Skin Lesions

Question 1

what is squamous cell carcinoma

Answer 1

carcinoma arising from epidermal cells

Question 2

what are the most common sites of squamous cell carcinoma

Answer 2

head, neck, and hands

Question 3

what are the risk factors for squamous cell carcinoma

Answer 3

sun exposure, pale skin, chronic inflammatory process, immunosuppression, xeroderma pigmentosum, arsenic

Question 4

what is a precursor skin lesion for squamous cell carcinoma

Answer 4

actinic keratosis

Question 5

what are the signs/symptoms of squamous cell carcinoma

Answer 5

raised, slightly pigmented skin lesion
ulceration/exudate
chronic scab
itching

Question 6

what is the treatment for squamous cell carcinoma

Answer 6

• small lesion (<1cm): excise with 0.5cm margin

- large lesion (>1cm): resect with 1-2cm margins of normal tissue

Question 7

what is the dreaded sign of metastasis in squamous cell carcinoma

Answer 7

palpable lymph nodes

Question 8

what is Marjolin’s ulcer

Answer 8

squamous cell carcinoma that arises in an area of chronic inflammation

Question 9

what is the prognosis of squamous cell carcinoma

Answer 9

excellent if totally excised

Question 10

what is the treatment for solitary metastasis

Answer 10

surgical resection

Question 11

what is basal cell carcinoma

Answer 11

carcinoma arising int he germinating basal cell layer of epithelial cells

Question 12

what are the risk factors for basal cell carcinoma

Answer 12

sun exposure, fair skin, radiation, chronic dermatitis, xeroderma pigmentosum

Question 13

what are the signs/symptoms of basal cell carcinoma

Answer 13

slow-growing skin mass (chronic, scaly)
scab
ulceration with or without pigmentation, often described as ‘pearl-like’

Question 14

what is the treatment of basal cell carcinoma

Answer 14

resection with 5mm margins

Question 15

what are the risk of metastasis

Answer 15

very low

Question 16

what is melanoma

Answer 16

neoplastic disorder produced by malignant transformation of the melanocyte
- melanocytes are derived from neural crest cells

Question 17

what are the four major histologic types of melanoma

Answer 17

superficial spreading
lentigo maligna
acral lentiginous
nodular

Question 18

what is superficial spreading melanoma

Answer 18

occurs in both sun-exposed and non sun-exposed areas

- most common

Question 19

what is lentigo maligna melanoma

Answer 19

malignant cells that are superficial, found usually in elderly patients on the head or neck

• called Hutchinson’s freckle if noninvasive
• least aggressive type, very good prognosis

Question 20

what is acral lentiginous melanoma

Answer 20

occurs on palms, soles, sublingual areas

Question 21

what is nodular melanoma

Answer 21

vertical growth predominates
lesions are usually dark
most aggressive type

Question 22

surgical margin for melanoma in situ

Answer 22

0.5cm

Question 23

surgical margin for <1mm thick melanoma

Answer 23

1cm margin

Question 24

surgical margin for 1-4mm thick melanoma

Answer 24

2cm margin

Question 25

surgical margin for >4mm thick melanoma

Answer 25

3cm margin

Question 26

treatment for digital melanoma

Answer 26

amputation

Question 27

treatment for palpable LN metastasis in melanoma

Answer 27

lymphadenectomy