carcinoma?

A
  • sun exposure
  • history of skin cancer
  • cigarette smoking
  • suppressed immune system
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13
Q

Evidence suggests that sunscreen is preventative for what kind of skin cancer?

A

squamous cell carcinoma

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14
Q

What are the treatment options for basal cell carcinoma?

A
  • surgery (MOHs for facial lesions)
  • cryosurgery
  • topical chemo
  • radiation
  • antiinflammatory diet
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15
Q

What are the preventative measures that can be taken for AK?

A
  • sunscreen
  • carotenoids (lycopene/tomato paste, vitamin A, Lutein, beta carotene)
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16
Q

What is the treatment for AK?

A
  • surgery/excision
  • cryosurgery
  • photodynamic therapy
  • 5 FU
  • topical NSAID
  • antiinflammatory diet
  • chemical peels (ingenol mebutate/Picato gel)
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17
Q

What cancer of the keratinocytes can develop from AK and is potentially metastatic?

A

squamous cell carcinoma

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18
Q

What are some risk factors for squamous cell carcinoma?

A
  • fair skin
  • excessive sun exposure
  • chemical carcinogen exposure
  • arsenic exposure
  • HPV/immunesuppresion
  • inflammatory diet
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19
Q

What skin condition is characterized by:

  • tender erythematous paule/nodule
  • hyperkeratosis/keratotic horn
  • ulcerations and bleeding of the lesion
  • commonly on lip, ear, tongue, head, neck and back of hand
A

Squamous cell carcinoma

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20
Q

What is the treatment for squamous cell carcinoma?

A
  • electrodessication and curettefe for small SCC
  • excision with biopsy for large SCC
  • MOHs surgery for facial SCC
  • cryotherapy for trunk and limb SCC
  • photodynamic therapy for superficial SCC
  • antiinflammatory diet
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21
Q

What are some possible CAM treatments for squamous cell carcinoma?

A
  • grapeseed oil
  • green tea
  • milk thistle
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22
Q

Cancer of the melanocytes?

A

malignant melanoma

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23
Q

What skin condition pictured here is often tender, ulcerates and bleeds?

A

squamous cell carcinoma

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24
Q

What are the risk factors for melanoma?

A
  • family or previous history
  • light skin/red hair
  • multiple sunburns
  • >50 nevi
  • immunesuppresion
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25
Q

What is the etiology of melanoma?

A

blistering sunburns appear to be the initiating event that causes melanoblastic tumor to develop

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26
Q

What skin condition is characterized by irregular, asymmetric raised nodules that are often multicolored?

A

melanoma

(Acral lentiginous melanoma pictured here)

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27
Q

LIst the 4 types of melanoma in order of most common to least common

A
  • superficial spreading (60-70%)
  • nodular melanoma (15-30%)
  • lentigo maligna (5-15%)
  • acral lentiginous melanoma (5-15%)
28
Q

This skin condition affects ages 30-50 and is characterized by radial growth with nodular formation when 2.5 cm or more

A

superficial spreading melanoma

29
Q

This skin condition affects individuals in the 6th decade of life, usually on the head, neck or trunk and has no radial growth

A

nodular melanoma

30
Q

This skin condition affects individuals in the 7th decade of life and has very slow radial growht primarily on the nose and cheeks

A

lentigo maligna melanoma

31
Q

What is Hutchinson’s sign?

A

periungual spread from nail as seen in acral lentiginous melanoma

32
Q

What is this and what is the concern?

A

a pigmented band that is normal in 90% of black individuals but if suddenly appears, could suggest acral lentiginous melanoma

33
Q

What is this and what is it suggestive of?

A

splinter hemorrhages could suggest acral lentiginous melanoma

34
Q

How is melanoma diagnosed?

A
  • excisional bipsy

depth of invasion determines whether lymph nodes are checked

35
Q

At what depth of melanoma invasion is there possible lymph node involvement?

A

0.75 to 1.5 mm

36
Q

At what depth of melanoma invasion is there likely lymph node involvement and thus sentinel nodes are checked?

