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Derm Surg questions > Other tumors > Flashcards

Other tumors Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the subclinical percent of spread for DSFP at 1cm 2cm 3cm and 5cm margins.

A

1 cm 75% 2cm 40% 3cm 15% 5cm 5%

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2
Q

what is the standard excision margin for DFSP

A

2-4 cm

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3
Q

How much of a layer should you take with each subsequent layer of MMS for DFSP

A

1 cm

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4
Q

What is a Bednar variant of DFSP which is about 5% of DFSPs

A

They have melanin producing cells with melanocyte or melanocyte-schwannian differentiation.

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5
Q

Where does DFSP most likely metastasis to?

A

hematogenous to the lungs

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6
Q

What is the Borst Jadassohn effect?

A

presence of sharply defined nests of morphologically distinct cells within the epidermis

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7
Q

What three growths can show the Borst Jadassohn effect.

A

Bowens disease
Clonal seb kers
Hidroacanthoma simplex

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8
Q

What are the four histologic signs of a wart?

A
  • intoeing of rete ridges
  • Koilocytes- big pale nuclei with keratohyline granules
  • Church spire parakeratosis over papillary protrusions
  • Hypergranulosis
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9
Q

In Merkel cell carcinoma which patients do better. With polyoma virus or without polyomavirus.

A

With polyomavirus.

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10
Q
A
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11
Q

what is the diagnosis

A

dermoid sinus cyst of the nose

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12
Q

What study should be ordered with this lesion.

A

MRI to r/o intercranial connections with a midline dermoid cyst.

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13
Q

what glove will not be penetrated by nickel sulfate

A

vinyl

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14
Q

Granulomatous slack skin is associated with what?

A

MF

erythematous indrated plaques on the flexural surfaces

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15
Q

Epidermodysplasia Verruciformis an autosomal recessive disorder that is immuno suppressive is associated with what HPV viruses?

A

5 and 8

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16
Q

What melanogen drives pigmentation in seborrheic keratosis

A

edothelin-1

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17
Q

Oral hairy leukoplakia is associated with what virus?

A

Epstein Barr virus EBV

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18
Q

Lipshutz ulcers and Extranodal T cell lymphoma (T cell type) are associated with what virus that can cause oral hairly leukoplakia?

A

Epstein-Barr virus

Lipshutz ulcers are non sexually related genital ulcers in females

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19
Q

Mutations of what gene are associated with malignant pilomatrixoma

A

Beta-catenin

20
Q

Beta-catenin gene mutation is associated with what tumor

A

Pilomatrixoma.

21
Q

Basal cell carcinomas only arise in skin that contains what?

A

Pilosebaceous units

22
Q

What is the difference between primary and secondary Extramammary Padgets disease

A

Primary is more apocrine in origin

Secondary is spread from an underlying malignancy (usually GI or GU cancers)

23
Q

What stain is usually + in primary extramammary padgets disease but is negative in secondary padgets?

A

GCDFP

gross cystic disease fluid protien

24
Q

What is the most common site for mucinous carcinoma?

A

Eyelid/canthous/brow area

25
Q

List 4 key features of MAC Microcystic Adenxal Carcinoma

A

asymetrical

horn cysts in superficial part of lesion

infiltrative basoloid strands with small lumina

infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle

bonus

may also see perineural invasion and solar elastosis

sclerotic plaque on nose and lip of women that look like a sclerosing bcc

26
Q

What is this tumor

A

Microcystic Adenexal Carcinoma

asymetrical

horn cysts in superficial part of lesion

infiltrative basoloid strands with small lumina

infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle

bonus

may also see perineural invasion and solar elastosis

sclerotic plaque on nose and lip of women that look like a sclerosing bcc

27
Q

What is this tumor and it’s features

A

Tricholemmoma

growing down of epidermis with glycogen filled keratinocytes

centers appear clear

there is a rim of palisaded basal cells

28
Q

What is tricholemmoma associated with?

A

Cowden’s disease

palmar planter keratosis

oral mucosal papillomatosus

pigmented macules on penis

Breast cancer, Thyroid cancer, Endometrial cancer, multiple GI hamartomas

29
Q

What are the two most common tumors associatied with nevus sebaceous?

A
  1. Trichoblastoma
  2. syringocystandoma papilliferum
30
Q

What mutation of MAKP pathway can be the same in nevus sebaceous, trichoblastoma, and sryringocystadenoma pappilliferum

A

HRAS

31
Q

What is the risk of a secondary carcinoma developing in a nevus sebaceous?

A

<1%

32
Q

What is Schimmelpenning syndrome and Phacomatosis pigmentokeratotica

A

both rare varients of the epidermal nevus syndrome

both can be associated with nevus sebaceous

33
Q
A
34
Q

What is the cure rate for DFSP by mohs surgery?

A

97%

35
Q

What is the recurrance rate of DFSP by wide excision?

A

approximately 30%

36
Q

What are the surgical margins for DFSP by NCCN guidelines

A

2-4 cm to facia

37
Q
A
38
Q
A
39
Q

beside the lips where else can you see fordyce spots (a form of free sebaceous glands)

A

buccal mucosa

40
Q

what are #3 called

A

Montgomery tubercles

free sebacous glands

41
Q

what are these called

A

Tyson glands

free sebaceous glands

42
Q

What are these?

A

Meibomium gland openings

free sebaceeous glands inside the tarsal plate

when inflammed are Chalazion

43
Q

the free sebaceous gland at the base of the eyelids are known as what.

A

zies glands

when inflammed they are a sty

44
Q

what are the glands of Moll

A

apocrine glands that are right next to the glands of zeis at the base of the eyelashes

45
Q

where do desmoplastic trichoepitheliomas usually arise

A

cheeks of women

a plaque with a central dell

46
Q

What is the NCCN recommendation for F/U of completely excised DFSP

A

6-12 months

47
Q

What type of primary cutaneous lymphoma can you not treat with surgery alone.

A

Primary cutaneous large cell B lymphoma (leg type)

TX with Rituximab, CHOP, + radiation

You can excise follicle center and marginal lymphomas

Derm Surg questions (26 decks)

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