Patient With Pigmented Skin Lesions

Question 1

Define moles

Answer 1

Benign tumors arising from melanocytes

Question 2

Blue Nevus site and origin

Answer 2

Face and dorsum of hands, arises from dermal melanocytes

Question 3

Classification system of nevi?

Answer 3

ABCD system

Question 4

What causes the pre-malignant lesion, Keratoacanthoma?

Answer 4

The overgrowth and subsequent necrosis of a sebaceous gland

Question 5

What is Xeroderma Pigmentosa, and what does it present as

Answer 5

A rare genetic diseases, patients exhibit severe sensitivity to sunlight from childhood

Question 6

What is Marjolin’s Ulcer

Answer 6

Carcinoma arising at sites of chronic inflammation

Question 7

Explain who gets BCC and why

Answer 7

Older males over 65 years, associated with UV exposure in countries of sunlight.

Question 8

Explain BCC

Answer 8

basal cell carcinoma, locally invasive carcinoma that doesn’t metastasize, yet kills via local infiltration

Question 9

Commonest BCC?

Answer 9

Nodulo-ulcerative

Question 10

Describe Morphea-like BCC (sclerosing BCC)

Answer 10

Firm elevated yellow-ish plaque

Question 11

BCC investigations?

Answer 11

Both biopsies, incisional and excisional, and a CT to assess depth of invasion.

Question 12

Treatment of choice for BCC?

Answer 12

Surgical excision with safety margin

Question 13

BCC treatment fot elderly not suitable for surgery?

Answer 13

Radiotherapy

Question 14

What is the 2nd most common skin cancer after BCC?

Answer 14

SCC, squamous cell carcinoma

Question 15

Explain the cause/incidence of SCC?

Answer 15

Prolonged exposure to sunlight, like sailors for example

Question 16

Site of SCC?

Answer 16

Exposed skin, generally head and neck, lower lips too.

Question 17

Symptoms of SCC

Answer 17

Enlarged LN, bleeding ulcer

Question 18

SCC investigation?

Answer 18

Biopsy

Question 19

SCC treatment

Answer 19

Surgical excision with safety margin followed by reconstruction

Question 20

SCC treatment for metastatic lesions?

Answer 20

Systemic Chemotherapy

Question 21

SCC treatment for massive unresectable tumors in critical anatomical sites?

Answer 21

Radiotherapy

Question 22

Melanoma incidence?

Answer 22

Sunlight again, in caucasians

Question 23

Melanoma Etiology/risk factors?

Answer 23

Family history, blonde hair, freckling of upper back

Question 24

Melanoma symptoms?

Answer 24

Itching, change in colour, evidence of distant metastasis, like weight loss etc…

Question 25

Site of Melanoma in men and women?

Answer 25

Lowe leg, and in the men, Trunk.

Question 26

Grading system of Melanoma called?

Answer 26

Clark’s Level

Question 27

Commonest type of melanoma?

Answer 27

Superficial spreading

Question 28

Most malignant melanoma?

Answer 28

Nodular melanoma

Question 29

Least common and least malignant melanoma?

Answer 29

Hutchinson’s melanotic freckle, occurs in the face

Question 30

Investigations of melanoma?

Answer 30

Biopsy, CT, serum LDH and S-100 levels.

Question 31

Treatment of melanoma lesion?

Answer 31

Surgical resection with safety margin