Skin Lesions

Question 1

Most important risk factor for development of skin cancer

Answer 1

exposure to natural and artificial UV radiation

Question 2

Other risk factors for skin cancer besides exposure

Answer 2

family history, prior history, fair skin, red/blonde hair, easily sunburnt, chronic exposure to toxic compounds such as creosote, arsenic, radium, and suppressed immune system

Question 3

Types of melanoma (+1 not quite a melanoma)

Answer 3

superficial spreading melanoma, 
lentigo maligna, 
amelanotic melanoma, 
acral lentiginous melanoma, 
nodular melanoma
melanoma in situ

Question 4

Which melanoma has no invasion and is localized to dermis

Answer 4

melanoma in situ…if diagnosed early, should be excised with 5mm borders

Question 5

What is the most common type of melanoma, clinical features of raised borders and brown lesions with pinks, whites, grays, blues

Answer 5

superficial spreading melanoma

Question 6

Which melanoma is most often found in elderly, but is less common than other types, very irregular borders

Answer 6

lentigo maligna

Question 7

Which melanoma usually remains undiagnosed

Answer 7

amelanotic melanoma

Question 8

Most common melanoma found in AAs and Asians

Answer 8

acral lentiginous melanoma

Question 9

Which is the most aggressive melanoma and is usually invasive by time of diagnosis

Answer 9

nodular melanoma; mostly black

Question 10

What criteria can you use to help find suspicious lesions?

Answer 10

ABCD criteria

Question 11

ABCD criteria for suspicious lesions)

Answer 11

Asymmetry
Borders (irregular)
Color (different colors)
Diameter (>6mm)
Elevation (raised)
Evolving (enlarging, thickening, or bleeding)

Question 12

What can also be done in office to evaluate skin lesions

Answer 12

dermoscopy

Question 13

Which lesions should be excised immediately

Answer 13

Any preexisting nevus that has changed or any new pigmented lesions with ABCDE signs with 2-3mm margin around lesions

Question 14

If you can’t immediately excise for cosmetic reasons, what can you do to help figure out malignancy?

Answer 14

biopsy….then if positive, then excision

Question 15

Malignant melanomas need an excision of at least…

Answer 15

5mm

Question 16

Once a malignant lesion is identified, how often should a patient be checked

Answer 16

Annually for any new or changing skin lesions

Question 17

Biggest indicator for prognosis of melanoma

Answer 17

thickness

1 = poorer prognoses, more likely to metastasize

Question 18

Who is recommended for behavioral counseling regarding sun exposure and skin cancer prevention

Answer 18

between 10-24 who are fair skinned

Question 19

What are other skin malignancies other than melanoma

Answer 19

Basal cell and squamous cell

Question 20

Most common of all cancers

Answer 20

basal cell carcinoma

Question 21

Typical features of basal cell carcinoma

Answer 21

pearly papules often with central ulceration or with multiple telangietctasias
presents with growing lesions sometimes bleeding/itching

Question 22

Prognosis for basal cell and squamous cell

Answer 22

basal cell less likely to metastasize but potential to grow large and destructive…excise that shit nigga

squamous cell more likely to metastasize (but still not very likely)

Question 23

Tan colored lesions on sun damaged skin with very irregular borders, more common in elderly

Answer 23

lentigo maligna