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Dermatology > Tumours > Flashcards

Tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

Benign neoplasms of the skin

A

Seborrhoeic keratosis Keloid scars
Cysts (pilar & epidermoid) Dermatofibroma
Skin tags (Acrochordons) Capillary haemangioma
Pyogenic granuloma Benign Melanocytic lesions

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2
Q

Benign Melanocytic lesions

A

Freckle Lentigo
Junctional naevus Compound naevus
Intradermal naevus Other (blue naevus, mongolian blue spot, beckers naevus, halo naevus)

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3
Q

Lentigo

A

like freckles but due to sun exposure (sun spots)

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4
Q

Melanocytic naevus

A

A collection of melanocytes –> a mole
The nature depends on the location within the skin and the bodily reaction
If congenital have a very small but real risk of malignancy

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5
Q

Junctional naevus

A

A form of melanocytic naevus where the collection of melanocytes are in the junction between the dermis and the epidermis

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6
Q

Compound naevus

A

A raised, benign development of a junctional naevus which arises later in life

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7
Q

Intradermal naevus

A

A mole/naevus which is the same colour as the surrounding skin – may be noticed as a patch of hairlessness on the scalp

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8
Q

Halo naevus

A

An autoimmune reaction to a naevus leading to a pale ring around it. the central naevus may become involuted leaving a small grey centre

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9
Q

Beckers naevus

A

A large hyperpigmented lesion which appears at adolescence in males with some unclear genetic link

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10
Q

Atypical Naevi

A

Clinical signs – irregular edge and pigmentation, >5mm, inflammed
Histology – Architectural atypia, cytological atypia

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11
Q

Photocarcinogenesis

A

UV causes DNA damage – the most important cutaneous carcinogen
UV may also alter immune surveillance

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12
Q

Skin types (Fitzpatrick)

A

I - V. white, pale/freckly, ginger - burn not tan (irish)
II - white, pale, no freckles - tan after burning (cornish)
III - kinda white, dark hair - tan easily (south french)
IV - mediterranean - tan dont burn (spainish)
V - Brown - mixed race or arab VI - black african

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13
Q

History of sun exposure

A 
Where did you grow up?
Occupation? (outdoors or not)
Hobbies? (outdoors or not)
Sun-bed use
How many times have you been sun burned?
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14
Q

Pre-malignant neoplasms

A

Carcinoma in situ – on the way to cancer but not invaded yet

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15
Q

Actinic (solar) keratosis

A

Can be single or multiple. Dry, rough and scaly lesion

Occur in areas of chronic sun exposure - keratinocyte atypia on histology. Can be treated with 2-3wks of fluorouracil

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16
Q

Bowen’s disease

A

Squamous cell carcinoma in situ – should be treated as risk of invasive disease
A solitary, well defined erythematous patch on the skin

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17
Q

Treatment of pre-malignant or atypic lesions

A

Cryotherapy
Topical 5-fluoracil or imiquimod (immune modulator)
Surgical removal

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18
Q

Lentigo maligna

A

Irregular macula stains on the head or neck - atypical melanocytes in situ – precursor to malignant melanoma

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19
Q

Risk factors for Skin cancers

A

UV radiation is the biggest – other ionising radiation
Skin type I or II Burns or vaccine scars
Arsenic poisoning Immunosuppression

20
Q

Basal cell carcinoma (BCC)

A

Most common type of skin cancer – locally aggressive and destructive but with limited ability to metastase - rolled, pearly edge
Can be nodular, morphoeic or pigmented
Manage with surgical excision, curettage or radiotherapy

21
Q

Squamous cell carcinoma (SCC)

A

If differentiated will be keratinised – if not may ulcerate, erode or bleed
90% remission rate but depends on differentiation
Requires urgent excision and possible radiotherapy

22
Q

Keratoacanthoma

A

A mildly common, benign neoplasm of the pilosebaceous glands. Domed rapidly growing nodule with a keratinous centre – rarely becomes malignant, may be a marker for Muir-Torre syndrome. Should refer to exclude SCC/BCC

23
Q

Features of Malignant Melanoma

A

Major – change in size, shape or colour

Minor – >6mm, inflammed, Oozing/bleeding, itch or altered sensation

24
Q

ABCDE check list for melanoma

A

Asymmetry. Border. Colour. Diameter. Evolving

25
Q

Risk factors for malignant melanoma

A

Intense, intermittent UV Skin type I or II
Pre-existing melanocytic lesions – greater risk with increasing atypia
FH of melanomas or multiple naevi

