Skin Cancer Flashcards

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1
Q

define this lesion

A

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

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2
Q

what is the term used for lower lip involvement with actinic keratoses?

A

actinic cheilitis

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3
Q

incidence of malignant transformation to SCC for actinic keratosis

A

0.01- 5% incidence

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4
Q

this erythematous patch histologically would show

A

actinic keratosis

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5
Q

thicker, crustier lesions of actinic keratosis are known as

A

hypertrophic AK

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6
Q

this is a manifestation of AK (T/F)

A

T - flat, erythematous macule

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7
Q

prevention of AK

A

aggressive sun avoidance

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8
Q

treatment of AK

A

liquid nitrogen cryotherapy/superficial curettage and cautery

5-fluorouracil 5% cream for extensive areas (cause hemorrhagic crusting)

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9
Q

describe cryosurgery

A

liquid nitrogen -196C

blistering and scarring can occur

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10
Q

most common skin cancer

A

basal cell carcinoma

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11
Q

BCC is a neoplasm of _______

A

basal kertinocytes

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12
Q

what are the 4 types of BCC

A

nodular (most common)

infiltrating

pigmented (African, hispanic, asian)

superficial

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13
Q

BCC is metastasizing (T/F)

A

F

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14
Q

describe this lesion

A

nodular BCC

pearly papule

rolled border

may ulcerate

superficial telangiectasias

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15
Q

what pathway is affected in BCC

A

Sonic-hedgehog pathway

inactivation of PTCH1 gene

activation of SMO genes

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16
Q

this is also a form of ____ BCC

A

nodular

central erosion and ulceration

17
Q

this lesion is _____; describe the lesion

A

superficial BCC

dry, flat papules or plaques that may have raised border

well-defined, pink to red in color

18
Q

this lesion is ______; describe the morphology

A

pigmented BCC

brown, black, or blue macule, papule, or nodule

can have telangiectasia and translucency

rolled edge with depressed center may be present

19
Q

treatment for BCC

A

imiquimod

surgical:

electrodessication and curettage, excision

cyrosurgery

radiation

Mohs surgery

20
Q

indications for Mohs surgery

A

skin cancers cosmetically sensitive areas

high occurrence areas

nose, ears, eyes, mouth, groin

21
Q

describe this lesion

A

SCC

erythematous, hyperkeratotic papule or nodule

may ulcerate or may be smooth

often develop a depressed center

22
Q

in the immunocompromised patient, SCC occur _____

in fair-skinned transplant patient, SCC occur ____

A

anywhere on the body

oral, anal, cervical mucosa, male genitals

in areas of prior sun damage

23
Q

what are these lesions indicative of?

A

Bowen’s disease

slow growing, superficial SCC seen on background of sun damaged skin

24
Q

what are the ABCDEs of melanoma

A

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)

25
Q

describe the lesion below

A

nodular melanoma

dark brown to bluish-black nodule that grows rapidly

most likely to ulcertate or bleed

26
Q

describe this lesion

A

superficial spreading melanoma

nodule

27
Q

regression is a result of ______

A

body’s immune defences

28
Q

describe this lesion

A

superficial spreading MM

asymmetry

border exhibits pseudopod ike growth (scalloped border)

color variation

diamter is >6mm

history of change

29
Q

define this lesion

A

acral lentiginous MM

found on palms, soles, nail apparatus

30
Q

what is Hutchinson’s nail sign

A

pigment in skin surrounding the nail, suggestive of ALMM

31
Q

describe this lesion

A

lentigo maligna malignant melanoma

asymmetric brown to black macule or patch with color variegation and irregular borders

slow growing SSMM

32
Q

melanomas have ____ and _____ growth phase

A

radial and vertical

33
Q

why does nodular melanoma have poorer prognosis than SSMM?

A

greater depth at time of diagnosis

SSMM have longer radial growth phase

34
Q

Tx for MM

A

surgery

margins depend on depth of invasion

at least 0.5cm

greater than 4mm, 2cm margins

35
Q

define this presentation

A

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

36
Q

describe these lesions

A

more subtle solar elastosis

small yellow papules

loss of effective elastin and collagen around opening of pilo-sebaceous units (hair follicle)

37
Q

what is the name of this condition?

A

cutis rhomboidalis nuchae (CRN)

deep furrowing in geometric pattern

marker of chronic sun damage

damaged collagen and elastic tissue

38
Q

is CRN reversible?

A

no

39
Q

what is this lesion?

A

Favre and Racouchot disease (FRD)

solar/senile comedones

chronic exposure to sun

small cysts and large blackheads

smoking Hx

radiation exposure