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HMS IDD > Skin Cancers > Flashcards

Skin Cancers Flashcards

1
Q

Most skin cancers originate in the ___.

A

Most skin cancers originate in the epidermis

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2
Q

Melanocytes live at the ___.

A

Melanocytes live at the dermal-epidermal junction.

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3
Q

Types of keratinocyte carcinoma

A

Basal cell carcinoma (arising from basal layer keratinocyte)

Squamous cell carcinoma (arising from any other layer)

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4
Q

Acanthosis

A

Hyperplasia-induced thickening of skin

Equivalent to saying “hyperplasia” when talking about skin cancer

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5
Q

Hyperkeratosis

A

Hyperplasia of keratinocytes in the stratum corneum

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6
Q

Intraepithelial neoplasm

A

Squamous cell carcinoma in-situ

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7
Q

Keratin pearls

A

Clumbs of keratin in the dermis or epidermis in skin cancer which are produced by atypical keratinocytes. Stain brightly with eosin

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8
Q

Histological characteristics of BCC

A
  • Retraction artifact (white highlighting of subepidermal clusters of basiloid cells)
  • Prominent nuclei
  • Peripheral pallisading (linear layer of cancer cells between tumor and normal tissue)
  • No scaling
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9
Q

Histological characteristics of squamous cell carcinoma

A
  • Hyperkeratosis
  • Acanthosis
  • Nuclear pleiomorphism
  • Variable thickness of epidermis
  • Keratin pearls
  • Keratin staining subepidermally
  • Immune cell infiltration
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10
Q

telangiectasia

A

Dilated blood vessel which may be visible to the naked eye or with low-lower microscope

Sign of angiogenesis

Hallmark feature of many basal cell carcinomas

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11
Q

A nevus is defined by. . .

A

. . . the presence of melanocytes outside of the dermal-epidermal junction

(This may mean intraepidermally, or intradermally. Note that this has nothing to do with whether there is a malignant process occuring or not)

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12
Q

In a benign nevus. . .

A
  • Clusters are well-demarkated and orderly
  • Often symmetrical in distribution
  • Uniform morphology of melanocytes
  • Low level or absent inflammation
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13
Q

In a melanoma lesion. . .

A
  • Clusters are not well demarkated and disorderly
  • Melanocytes appear heterogeneous
  • Distribution is often asymmetric
  • High degree of inflammation
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14
Q

Early horizontal growth phase

A
  • Early lesion of melanoma. Melanoma cells tend to spread horizontally along the dermal-epidermal junction before they spread veritcally
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15
Q

Melanoma in-situ

A

Hornziontal growth of melanoma along the basement membrane, but no penetration through the basement membrane. Prognosis is quite good for excision with excess margins,

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16
Q

Breslow tickness

A

Measurement from epidermis to point of deepest invasion of dermis

Single most important prognostic factor for patients. The deeper the melanoma, the worse the prognosis.

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17
Q

Types of benign nevus

A
  • Junctional (melanocytes at dermal-epidermal junction)
  • Dermal (melanocytes in dermis)
  • Compound (some of both)
18
Q
A

Junctional nevus

19
Q
A

Compound nevus

20
Q
A

Dermal nevus

21
Q
A

Melanoma

22
Q

ABCDE mnemonic

A
  • Asymmetry
  • Border
  • Color (red, white, blue)
  • Diameter (>6mm)
  • Evolution
23
Q

Why are red, white, blue worrisome on a nevus?

A

Red indicates inflammation

White indicates “regression,” or loss of melanocytes in a patch due to an adaptive immune response against them

Blue indicates deep dermal melanin (because of light scattering by collagen)

24
Q

Subtypes of melanoma

A
  • Superficial spreading
  • Nodular
  • Lentigo maligna
  • Acral lentiginous
25
Q
A

Superficial spreading melanoma

26
Q
A

Nodular melanoma

27
Q
A

Lentigo maligna melanoma

28
Q
A

Acral lentiginous melanoma

29
Q
A

Basal cell carcinoma

30
Q

What is the correct order of prevalence for the most common skin cancers?

A

BCC > SCC > Melanoma

31
Q

While ___ itself is not a risk factor for carcinoma, methods of treating ___ may induce cancer.

A

While psoriasis itself is not a risk factor for carcinoma, methods of treating psoriasis may induce cancer.

32
Q
A

Squamous cell carcinoma

33
Q

Most non-melanoma skin cancers occur at. . .

A

. . . sun-exposed surfaces

34
Q

Non-radiation risk factors for skin cancer

A
  • Arsenic
  • Hydrocarbons
  • HPV
  • Scars
  • Chronic inflammatory processes
  • Ulcers
  • Immunosuppression
35
Q

Metastatic BCC is. . .

A

. . . EXTREMELY rare. Less than 0.1% of all BCCs metastasize

36
Q
A

Basil cell carcinoma

37
Q

actinic keratosis

A

precursor lesion to SCC.

Extremely common in fair-skinned elderly Caucasian individuals who have had significant chronic sun exposure. AKs occur as well-demarcated, scaly, rough patches or plaques on chronic sun-exposed skin surfaces.

Often more easily palpated than seen.

38
Q

___ is the most common form of skin cancer in immunosuppressed individuals.

A

SCC is the most common form of skin cancer in immunosuppressed individuals.

39
Q
A

SCC with keratin pearl

40
Q

First step for treating any skin cancer

A

Biopsy!!! It is important to know which cancer it is FOR SURE.

41
Q

The most frequent site for melanoma in men is the ___. The most frequent sites for melanoma in women are the ___.

A

The most frequent site for melanoma in men is the trunk. The most frequent sites for melanoma in women are the legs.

42
Q

In invasive melanoma, ___ is the most powerful predictor of overall survival.

A

In invasive melanoma, the status of the regional lymph node basin is the most powerful predictor of overall survival.

HMS IDD (28 decks)

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