Neoplastic Skin Changes- Schaper Flashcards
Flat or slightly elevated, smooth, sharply circumscribed, uniform brown/black/tan
What is the most likely diagnosis?
Junction Nevi
Slightly elevated, dome-shaped, papule;
smooth or papillomatous surface; fleshy or brown
What is the most likely diagnosis?
Compound Nevi
The nevus cells are at the dermo-epidermal junction and upper dermis
Dome shaped, verrucoid (warty) pedunculated or sessile
brown, black, pink
What is the most likely diagnosis?
Dermal Nevi
nevus cells at dermis, sometimes among fat cells
where are the nevus cells located for a blue nevi and Nevus spilus?
Dermal layer
Characteristics of benign nevi
symmetric
well defined border
uniform color
<6 mm
reddish pink, dome shaped, smooth papule
usually on the face, scalp, or legs
Pre- adolescentWhat is the most likely diagnosis?
Spitz
a spitz nevus can be a compound or dermal nevus
the vast majority of atypical spitz tumors are cured with local excision
a 55 yo presents w
Red, Vascular papual on the trunk
normally 2-5 mm
What is the most likely diagnosis?
Hemangioma
noncancerous overgrowth of blood vessels in the skin
no known cause and no treatment needed
a pregnant female presents with
red, vascular papule that bleeds easily
2mm-2cm
What is the most likely diagnosis?
what is the treatment
Pyogenic granuloma
usually occurs on the head, neck, upper trunk and fingers
Treatment: curettage and cauterization, cryotherapy
a child comes in with a red papule with a yellow-white hue on his face
What is the most likely diagnosis?
juvenile xanthogranuloma
usually disappears on its own and requires no treatment
Buzzwords for Melanoma
S-100 tumor marker
sun exposure
Breslow depth (associated with risk of metastasis)
mutation in BRAF kinase
treat with vemurafenib or excision with 2 mm margins
a 65 yo female presents with
a >6mm flat, asymmetric mass with varying colors
What is the most likely diagnosis?
Superficial Spreading Melanoma
the lesion can spread laterally for years prior to developing nodules
a pt comes in with a rapidly growing lesion on the right forearm.
The lesion is raised, brown, and appeared suddenly.
What is the most likely diagnosis?
Nodular melanoma
equally common in females and males
can be found in any location but more often on the extremities
lesions are raised
may bleed
evolove over moths and tend to extend vertically into skin
a pt presents with:
a flat, irregularly outlined, mottled, brown lesion on the cheack
a wood’s light reveals irregular pigmentation around the lesion.
What is the most likely diagnosis?
Lentigo Maligna Melanoma
a 67 yo male comes in with a strip down the center of his big toe.
What is the most likely diagnosis?
Acral Melanoma
more common in older patients (don’t think kids on this one)
usually located on the hands and feet including the nails of darker skinned people
Hutchinson’s sign is a black or brown pigment from the nailbed
Buzzwords
Basal Cell Carcinoma
Most common form of skin cancer
sun-exposed
local invasive
pink, pearly nodules with rolled borders
Palisading nuclei
a 30 yo comes in with multiple lesions that are oval, red, and scaling.
What is the most likely diagnosis?
Superficial BCC
Thinnest and least aggressive
multiple lesions, appears earlier in life
the tumor spreads peripherally, sometimes for several centimeters
round to oval, red, scaling plaques
pt has been diagnosed with BCC on the face.
How do we treat it?
Moh’s micrographic surgeryremove skin cancer one layer at at time and examine them under a microscope immediately
pt presents with yellowish scale that can be felt. He said the lesion originally presented as redness with some spider-web looking red bv.
What is the most likely diagnosis?
How do we treat it?
Actinic keratosis
common keratotic lesion with malignant potential → SCC
Cryotherapy, topical 5 FU, topical Imiquod, photodynamic theraapy
Buzzwords
Squamous cell Carinoma
sunlight, immunosuppression, arsenic exposure
lower lip, ears, hands
locally invasive and may spread to lymph nodes
ulcerative red lesions with frequent scale
chronic draining
kerating pearls
Actinic Keratosis
A pt presents with
purple patches on the distal lwer extremitiy that have progressed proximally
the individual lesions darken and thicken before becoming brown and verrucous
What is the most likely diagnosis?
Kaposi’s Sarcoma
a malignancy of lymphatic endothelial cells associated with a gamma herpes virus, HHV8
The most common AIDS-associated cancer
