Skin Cancer Flashcards
define this lesion
actinic (solar) keratosis
flat, scaly papule, ill-defined border
may have red base
variable size
coalesce to form plaques
begin as rough localized skin lesions
what is the term used for lower lip involvement with actinic keratoses?
actinic cheilitis
incidence of malignant transformation to SCC for actinic keratosis
0.01- 5% incidence
this erythematous patch histologically would show
actinic keratosis
thicker, crustier lesions of actinic keratosis are known as
hypertrophic AK
this is a manifestation of AK (T/F)
T - flat, erythematous macule
prevention of AK
aggressive sun avoidance
treatment of AK
liquid nitrogen cryotherapy/superficial curettage and cautery
5-fluorouracil 5% cream for extensive areas (cause hemorrhagic crusting)
describe cryosurgery
liquid nitrogen -196C
blistering and scarring can occur
most common skin cancer
basal cell carcinoma
BCC is a neoplasm of _______
basal kertinocytes
what are the 4 types of BCC
nodular (most common)
infiltrating
pigmented (African, hispanic, asian)
superficial
BCC is metastasizing (T/F)
F
describe this lesion
nodular BCC
pearly papule
rolled border
may ulcerate
superficial telangiectasias
what pathway is affected in BCC
Sonic-hedgehog pathway
inactivation of PTCH1 gene
activation of SMO genes
this is also a form of ____ BCC
nodular
central erosion and ulceration
this lesion is _____; describe the lesion
superficial BCC
dry, flat papules or plaques that may have raised border
well-defined, pink to red in color
this lesion is ______; describe the morphology
pigmented BCC
brown, black, or blue macule, papule, or nodule
can have telangiectasia and translucency
rolled edge with depressed center may be present
treatment for BCC
imiquimod
surgical:
electrodessication and curettage, excision
cyrosurgery
radiation
Mohs surgery
indications for Mohs surgery
skin cancers cosmetically sensitive areas
high occurrence areas
nose, ears, eyes, mouth, groin
describe this lesion
SCC
erythematous, hyperkeratotic papule or nodule
may ulcerate or may be smooth
often develop a depressed center
in the immunocompromised patient, SCC occur _____
in fair-skinned transplant patient, SCC occur ____
anywhere on the body
oral, anal, cervical mucosa, male genitals
in areas of prior sun damage
what are these lesions indicative of?
Bowen’s disease
slow growing, superficial SCC seen on background of sun damaged skin
what are the ABCDEs of melanoma
A - asymmetry (one half of lesion doesn’t mirror other half)
B - border (irregular or indistinct)
C - color (variegated, not uniform)
D - diameter (greater than 5-6mm is concerning)
E - evolving (notable changes raises suspicion for malignancy)
describe the lesion below
nodular melanoma
dark brown to bluish-black nodule that grows rapidly
most likely to ulcertate or bleed
describe this lesion
superficial spreading melanoma
nodule
regression is a result of ______
body’s immune defences
describe this lesion
superficial spreading MM
asymmetry
border exhibits pseudopod ike growth (scalloped border)
color variation
diamter is >6mm
history of change
define this lesion
acral lentiginous MM
found on palms, soles, nail apparatus
what is Hutchinson’s nail sign
pigment in skin surrounding the nail, suggestive of ALMM
describe this lesion
lentigo maligna malignant melanoma
asymmetric brown to black macule or patch with color variegation and irregular borders
slow growing SSMM
melanomas have ____ and _____ growth phase
radial and vertical
why does nodular melanoma have poorer prognosis than SSMM?
greater depth at time of diagnosis
SSMM have longer radial growth phase
Tx for MM
surgery
margins depend on depth of invasion
at least 0.5cm
greater than 4mm, 2cm margins
define this presentation
solar elastosis (actinic elastosis)
common manifestation of chronic sun exposure
dermatoheliosis (photoaging)
amorphous, yellow, elastin-like material in upper dermis in histology
clinically - yellow, thickened, coarsely wrinkled skin
telangiectasias
describe these lesions
more subtle solar elastosis
small yellow papules
loss of effective elastin and collagen around opening of pilo-sebaceous units (hair follicle)
what is the name of this condition?
cutis rhomboidalis nuchae (CRN)
deep furrowing in geometric pattern
marker of chronic sun damage
damaged collagen and elastic tissue
is CRN reversible?
no
what is this lesion?
Favre and Racouchot disease (FRD)
solar/senile comedones
chronic exposure to sun
small cysts and large blackheads
smoking Hx
radiation exposure
