Skin disorders (malignancy and systemic)

Question 1

Actinic Keratosis

Answer 1

Premalignant lesion due to atypical keratinocytes in the epidermis (can develop into SCC). Rough erythematous papule with a white to yellow scale. Lesions typically cluster at sites of chronic sun exposure (questions may mention a gardener etc)

Question 2

Squamous cell carcinoma in situ

Answer 2

Also called bowen’s disease. Typically an elevated plaque arising on sun exposed skin in elderly patients (there may be a history of prior actinic keratosis). Full thickness dermal keratinocytes, Nuclear pleomorphism, apoptosis and abnormal mitoses are seen

Question 3

Invasive SCC

Answer 3

Erythematous keratotic papule or nodule on a background of sun exposure. Ulceration may occur, regional lymphadenopathy may be seen.

Question 4

What are the five types of BCC

Answer 4

Nodular, superficial, morpheaform, cystic and basosquamous

Question 5

Nodular BCC

Answer 5

Commonest, raised translucent papule, typically on the face. When larege can become locally destructive.

Question 6

Superficial

Answer 6

Superficial macule affecting the trunk, affects younger patients (average is 57) may show spontaneous regression. High recurrence rate

Question 7

Morpheaform BCC

Answer 7

Resembles flat slightly atrophic lesion or plaque without well defined borders. Sub clinical later spread (which increases recurrence rates)

Question 8

Cystic BCC

Answer 8

Often has a blue grey appearance, degeneration may not be obvious or may resemble a nodular BCC

Question 9

Basosquamous carcinoma

Answer 9

Atypical BCC, more aggressive and more locally destructive may resemble an SCC and higher rates of metastasis.

Question 10

Keratocanthoma

Answer 10

Dome shaped lesions containing a pit of keratin that develop over a period of days can be precursors of malignancy but are normally benign

Question 11

Pyogenic granuloma

Answer 11

friable overgrowths of granulation at sites of minor trauma. Bleeding on contact is common, can be treated with curettage and cautery

Question 12

Lentigo maligna melanoma

Answer 12

Slowly developing melanoma but becomes invasive. Develops from a Hutchinson malignant freckle

Question 13

Premalignant lesion due to atypical keratinocytes in the epidermis (can develop into SCC). Rough erythematous papule with a white to yellow scale. Lesions typically cluster at sites of chronic sun exposure (questions may mention a gardener etc)

Answer 13

Actinic Keratosis

Question 14

Also called bowen’s disease. Typically an elevated plaque arising on sun exposed skin in elderly patients (there may be a history of prior actinic keratosis). Full thickness dermal keratinocytes, Nuclear pleomorphism, apoptosis and abnormal mitoses are seen

Answer 14

Squamous cell carcinoma in situ

Question 15

Erythematous keratotic papule or nodule on a background of sun exposure. Ulceration may occur, regional lymphadenopathy may be seen.

Answer 15

Invasive SCC

Question 16

Commonest BCC, raised translucent papule, typically on the face. When larege can become locally destructive.

Answer 16

Nodular BCC

Question 17

Superficial macule affecting the trunk, affects younger patients (average is 57) may show spontaneous regression. High recurrence rate

Answer 17

Superficial

Question 18

Resembles flat slightly atrophic lesion or plaque without well defined borders. Sub clinical later spread (which increases recurrence rates)

Answer 18

Morpheaform BCC

Question 19

Often has a blue grey appearance, degeneration may not be obvious or may resemble a nodular BCC

Answer 19

Cystic BCC

Question 20

Atypical BCC, more aggressive and more locally destructive may resemble an SCC and higher rates of metastasis.

Answer 20

Basosquamous carcinoma

Question 21

Dome shaped lesions containing a pit of keratin that develop over a period of days can be precursors of malignancy but are normally benign

Answer 21

Keratocanthoma

Question 22

friable overgrowths of granulation at sites of minor trauma. Bleeding on contact is common, can be treated with curettage and cautery

Answer 22

Pyogenic granuloma

Question 23

Slowly developing melanoma but becomes invasive. Develops from a Hutchinson malignant freckle

Answer 23

Lentigo maligna melanoma