Skin

Question 1

Subtypes of melanoma
(+some prognostic characteristics)

Answer 1

Superficial spreading
- most common
- associated with naevi
- most superficial, 5% deep invasion

Nodular malignant
- often dome shaped
- de novo
- aggressive - both invasion and LN spread

Lentigo maligns melanoma
- least common
- arises from Hutchinson’s melanotic freckles
- good prognosis

Acral lentiginous
- thick epidermis eg soles, palms and subungal
- poor prognosis

Desoplastic malignant
- head and neck most common sites
- High recurrence rates but lower rates metastases

Non-cutaneous melanoma
- occular, mucous membranes, genitalia, anorectum
- Can be amelanotic

Question 2

Clinical features of melanoma

Answer 2

A asymmetry
B border irregularities
C colour variation
D diameter >6mm
E elevation

Question 3

Risk factors for SCC

Answer 3

Male
Older age
Cumulative Sun exposure
Pale skin
Tanning beds
Immunosuppression
Chronic inflammation
Ionizing radiation, arsenic or radon
Genetic conditions incl XP

Question 4

What factors are involved in the pathogenesis of hidradenitis suppurativa?

Answer 4

Follicular occlusion
An abnormal cutaneous of follicular microbiome
Release of pro-inflammatory cytokines
Inflammation causing rupture of the follicular wall, destroying sebaceous and apocrine glands and ducts