Skin - Dami + Pathoma

Question 1

What has a mutation in NER?

RF for what?

Answer 1

Xeroderma pigmentosum

SCC

Question 3

Actinic keratosis that worsen may progress to what?

Involvement of the lip is called what?

Answer 3

Cutaneous SCC

Actinic cheilitis

Question 5

What is Breslow thickness?

Answer 5

Distance from sup. Epidermal granular cell layer to deepest intradermal tumor

Question 6

Multiple BCC before age 20, increased medulloblastomas and ovarian fibromas is what?

Inheritance?

Answer 6

NBCCS / Gorlin syndrome

AD

Question 8

What presents as an elevated nodule w/central ulcerated crater surrounded by telangiectasia vessels? Where?

Ulcerated nodular mass on lower lip?

Answer 8

BCC - upper lip

SCC

Bull
Shit

Question 9

What is < 1 cm in diameter and causes a “cutaneous horn”?

Answer 9

Actinic keratosis

Question 10

What type of melanoma is most common?

What kind of growth?

Answer 10

Superficial

Horizontal

Question 11

Tx of actinic keratosis?

What mechanism?

Answer 11

Imiquimod

activates TLRs

Question 16

What is the most important cause of SCC?

Incidence is proportional to what?

Answer 16

DNA damage from UVB light

Lifetime sun exposure

Question 17

What is an ephelis?]

Occurs bc of what?

Answer 17

Freckle

Increased # of melanosomes

Question 18

What has morphology of peripheral palisading w/clefts?

What may happen to the lesions?

Answer 18

BCC

Ulcerate

Question 20

Melanocytic nevus (mole) is a result of what acquired activating mutation?

Precursor lesion for what?

Answer 20

RAS or BRAF

Melanoma

Question 22

Name the layers of the skin from superficial to deep

Answer 22

Corneum 
Lucidum
Granulosum
Spinosum - has desmosomes 
Basalt

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Question 23

Lentiginous hyperplasia, melanin incontinence, and linear fibrosis surrounding epidermal rete ridges is what morphology?

Answer 23

Dysplastic nevi

Question 24

Familial melanoma on what chromosome and mutation?

Answer 24

9, p16 mutation

Question 26

What has morphology of keratin pearls, intercellular bridges w/prominent nucleoli?

Answer 26

SCC

Question 27

Blue nevus potential for malignancy?

If yes, for what?

Answer 27

No, blue-black nodule

Assoc w/fibrosis

Question 28

Melanoma has mutation in what?

Answer 28

CDKN2A
RAS
BRAF
TERT

Question 30

What type of melanoma is the worst type due to vertical growth?

Answer 30

Nodular

Question 32

Pearly nodules w/telangiectasia?

Answer 32

BCC

Question 35

What is the #1 invasive cancer that is locally aggressive?

Does it metastasize?

Gene mutation?

Answer 35

BCC

Rarely

PTCH

Question 36

What occurs in sun damaged skin commonly in the face, arm, dorsum of hands?

What pt population?

What other RFs?

Answer 36

Actinic keratosis

Truck drivers

Hydrocarbons, Arsenic, ionizing radiation

Question 37

What are the earliest lesions of moles?

These grow into what?

Finally?

Answer 37

Junctional - flat, more often in children

Compound - raised

Intradermal - raised

Question 38

SCC may also occur in what setting?

Answer 38

Immunosuppression

I.e. Transplant or steroids

Question 39

What is assoc. w/local invasion of bone or facial sinuses? Called what?

Answer 39

BCC Rodent ulcer

Question 40

HMB 45 is a stain for what?

Answer 40

Melanoma

Question 43

Fitzpatrick scale of 1? 4? 6?

Answer 43

Ivory - ginger Medium brown - ME STRONG sickle celler

Question 46

Nevus cell nests within the epidermis may be enlarged and often fuse or coalescence w/adjacenct nests is seen in what morphology?

Answer 46

Dysplastic nevi

Question 47

Dysplastic nevus potential for malignancy? If yes, for what?

Answer 47

Yes Convalescent intraepidermal nests - melanoma

Question 49

What is the best prognosticator for melanoma?

Answer 49

Depth of invasion aka Breslow Thickness

Question 51

RF for melanoma?

Answer 51

``` #1 - amount of UVB exposure as a child Xeroderma pigmentosum Tanning booth FH Dysplastic nevi ```

Question 56

Halo nevus potential for malignancy? If yes, for what? If no, what is it?

Answer 56

No Host immune response w/lymphocytic infiltration

Question 57

Spindle and epithelial (Spitz) nevus potential for malignancy? If yes, for what?

Answer 57

No Fascicular growth, red-pink nodule

Question 58

What is the most dead of all skin cancer? inheritance? Pathogenesis?

Answer 58

Melanoma AD UVB

Question 59

What develops in non-sun exposed areas as a flat lesion in dark-skinned pts? Mutation?

Answer 59

Acral lentiginous (LE) KIT

Question 60

What occurs in older man as a mole on the face that is indolent and remains in radial growth for years w/good prognosis?

Answer 60

Lentiginous maligna

Question 65

Dysplastic nevus syndrome has mutations in what genes? Inheritance? Presents as what, in what age group?

Answer 65

LOF CDKN2A or CDK4 AD 50% Melanoma by age 60

Question 66

Name the potential steps of tumor progression in dysplastic nevi: (Fig. 25-5)

Answer 66

``` Lentiginous melanocytic hyperplasia Lentiginous junctional nevus Lentiginous compound nevus w/abnormal architecture and cytology (dysplastic nevus) Early melanoma in radial phase Advanced melanoma in vertical phase ```

Question 75

Congenital nevus potential for malignancy? If yes, for what?

Answer 75

Yes if large enough Melanoma