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Derm > Skin Neoplasms > Flashcards

Skin Neoplasms Flashcards

1
Q

Which types of UV are most associated with skin changes and aging?

A

UVA & UVB

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2
Q

UVA

A

not absorbed by ozone layer

-leads to photo aging, not cancer

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3
Q

UVB

A
  • mostly absorbed by ozone layer
  • some reaches Earth’s surface
  • carcinogenic
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4
Q

UVC

A

very carcinogenic but completely absorbed by ozone layer

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5
Q

Which layer of skin is affected by UVB?

A

epidermis

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6
Q

What is the primary agent responsible for sunburns

A

UVB

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7
Q

What does UV exposure cause to skin?

A
  • thickening & thinning of skin
  • thick skin found in coarse wrinkles especially on back of neck
  • don’t disappear when skin is stretched
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8
Q

solar elastosis

A

thickened coarse wrinkling and yellow discoloration of skin

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9
Q

Define nevi

A
  • moles
  • benign overgrowth of melanocytes on skin surface
  • can be congenital or acquired
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10
Q

Congenital nevi include what?

A
  • mongolian spot
  • cafe-au-lait spots
  • nevus spilus
  • congenital melanocyte nevi
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11
Q

What are acquired nevi?

A

pigmented moles

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12
Q

What are the three types of acquired nevi?

A
  • junctional
  • compound
  • intradermal
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13
Q

Junctional nevi

A
  • flat brown/black, slightly elevated

- common on sun exposed surfaces

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14
Q

Compound nevi

A

brown/black

  • slight elevated
  • may have coarse hairs
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15
Q

Intradermal nevi

A
  • dome shaped or pedunculate (hangs by a stalk)
  • may become fleshy colored
  • may develop coarse hairs
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16
Q

Spitz nevi

A
  • acquired melanocytic nevi

- brown to pink, dome shaped

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17
Q

blue nevus

A
  • acquired melanocytic nevi

- benign dome shaped blue to black nodule

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18
Q

What is the most common non melanoma skin cancer?

A

Basal Cell Carcinomas

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19
Q

Clinical presentation of BCC

A
  • pearly bordered, translucent nodules

- intralesional telangiectasis (little blood vessels)

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20
Q

Define BCC

A
  • neoplasm of nonkeratinizing cells of the basal layer of the epidermis
  • spreads wide and deep without treatment
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21
Q

Two types of BCC

A

nodular ulcerative and superficial basal cell

22
Q

Nodular Ulcerative BCC

A
  • nondulocystic, small flesh colored or pink translucent
  • enlarges over time
  • can see telangiectatic vessels
  • central depression forms
  • ulcer surrounded by waxy rim
  • darkly pigmented in dark skinned
23
Q

Incidence of BCC

A
  • most common skin cancer in white skin

- higher in men than women

24
Q

BCC treatments

A
  • biopsy all suspicious lesions

- curettage, surgical excision, irradiation

25
Q

Which layer does Squamous Cell Carcinoma happen in

A

epidermal layer

26
Q

What does squamous cell carcinoma usually arise from?

A

actinic keratoses

27
Q

What are two types of Squamous Cell Carcinoma?

A
  • Intraepidermal squamous cell

- invasive squamous cell

28
Q

Incidence of SCC

A
  • second most frequent occurring malignant tumor
  • men twice as likely
  • dark skinned rarely affected
29
Q

SCC presentation

A
  • red, scaling, keratotic, slightly elevated lesion with irregular border
  • usually with a chronic shallow ulcer
  • lesions grow outward, large ulcerations have persistent crusts and raised red borders
30
Q

Where does Keratoacanthoma originate?

A

pilosebaceous galnds

31
Q

What is Keratoacanthoma?

A

an involuting type of SCC

32
Q

SCC treatment

A
  • excision

- shave excision, curettage, cryosurgery

33
Q

Actinic keratosis AKA

A

solar keratosis

34
Q

Presentation of Actinic Keratosis

A
  • single or multiple discrete, dry, rough adherent scaly lesions occur on sun-exposed areas of adults
  • precancers
35
Q

What is melanoma

A
  • malignant tumor of the melanocytes

- rapidly progressing and METASTATIC

36
Q

Four type of melanoma

A
  • superficial spreading melanoma
  • nodular melanoma
  • lentigo maligna melanoma
  • acral lentiginous melanoma
37
Q

ABCDE for melanoma

A
  • Asymmetry: one half unlike the other
  • Border: irregular, scalloped or poorly defined
  • Color: varied from one area to another
  • Diameter: larger than 6mm/size of pencil eraser
  • Elevation change or evolution
38
Q

Melanoma Incidence

A
  • risen over past decade

- sun exposure (but many areas are not sun exposed.soooo…)

39
Q

Melanoma Presentation

A
  • usually rapidly changing flat mole
  • slightly raised, flat, bulbous
  • black, brown, red, white, blue, mottled
  • can arise from previous moles or by themselves
  • surrounding redness
  • periodic ulceration and bleeding
40
Q

Blue grey veil sign is indicative of what?

A

melanoma

41
Q

Types of Melanoma

A
  • superficial spreading melanoma
  • lentigo maligna melanoma
  • acral-lentiginous melanoma
  • nodula melanoma
42
Q

What percentage of cases do you see superficial spreading melanoma?

A

70% of cases

43
Q

Lentingo meligna melanoma

A
  • usually older patients 65-70yo
  • usually 10cm diameter (don’t normally spread but can be HUGE)
  • color variations
  • higher irregular and notched borders
  • surface usually flat with raised papular foci that occasionally are blue
44
Q

Nodular Melanoma

A
  • no radial growth phase
  • lesions 5mm-1cm
  • ABCDE rules do NOT apply
45
Q

Acral Lengtiginous melanoma

A
  • diagnosed older
  • occurs on palms/soles or beneath nails
  • non homogenous color
  • malignant pigmented melanochyia striata in nails are early presentation
46
Q

Thickness matters in lesions

A

Thickness matters in lesions

47
Q

Breslow’s Classification

A
  • tumor thickness is single most prognostic factor

- >3.6mm = 31%

48
Q

Clark system

A

tumor rated depending on depth of tumor invasion

49
Q

Why is nodular melanoma most dangerous?

A

Because there is no lateral growth (no radial growth)–. just vertical growth

50
Q

Methods of Exam for Melanoma

A
  • H&P, family hx

- Epiluminescent microscopy

51
Q

Treatment of melanoma

A

-excision based on tumor thickness

Derm (8 decks)

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