A

> 1.5 mm

37
Q

What are some preventative measures for melanoma?

A
  • Vitamin D
  • polyphenols (green tea, grapeseed, pomegranate)
  • mediterranean diet
  • avoid intense, intermittent UV exposures and sunburns
38
Q

What is the conventional treatment for melanoma?

A
  • surgery with possible removal of lymph nodes
  • interferon/immune based therapy
  • cytotoxic therapy
  • radiation
39
Q

What are some supportive therapies to conventional treatment for melanoma?

A
  • antiinflammatory diet
  • citruc pectin and bioflavonoids prior to surgery
  • cytotoxic agents (vitamin A, C, green tea and carotenoids)
  • silymarin, curcumin, vit E and melatonin reduce side effects of treatment
  • Vit D, azelaic acid, birch bark, licorice, ginseng
40
Q

Brown macule/melanocytic nest at the junction of the epidermis and dermis?

A

junctional nevus

41
Q

Skin-colored or lightly pigmented brown papule with nest of melanocytes in the dermis?

A

intradermal/dermal nevus

42
Q

What kind of nevus can resemble basal cell carcinoma?

A

dermal nevi

43
Q

brown papule that has melanocyte nest both in the dermis at at the junction of the dermis and epidermis

A

compound nevus

44
Q

Name the different types of benign nevi?

A

junctional

dermal

compound

45
Q

What skin condition is this?

A

junctional nevus

46
Q

What skin condition is this?

A

dermal nevus

47
Q

What skin condition is this?

A

compound nevus

48
Q

What is the treatment of benign nevi?

A
  • leave alone and monitor
  • if any changes occur, consider removal
49
Q

This skin condition has telangectasia, is soft, small and shows central umbilication. What is it and what is the DDX?

A

sebaceous hyperplasia

DDX = basal cell carcinoma which would be firmer on palpation

50
Q

What age group is most often affected by sebaceous hyperplasia?

A

30’s

51
Q

What is the treatment for sebaceous hyperplasia?

A
  • shave excision
  • light electro
  • chemical cautery
52
Q

What skin condition has a posible viral etiology, is characterized by a dome shoped papule or nodule with central keratin plug and shows rapid growth?

A

keratocanthoma

53
Q

What age group is commonly affected by keratoacanthoma?

A

50+

54
Q

What are the differential diagnoses for keratoacanthoma?

A

BCC, SCC, AK and wart

55
Q

What skin condition is a possible precursor to superficial spreading melanoma?

A

atypical/Clark’s malnocytic/dysplastic nevus

56
Q

Where are atypical/Clark’s malnocytic/dysplastic nevi typically found on caucasians?

A

anywhere on skin surface

57
Q

Where do atypical/Clark’s malnocytic/dysplastic nevi typically occur on races other than caucasian?

A

acral and mucosal surfaces

58
Q

What asymptomatic skin condition is often characterized by accentuated “pebbling”?

A

atypical/Clark’s malnocytic/dysplastic nevus

59
Q

What is the management for atypical/Clark’s/dysplastic nevi?

A
  • follow with regular photo documentation
  • recommend regular eye exams for retinal lesions
  • if changes observed, consider removal
60
Q

Dermal nodule with positive “dimple sign”.

A

dermatofibroma

61
Q

What is the treatment for dermatofibroma?

A
  • leave alone
  • excision or cryo for cosmetic reasons
62
Q

non invasive, benign tumor originating in the epidermis and affecting individuals after age 30

A

seborrheic keratosis

63
Q

What is the treatment for seborrheic keratosis?

A
  • none required
  • cryo, electrocautery for cosmetic
  • shave biopsy for all black lesions without horn cysts
64
Q

What skin condition primarily affects Asians and dark skinned people on the palms, soles and subungual regions?

A

Acral lentiginous melanoma

65
Q

A) _______ is a precursor to B) __________

A

A) Nevi - Atypical/Dysplastic/Clark

B) Melanoma - Superficial Spreading

Derm 1 (8 decks)

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