Skin Neoplasms

Question 1

what are some indications of malignancy?

Answer 1

• sore or lump that bleeds or develops a crust or a scab
• flat red spot that is rough, dry, or scaly and may become itchy or tender
• red or brown patch that is rough and scaly

Question 2

stages of skin cancer are based on what?

Answer 2

size and depth of involvement

Question 3

what is the most common malignant cutaneous neoplasm (among caucasians)

Answer 3

basal cell CA

occurs over sun-exposed areas

Question 4

describe the malignancy potential of basal cell CA.

Answer 4

• locally invasive, rarely metastasizes

- slow growing destructive lesion

Question 5

which form of basal cell CA is most aggressive? least aggressive?

Answer 5

nodular form- (large nests of tumor cells); least

morpheaform- (small nests of tumor cells); more aggressive

Question 6

what is the most common form of BCC?

Answer 6

nodular basal cell CA (BCC)

Question 7

a patient presents with a small, white dome shaped nodule that has telangiectatic vessels that make appearance “erythematous”. which neoplasm is this?

Answer 7

nodular BCC

Question 8

what is the least aggressive of BCC?

Answer 8

superficial BCC

Question 9

what is the most common BCC of LE and feet?

Answer 9

superficial BCC

*appears very smooth and red!

Question 10

whicn neoplasm is the second-most prevalent malignant tumor of the skin? (and is most common among AA and Asian-Indians)?

Answer 10

squamous cell CA

Question 11

describe the malignancy potential of squamous cell carcinoma.

Answer 11

DANGEROUS TUMOR, CAN METASTASIZE TO LYMPH NODES

Question 12

between basal cell CA and squamous cell CA, which will metastasize?

Answer 12

squamous cell CA will metastasize to lymph nodes

Question 13

which neoplasm is NOT pearly (unlike basal cell CA)?

Answer 13

squamous cell CA

Question 14

amount of margins during excisional skin surgery depends on what?

Answer 14

type of lesion

depth of lesion

Question 15

is radiation therapy a common treatment for skin cancer?

Answer 15

no

-it can be used for areas that are difficult for surgery or leave a bad scar

Question 16

what is the most serious type of cancer of the skin?

Answer 16

melanoma

Question 17

what are the risk factors for developing melanoma?

Answer 17

1. dysplastic nevi
2. 50+ ordinary moles
3. fair skin
4. personal hx of melanoma or skin cancer
5. FMHx of melanoma
6. weakened immune system
7. sever, blistering sunburns
8. UV radiation

Question 18

where does malignant melanoma metastasize to?

Answer 18

any organ; brain and heart

Question 19

do melanomas cause pain?

Answer 19

no

Question 20

what are the ABCDEs of malignant melanoma?

Answer 20

• asymmetry
• irregular borders
• color variation
• diameter enlargmenet
• evolution/elevated

Question 21

what is the clark staging for malignant melanoma based on?

Answer 21

level of invasion of the skin

Question 22

what is the Breslow’s staging for malignant melanoma based on?

Answer 22

layer of skin involved AND depth of the lesion

Question 23

what are the 2 staging systems for malignant melanoma that we discussed and which is more accurate?

Answer 23

Clark

Breslow’s depth- more accurate

Question 24

Using Breslow’s depth staging, classify tumors into their 4 categories.

Answer 24

4mm (Clarks 5)

Question 25

classify this according to Clark: all tumor cells above the basement mb (in situ)

Answer 25

Clarks Level 1

Question 26

classify this according to Clark: tumor extends to papillary dermis

Answer 26

Clarks Level 2

Question 27

classify this according to Clark: tumor extends to interface btwn papillary and reticular dermis

Answer 27

Clarks Level 3

Question 28

classify this according to Clark: tumor extends btwn bundles of collagen and reticular dermis

Answer 28

Clarks Level 4

Question 29

classify this according to Clark:tumor invasion of SC tissue

Answer 29

Clarks Level 5

Question 30

The American Joint Commiission on Cancer published a cancer staging manual that is based on what?

Answer 30

T-tumor thickness N-nodes (lymph) involvement M-metastasis

Question 31

how do you diagnose melanoma?

Answer 31

excisional biopsy

Question 32

what are the 4 main types of malignant melanoma?

Answer 32

1. superficial spreading 2. lentigo maligna 3. nodular 4. acral lentiginous

Question 33

which type of growth phase (radial or vertical) is more aggressive?

Answer 33

vertical growth phase- penetrates dermis

Question 34

superficial spreading melanoma has what type of spread (vertical or radial)?

Answer 34

radial spread- therefore is the least aggressive of the malignant melanomas

Question 35

which type of melanoma occurs over sun-exposed areas usually in elderly and on the face?

Answer 35

lentigo maligna melanoma

Question 36

which type of melanoma is least aggressive? which is most malignant?

Answer 36

least- superficial spreading melanoma most malignant- nodular melanoma

Question 37

what is Hutchinson's sign ? what does this indicate?

Answer 37

sudden apeparance of subungual pigmented band at proximal nail fold (suspect acral lentiginous melanoma)

Question 38

acral lentiginous melanoma affects where in the body mostly?

Answer 38

palms, soles and nail beds

Question 39

what are the pre-malignant lesions?

Answer 39

- acitinic keratosis | - cutaneous horns