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Malignant Vs Benign Lesions 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
What is the etiology of melanoma?
blistering sunburns appear to be the initiating event that causes melanoblastic tumor to develop
26
What skin condition is characterized by irregular, asymmetric raised nodules that are often multicolored?
melanoma (Acral lentiginous melanoma pictured here)
27
LIst the 4 types of melanoma in order of most common to least common
- superficial spreading (60-70%) - nodular melanoma (15-30%) - lentigo maligna (5-15%) - acral lentiginous melanoma (5-15%)
28
This skin condition affects ages 30-50 and is characterized by radial growth with nodular formation when 2.5 cm or more
superficial spreading melanoma
29
This skin condition affects individuals in the 6th decade of life, usually on the head, neck or trunk and has no radial growth
nodular melanoma
30
This skin condition affects individuals in the 7th decade of life and has very slow radial growht primarily on the nose and cheeks
lentigo maligna melanoma
31
What is Hutchinson's sign?
periungual spread from nail as seen in acral lentiginous melanoma
32
What is this and what is the concern?
a pigmented band that is normal in 90% of black individuals but if suddenly appears, could suggest acral lentiginous melanoma
33
What is this and what is it suggestive of?
splinter hemorrhages could suggest acral lentiginous melanoma
34
How is melanoma diagnosed?
- excisional bipsy depth of invasion determines whether lymph nodes are checked
35
At what depth of melanoma invasion is there possible lymph node involvement?
0.75 to 1.5 mm
36
At what depth of melanoma invasion is there likely lymph node involvement and thus sentinel nodes are checked?
\> 1.5 mm
37
What are some preventative measures for melanoma?
- Vitamin D - polyphenols (green tea, grapeseed, pomegranate) - mediterranean diet - avoid intense, intermittent UV exposures and sunburns
38
What is the conventional treatment for melanoma?
- surgery with possible removal of lymph nodes - interferon/immune based therapy - cytotoxic therapy - radiation
39
What are some supportive therapies to conventional treatment for melanoma?
- 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
Brown macule/melanocytic nest at the junction of the epidermis and dermis?
junctional nevus
41
Skin-colored or lightly pigmented brown papule with nest of melanocytes in the dermis?
intradermal/dermal nevus ![]()
42
What kind of nevus can resemble basal cell carcinoma?
dermal nevi
43
brown papule that has melanocyte nest both in the dermis at at the junction of the dermis and epidermis
compound nevus
44
Name the different types of benign nevi?
junctional dermal compound
45
What skin condition is this?
junctional nevus
46
What skin condition is this?
dermal nevus
47
What skin condition is this?
compound nevus
48
What is the treatment of benign nevi?
- leave alone and monitor - if any changes occur, consider removal
49
This skin condition has telangectasia, is soft, small and shows central umbilication. What is it and what is the DDX?
sebaceous hyperplasia DDX = basal cell carcinoma which would be firmer on palpation
50
What age group is most often affected by sebaceous hyperplasia?
30's
51
What is the treatment for sebaceous hyperplasia?
- shave excision - light electro - chemical cautery
52
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?
keratocanthoma
53
What age group is commonly affected by keratoacanthoma?
50+
54
What are the differential diagnoses for keratoacanthoma?
BCC, SCC, AK and wart
55
What skin condition is a possible precursor to superficial spreading melanoma?
atypical/Clark's malnocytic/dysplastic nevus
56
Where are atypical/Clark's malnocytic/dysplastic nevi typically found on caucasians?
anywhere on skin surface
57
Where do atypical/Clark's malnocytic/dysplastic nevi typically occur on races other than caucasian?
acral and mucosal surfaces
58
What asymptomatic skin condition is often characterized by accentuated "pebbling"?
atypical/Clark's malnocytic/dysplastic nevus
59
What is the management for atypical/Clark's/dysplastic nevi?
- follow with regular photo documentation - recommend regular eye exams for retinal lesions - if changes observed, consider removal
60
Dermal nodule with positive "dimple sign".
dermatofibroma
61
What is the treatment for dermatofibroma?
- leave alone - excision or cryo for cosmetic reasons
62
non invasive, benign tumor originating in the epidermis and affecting individuals after age 30
seborrheic keratosis
63
What is the treatment for seborrheic keratosis?
- none required - cryo, electrocautery for cosmetic - shave biopsy for all black lesions without horn cysts
64
What skin condition primarily affects Asians and dark skinned people on the palms, soles and subungual regions?
Acral lentiginous melanoma
65
A) _______ is a precursor to B) \_\_\_\_\_\_\_\_\_\_
A) Nevi - Atypical/Dysplastic/Clark B) Melanoma - Superficial Spreading

Derm 1 (8 decks)

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