Module 4: Keratinocyte carcinoma

Question 1

BCC common patterns

Answer 1

Blue and grey clods (sometimes brown)
Blue and grey dots (sometimes brown)
Radial lines

Question 2

BCC clues

Answer 2

Radial lines converging
Blue and grey clods
Ulcers 
Sticky fiber sign
White lines 
Absence of reticular lines (when he differential is melanoma)
Serpentine and branching vessels

Question 3

Pigmented Bowen’s disease, common patterns

Answer 3

Dots
Dots and structureless
Structureless

Question 4

Pigmented Bowen’s disease - least specific finding.

Answer 4

Structureless brown - present in many lesions

Question 5

Pigmented Bowen’s disease common clues - (> 10%)

Answer 5

hypo pigmented structureless zone (67%)
Coiled vessels (44%)
Brown or grey dots arranged in linear fashion (21%) 
Vessels arranged in linear fashion (11.5%)
Scale is also clue

Question 6

Pigmented Bowen’s disease uncommon clues - (< 10%)

Answer 6

Vessels arranged in clusters (5.8%)
No clue (10%)

Question 7

Non pigmented Bowen,s disease features

Answer 7

Coiled vessels

Scale

Question 8

How common is pigmented SCC

Answer 8

Pigmented SCC is rare

Question 9

Clues to highly differentiated SCC

Answer 9

Keratin
White circles are most specific clue
Keratin will often contain blood spots

Question 10

If there is central keratin, SCC will likely be diagnosed as …

Answer 10

Keratoacanthoma

Question 11

SCC - what does looped vessels at periphery mean?

Answer 11

Lesion is invasive - do not do cryotherapy

Question 12

SCC - what histopathological feature does white circles correspond to?

Answer 12

acanthosis of epidermis, acanthoses of follicular epithelium, hypergranulosis.

Question 13

SCC - predictors of poorly differentiated - positive

Answer 13

Bleeding
Ulceration
Vessels > 50% of lesion

Question 14

SCC - predictors of poorly differentiated - negative

Answer 14

Scale
White structureless
White circles
Halos