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PCM 4 exam 2 > Skin malignancies > Flashcards

Skin malignancies Flashcards

1
Q

Diagnostic features of Basal Cell Carcinoma

A

mc form

  • pearly papule, erythem patch, or nonhealing ulcer in sun exposed areas (face, trunk, lower legs)
  • waxy, “pearly” appearance w/ telangiectastic vessels easily visible
  • appears redish, somewhat shiny, scaly plaques on back and chest and lower legs

-history of bleeding occasionally

  • can be umbilicated
  • can be lobular/nodulated
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2
Q

Diagnostic features of Squamous Cell Carcinoma

A
  • nonhealing ulcer or warty nodule
  • small red conical hard nodules (occasionally ulcerate)
  • keratinization, erythemetic borders (can be red, crusty)
  • commonly on HANDDD, pinna of ear
  • can have keratinous growth
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3
Q

Diagnostic features of Malignant Melanoma

A
  • Description: non symmetrical, can have irregular borders, varied colors (mostly black), can have areas of fibrosis and ischemia at edges
  • white= ischemic
  • blue and whitish hues = bad (malignant present)

look at ABCDE criteria

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4
Q

GENERAL risk factors

A

history of sunburns/heavy sun exposure

  • blue/ green eyes
  • blonde/red hair
  • fair complexion
  • equatorial living
  • subq-equotorial living (new zealand)
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5
Q

risk factors for SCC

A

may arise from ACTINIC KERATOSES (15% chance)

other: Bowen dz, erythroplasia of queyrate, UV radiation, ionizing irradiation, HSC transplant, infection w/ HIV/AIDS, CLL, IS drugs, photosensitizing drugs
- if have areas of chronic inflammation, chronic ulceration and scarring–> predispose to SCC

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6
Q

risk factors for Malignant Melanoma

A
  • hx of sunburns and/or heavy sun exposure
  • green/blue eyes
  • blonde/red hair
  • fair complexion
  • > 100 typical nevi, any atypical nevi
  • prior fam hx or fam hx of melanoma**
  • p16 mutation**

-familial dysplastic nevus syndrome or severe dysplastic or atypical nevi = >5x risk for developing

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7
Q

epidemiology of cutaneous BCC

A

most often fair skinned person w/ hx of sun exposure (intense, intermitten)

persons of color: DIFF PX; often pigmented; can have rolled border; can also be in diff locations such groin, scrotum, perianal region and feet

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8
Q

epidemiology of cutaneous SCC

A
  • common in fair skinned individuals
  • organ transplant recipients + other IS pts
  • prolonged sun exposure on exposed parts in fair skinned and in those that burn easily/tan poorly
  • exposure to UV light

*persons of color- can see in non-sun exposed areas

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9
Q

epidemiology of malignant melanoma

A
  • mean age of dx = 63 y/o; 15% under 45 y/o
  • incidence rapidly rises in whites after 20 y/o
  • fair skinned individuals at highest risk
  • caucasions: back for men, LE and trunk for women, highly variable course
  • highly variable course
  • in african americans + asians–> palms, soles, nail beds
  • *INVERSE RELATIONSHIP bw incidence of melanoma and skin color**
  • -> highest incidence in caucasians, intermediate among hispanics, lowest among asians and african americanss
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10
Q

melanoma screening

A

ABCDE

Asymmetry

Border- irregular, notched, scalloped, ragged, or poorly defined

Color - various shades from one area to another (black = necrotic; blue = deeper depth of invasion; white = ischemic, fibrosis, deeper invasion)

Diameter- > 5mm

Evolution: changes in lesion over time

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11
Q

premalignant lesions

A

pyoderma gangrenosum–> malignancy

actinic keratosis–> SCC

erythroplasia of queryat–> precancerous lesion of penis; (20-30% assoc w/ malignancy); SCC predisposition

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12
Q

which are nonmelanoma skin cancers

A

basal + squamous cell skin cancers

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13
Q

risk factors for BCC

A
  • sun exposed skin in otherwise normal fair-skinned individuals
  • UV LIGHT = most often cause

in persons of color–> less common but still check!

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14
Q

which of the ABCDE melanoma screening criteria carries greatest sensitivity + specificity at predicting metastatic potential of lesion?

A

COLOR

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15
Q

what are the standard treatments/therapies for these cancers

A

mostly surgical EXCISION

adjuvant therapy differs

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16
Q

what can pruritus point to in systemic dz

A

malignancy

17
Q

what do gottrens papules point to in systemic dz

A

dermatomyositis

internal malignancy

18
Q

what does clubbing point to in systemic dz

A

internal malignancy

cyanotic Heart Dz

IBD

Lung dz

19
Q

Other skin lesions relating to systemic dz (probs not on exam)

A

kaposi sarcoma–> HIV/AIDS (#1)

malar rash–> SLE

PCM 4 exam 2 (6 decks)

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