premalignant lesion/ benign growths Flashcards
Actinic Keratosis
premalignant lesions that have the potential to transform into a skin cancer (if they do, it will most likely be a SCC)
may be considered a part of a dz spectrum (AK into SCC in situ-Bowen’s Dz into SCC)
risk of AK malignant progression
presistence of the AK, cumulative UV, hx of skin CA, genetic susceptibility and immunosuppression
what is the cell of origin for AK?
keratinocyte
common location of AK
face, scalp, neck ears, hands forearsm
actinic cheilitis
lower lip AK
AK CF
flesh-colored, yellowish, brown, pink, or red-colored, scaly, hyperkeratotic, or rough-textured (feel like sandpaper) papules. They may also present as cutaneous horns
lesions of AK that are most likely to progress to SCC
lips and ears
tx for AK
5-FU, imiquimod, cyrotherapy, ED&C
AK RF
UV exposure (p53 suppressor gene mutations) increasing age, fair skin, light eyes/hair (Fitz skin types 1,2) genetic syndrome (xeroderma pigmentosum, albinism)
AK dx)
often dx by feel (sandpaper)
always bx horns
chronic sundamaged skin features
atropy and hypertrophy, telangiectasia, spotty depigmentation and hyperpigmenation, wrinkles, “leathery”
solar lentigo
one/many small brown macules
cutis rhomboidalis nuchae
red neck with rhomboidal furrus
solar elastosis
fine nodularity, pebbly surface
actinic (senile) purpura
easy brusing, extravasted erythrocytes and increased perivascular inflammation
Seborrheic Keratosis
common benign epidermal growths
everywhere but palms and soles
SK CF
- Surface can be smooth, velvety, verrucous, or hyperkeratotic
- Color can be white, pink, tan, light brown, dark brown, or black
- Usually appear “stuck-on” and can sometimes come off or crumble if picked
- Hereditary and usually appear after 30’s
- May become irritated due to location or patient may find them cosmetically unappealing
clinical variations of SK
include dermatosis papulosis nigra in African Americans on the face and stucco keratosis in older Caucasians on lower legs, ankles, and dorsal hands and feet
TX of SK
necessary unless symptomatic and includes cryotherapy, shave remove, light electrocautery, or curettage
Leser-Trelat
sudden eruption of many SK’s may be a cutaneous sign of internal malignancy
clinical pearl of SK
using a 10x ocular or magnifying lens may help you to see multiple keratin cysts embedded within the surface of the lesion
