Skin Neoplasms Flashcards
1
Q
Which types of UV are most associated with skin changes and aging?
A
UVA & UVB
2
Q
UVA
A
not absorbed by ozone layer
-leads to photo aging, not cancer
3
Q
UVB
A
- mostly absorbed by ozone layer
- some reaches Earth’s surface
- carcinogenic
4
Q
UVC
A
very carcinogenic but completely absorbed by ozone layer
5
Q
Which layer of skin is affected by UVB?
A
epidermis
6
Q
What is the primary agent responsible for sunburns
A
UVB
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
8
Q
solar elastosis
A
thickened coarse wrinkling and yellow discoloration of skin
9
Q
Define nevi
A
- moles
- benign overgrowth of melanocytes on skin surface
- can be congenital or acquired
10
Q
Congenital nevi include what?
A
- mongolian spot
- cafe-au-lait spots
- nevus spilus
- congenital melanocyte nevi
11
Q
What are acquired nevi?
A
pigmented moles
12
Q
What are the three types of acquired nevi?
A
- junctional
- compound
- intradermal
13
Q
Junctional nevi
A
- flat brown/black, slightly elevated
- common on sun exposed surfaces
14
Q
Compound nevi
A
brown/black
- slight elevated
- may have coarse hairs
15
Q
Intradermal nevi
A
- dome shaped or pedunculate (hangs by a stalk)
- may become fleshy colored
- may develop coarse hairs
16
Q
Spitz nevi
A
- acquired melanocytic nevi
- brown to pink, dome shaped
17
Q
blue nevus
A
- acquired melanocytic nevi
- benign dome shaped blue to black nodule
18
Q
What is the most common non melanoma skin cancer?
A
Basal Cell Carcinomas
19
Q
Clinical presentation of BCC
A
- pearly bordered, translucent nodules
- intralesional telangiectasis (little blood vessels)
20
Q
Define BCC
A
- neoplasm of nonkeratinizing cells of the basal layer of the epidermis
- spreads wide and deep without treatment
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
Which layer does Squamous Cell Carcinoma happen in
epidermal layer
26
What does squamous cell carcinoma usually arise from?
actinic keratoses
27
What are two types of Squamous Cell Carcinoma?
- Intraepidermal squamous cell
| - invasive squamous cell
28
Incidence of SCC
- second most frequent occurring malignant tumor
- men twice as likely
- dark skinned rarely affected
29
SCC presentation
- 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
Where does Keratoacanthoma originate?
pilosebaceous galnds
31
What is Keratoacanthoma?
an involuting type of SCC
32
SCC treatment
- excision
| - shave excision, curettage, cryosurgery
33
Actinic keratosis AKA
solar keratosis
34
Presentation of Actinic Keratosis
- single or multiple discrete, dry, rough adherent scaly lesions occur on sun-exposed areas of adults
- precancers
35
What is melanoma
- malignant tumor of the melanocytes
| - rapidly progressing and METASTATIC
36
Four type of melanoma
- superficial spreading melanoma
- nodular melanoma
- lentigo maligna melanoma
- acral lentiginous melanoma
37
ABCDE for melanoma
- 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
Melanoma Incidence
- risen over past decade
| - sun exposure (but many areas are not sun exposed.soooo...)
39
Melanoma Presentation
- 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
Blue grey veil sign is indicative of what?
melanoma
41
Types of Melanoma
- superficial spreading melanoma
- lentigo maligna melanoma
- acral-lentiginous melanoma
- nodula melanoma
42
What percentage of cases do you see superficial spreading melanoma?
70% of cases
43
Lentingo meligna melanoma
- 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
Nodular Melanoma
- no radial growth phase
- lesions 5mm-1cm
- ABCDE rules do NOT apply
45
Acral Lengtiginous melanoma
- diagnosed older
- occurs on palms/soles or beneath nails
- non homogenous color
- malignant pigmented melanochyia striata in nails are early presentation
46
Thickness matters in lesions
Thickness matters in lesions
47
Breslow's Classification
- tumor thickness is single most prognostic factor
| - >3.6mm = 31%
48
Clark system
tumor rated depending on depth of tumor invasion
49
Why is nodular melanoma most dangerous?
Because there is no lateral growth (no radial growth)--. just vertical growth
50
Methods of Exam for Melanoma
- H&P, family hx
| - Epiluminescent microscopy
51
Treatment of melanoma
-excision based on tumor thickness
