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RB Y2 Dermatology > Non-Melanocytic Tumours > Flashcards

Non-Melanocytic Tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

what is Benign seborrheic keratosis

A

a benign warty spot that appears during adult life as a common sign of skin ageing

(basal cell papilloma)

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2
Q

Benign seborrheic keratosis appearance

A

stuck on and greasy hyperkeratotic surface (basal cell papilloma)

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3
Q

Benign seborrheic keratosis histology

A
  • benign proliferation of epidermal keratinocytes
  • keratin filled HORN CYSTS and ACANTHOSIS
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4
Q

what can the sudden emergence of lots of Benign seborrheic keratosis lesions indicate

A
  • The sudden emergency of many lesions may indicate internal malignancy – Leser-Trélat sign
  • Often occurs with malignant acanthosis nigricans when there is underlying adenocarcinoma of the stomach
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5
Q

BCC clinical presentation

A
  • Slow growing lump which may go on to form a non-healing ulcer (centrally – rodent ulcer).
  • Pearly/translucent edge with visible dilated blood vessels. ​
  • painless and often ignored
    *
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6
Q

BCC describe central ulceration

A

rodent ulcer

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7
Q

superficial variant of BCC

A
  • Most common type in younger adults
  • More common on upper arms and shoulders
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8
Q

morphoeic variant of BCC

A
  • A flat, diffuse superficial form exists as an ill-defined morphoeic variant – infiltrative (greater degree of morbidity)
  • These are often found on mid facial sites
  • Waxy scar-like plaque with indistinct borders
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9
Q

BCC where/who

A

sun exposed skin of middle aged and elderly white people

rarely found on ear

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10
Q

BCC histology

A

basal cells sprout from epidermis, groups of cells invade the dermis

desmoplastic stroma

there is characteristic PALISADING

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11
Q

BCC treatment

A

normally cured by total excision

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12
Q

BCC effect of delay in treatment

A

less important as invade locally but do not spread widely - metastases are rare

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13
Q

BCC what mutation is associated

A

PTCH1 - component of the hedgehog signalling pathway

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14
Q

what does the hedgehog signalling pathway do

A

activate transcription factors leading to induction of cell proliferation genes and angiogenesis activators

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15
Q

what blocks hedgehog signalling

A

vismodegib

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16
Q

what is naevoid BCC also known as

A

gorlins syndrome

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17
Q

gorlins syndrome inheritance

A

Au D

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18
Q

gorlins syndrome features

A

multiple early onset basal cell skin cancers and other cancers

palmar pits, jaw cysts and ectopic

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19
Q

what is butterfly disease caused by

A

genetic defects in the genes that encode for type VII collagen

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20
Q

another name for butterfly disease

A

Recessive dystrophic epidermolysis bullosa

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21
Q

name two precursors to SCC

A

acitinic keratosis and bowen disease

22
Q

acitinic keratosis

A

Frequently develop later in life in white-skinned people who have had significant sun exposure.

They appear on the skin as erythematous silver-scaly plaques or patches with a conical surface and a red base.

The background skin is often inelastic, wrinkled and may show flat brown macules (solar lentigos) reflecting diffuse solar damage.

a small proportion may transform into SCC, but only after many years

23
Q

bowen disease

A

intra-epidermal carcinoma in situ (no dermal invasion), which can rarely become invasive

thought to be due to long term sun exposure, presents on exposed skin (most commonly womens legs)

epidermal neoplastic lesions that cannot yet invade the underlying tissues

24
Q

bowens disease features

A

erythematous scaly patches/plaques with an irregular border

can mimic inflammatory conditions

lesions do not clear but slowly increase in size with time

25
Q

where is bowens disease most commonly found

A

legs

26
Q

what is a viral lesion that is a pre cancerous disease of the penis

A

erythroplasia of Queryat-penile

27
Q

what is erythroplasia of Queryat-penile associated with

A

HPV

28
Q

SCC features

A

hyperkeratotic (crusted) nodule or area of induration. can advance to ulceration and destruction of underlying tissues may be painful or bleed

fast!!

29
Q

do SCC grow fast or slow

A

fast - more aggressive than BCC

30
Q

do SCC metastase

A

5% risk - incurable to regional lymph nodes and bone

31
Q

where can SCC occasionally arise

A

on chronic leg ulcers eg stasis ulcers

sites of burns, sinuses eg chronic osteomyelitis

chronic lupus vulgaris

32
Q

chronic lupus vulgaris

A

chronic inflammation, invasion of the skin by M. Tuberculosis

can rarely be complicated by SCC

33
Q

what is SCC rarely associated with

A

xeroderma pigmentosum (cant repair skin damage from UV light so obv get cancer) and dystrophic variant epidermolysis bullosa (butterfly disease)

34
Q

what are some adverse prognosis features of SCC

A

thickness >4mm and poor differentiation

lymphatic/vascular space invasion

perineural spread

specific sites - ear, nose, scalp

ulceration

35
Q

keratocanthoma

A

Keratocanthoma is a skin cancer tumour that is benign.

  • It originates in the pilosebaceous glands.
  • Clinically and pathologically resembles SCC and rarely progresses into an invasive SCC
  • Typically grow rapidly (faster than a SCC would)
  • Tend to develop on sun-exposed skin
  • Nodular with a central crater containing a keratin plug
  • As it cannot reliably be clinically distinguished from SCC, is usually surgically removed. If left untreated, most resolve in 4-6 months but leave residual scarring.
36
Q

merkel cell carcinoma

A

highly aggressive, readily metastases

Present as a red/blue nodule

Merkel cells exist in the basal layer between keratinocytes and nerve fibres – act as mechanoreceptors. Carcinomas are referred to as neuroendocrine carcinoma of the skin.

37
Q
A

rodent ulcer - BCC

38
Q
A

nodular BCC

39
Q
A

superifical BCC

40
Q
A

bowens disease

41
Q
A

keratocanthoma (subtype of SCC)

42
Q
A

merkel cell carcinoma

43
Q
A

acitinic keratosis

44
Q

BCC or SCC

A

BCC

45
Q

BCC or SCC

A

BCC

46
Q

BCC or SCC

A

SCC

47
Q

BCC or SCC

A

SCC

48
Q
A

keratocanthoma

thought it was an SCC? clinically hard to distinguish, this is why they are removed

49
Q
A

cutaeneous horn - subtype of SCC

also associated with viral warts (HPV)

50
Q

what disease is this a feature of

A

palmar pits - Gorlins syndrome

51
Q

kaposi’s sarcoma

A

This is a tumour of vascular and lymphatic endothelium that presents as purplish nodules and plaques. There are 3 types:

  • Classic/sporadic
  • Endemic
  • Immunosuppression related form - more severe and common in HIV positive men who have sex with men

Can cause chronic adrenal insufficiency

RB Y2 Dermatology (22 decks)

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