26
Q

Prognostic factors for melanoma

A

Tumour thickness – Breslow Histology
Stage at start of treatment
Depends on stage - 95% at stage I to 25% at stage III

27
Q

Management of melanoma

A

Uregent excision – second excision if margin is not clear

Lymph node sampling and staging decides next steps

28
Q

Metastasis of melanomas

A

Lymphatic - regional lymph nodes
Blood - lung, liver, brain
Local - surrounding skin and subcutaneous tissue

29
Q

Amelanotic melanoma

A

A rare type of melanoma which does not produce melanin and so is not dark. the resulting delay in detection means it has a poor prognosis and recurrence is high

30
Q

Cutaneous lymphoma

A

A monoclonal T cell tumour which initially migrates to the skin forming an itchy psoriasiform rash – subsequently spreads to lymphatics and organs

31
Q

Kaposi’s sarcoma

A

A multisystem vascular neoplasm linked to HHV-8 which arises during immunosuppression/ presents as purple papules on the skin and mucosa. these can ulcerate leading to effusion or haemoptysis
Treat with improving immune function, chemotherapy and radiotherapy

32
Q

Cancers which metastase to skin

A

Breast Lung
GI (bowel and stomach) Kidney
Bladder Thyroid
Liver

33
Q

Important genetic skin cancer conditions

A

Tuberous sclerosis. Neurofibromatosis. Gorlin’s syndrome

Oculo-cutaneous albinism. Xeroderma pigmentosa

34
Q

Tuberous sclerosis

A

Mutation in TSC1/2 - autosomal dominant
hamartomas in skin, brain, eye and heart
Clusters of firm, pink/violet papules around the muzzle
(adenoma sebaceum)

35
Q

Neurofibromatosis

A

Mutation in NF1 (neurofibrin) - autosomal dominant

Cafe-au-lait macules, neurofibromas, freckling, optic gliomas, lisch nodules, osseus lesions

36
Q

Gorlin’s syndrome

A

BCC syndrome - also skeletal anomalieis and odontogenic cysts
Mutations in PTCH tumour suppressor gene

37
Q

Oculo-cutaneous albinism

A

Partial or total lack of melanin – no protection from UV

38
Q

Xeroderma pigmentosa

A

Defective DNA repair leading to photosensitivity and photodamage from infancy – melanomas by age 8

39
Q

Strawberry Naevi (capillary haemangioma)

A

Not present at birth by may develop rapidly in the first month of life. Erythematous, raised and multilobed tumour. grow until 6-9months then regress by 10yrs (95%). 10% of white infants and females, premature babies and babies whose mothers underwent chorionic villous sampling are at greater risk. Treatment if needed is systemic steroids.

40
Q

Cavernous Haemangioma

A

A deep capillary haemangioma

41
Q

Leukoplakia

A

A premalignant condition more common in smokers with hard, white spots on the mucous memebranes of the mouth, Cannot be ‘rubbed off’ –> transformation to SCC occurs in 1%.

42
Q

Cherry Haemangioma (Campbell de morgan spots)

A

Benign skin lesions containing an abnormal proliferation of capillaries. Increasingly common with age and equal gender balance. erythematous, papular lesions (1-3mm in size). Non-blanching and not found in mucous membranes. No treatment needed.

43
Q

Chondrodermatitis nodularis helicis

A

Common, benign condition causing a painful nodule on the ear due to pressure. More common in men and with increasing age. Treat by reducing pressure, cryotherapy, steroid injections, collagen injections. Surgery can be used but there is a high recurrence rate.

44
Q

SSC and psoriasis

A

SCC is the most significant complication of PUVA with psoralen.

45
Q

Spider naevi

A

Benign blanching lesions found on the upper body in 10-15% of people. (more in children). Increased number is associated with liver disease, Pregnancy, COC,

46
Q

Pyogenic granuloma (eruptive haemangioma)

A

Relatively common benign lesions associated with trauma, pregnancy and more common in women and young adults. Small spot which rapidly progresses within days into a spherical raised lesion. Usually on the hands, head or upper trunk and oral lesions are common in pregnancy. Pregnancy related lesions will resolve spontaneously but others require excision, cryotherapy etc.

Dermatology (6 decks)

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