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Details

Dermatology
Tumors and Pigmented Lesions
44
Medical
Graduate
12/12/2009

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Cards

Term
What is the most common cutaneous malignancy?
Definition
Basal cell CA (BCC)
Term
Describe BCC. Who is it most common in?
Definition
Locally invasive, usu. slow-growing, rarely metastasizes. >age 40, fair skin.
Term
Name 5 variants of BCC.
Definition
Nodular, Pigmented, Superficial, Micronodular, and Morpheaform.
Term
What is the most common type of BCC? Describe it.
Definition
Nodular. Pearly pink paules, often ulcerate, bleed, and become crusted
Term
Why is the BCC pigmented in the pigmented type?
Definition
It contains melanin. May resemble malignant melanoma.
Term
What is the least aggressive form of BCC? Describe it.
Definition
Superficial. Lesions are flatter, not as deeply invasive, MC on truck and extremities
Term
What is the diff. b/t micronodular and nodular BCC?
Definition
Micronodular is clinically similar but histologically extends further making recurrence more frequent
Term
What is the most subtle and least common form of BCC? Describe it.
Definition
Morpheaform (sclerosing) -resembles scar tissue, extensive, more aggresive and most difficult to tx.
Term
What tx for BCC is an option for well-defined, small nodular and superficial types, but causes a very slow healing wound?
Definition
Electrodessication and Curettage (ED&C)
Term
What is the best option for recurrent or aggressive tumors and is the TOC for morpheaform BCC?
Definition
Mohs surgery
Term
What tx is useful for BCC difficult to tx surgically and pts unwilling to undergo surgery?
Definition
Radiation
Term
What is a common, persistent keratotic lesion w/ malignant potential that is most common on sun-exposed areas?
Definition
Actinic Keratosis (AK)
Term
About 10-20% of AK cases progress to ____ over several yrs.
Definition
Invasive squamous cell CA (SCC)
Term
Describe physical appearance of AK.
Definition
Initially poorly defined area of redness w/ thin scale that thickens and becomes yellow over time
Term
What tx can be used for solitary AK lesions? Diffuse lesions?
Definition
Cryotherapy. Topical 5-FU or imiquimod
Term
An invasive, primary cutaneous malignancy arising from keratinocytes of skin or mucosa that is the 2nd most common skin CA?
Definition
SCC
Term
Where does SCC typ. occur on the body?
Definition
Head, neck, and hands
Term
Skin findings of SCC?
Definition
Red lesions w/ poorly defined base and yellow-white scale.
Term
What is a very superficial SCC that is intraepidermal? Does it metastasize?
Definition
SCC in situ (Bowen's). No but can be invasive if untx.
Term
A rapidly growing crateriform nodule, considered a low-grade SCC?
Definition
Keratocanthoma
Term
Peak incidence of keratocanthoma? Areas of distribution?
Definition
Ages 50-70. Face, neck, dorsal hands and sun-exposed areas.
Term
Describe skin findings in keratocanthoma.
Definition
Solitary lesion w/ keratotic plug that gives char. volcano shape.
Term
What is the only skin CA w/ a genetic component?
Definition
Melanoma.
Term
Melanoma is the most common malignancy in what group?
Definition
Women age 25-29
Term
What is the most common early sx of melanoma?
Definition
Itchy, but most are asymptomatic
Term
what is the most importane warning sign in melanoma?
Definition
changing mole
Term
What is lentigo maligna?
Definition
In situ melanoma, usu. flat w/ irregular border, brown w/ pigment variation. nodules and ulcers may indicate local invasion.
Term
what are the only rec. methods of bx on suspicious lesions?
Definition
Punch or excision
Term
What means a better prognosis in melanoma?
Definition
The thinner the breslow depth at the time of dx
Term
What causes Kaposi's sarcoma?
Definition
HSV 8
Term
Describe classic Kaposi's sarcoma.
Definition
Sporadic and slowly progressive occuring mainly in men 50-70yo of E. European or MEditerranean descent.
Term
Who is at increased risk of dev. Kaposi's sarcoma?
Definition
Organ transplant pts, AIDS pts
Term
Describe skin lesions in Kaposi's sarcoma.
Definition
Purple patches. In classic on lower legs and progress proximally. In AIDS pts on face, torso, and oral mucosa.
Term
What is seen on skin bx in Kaposi's sarcoma?
Definition
Neoplastic spindle-shaped cells
Term
Common, benign, brown macules occuring on sun-exposed skin that appear in childhood as ephelides (freckles)?
Definition
Lentigo
Term
Flat or raised brown to tan macules, MC in children?
Definition
Junctional Nevi
Term
Slightly or markedly raised pigmented papules.
Definition
Compound nevi
Term
Commonly elevated, fleshy and slightly or moderately pigmented that may have coarse, dark hairs growing from them?
Definition
Intradermal nevi
Term
Sharply defined tan to brown background patch containing several small monomorphic slightly raised dark brown nevi?
Definition
Nevus spilus
Term
Solitary bluish macules or papules usually on the head, neck, or buttocks?
Definition
Blue nevi
Term
Usually reddish pink, dome-shaped, smooth papule.
Definition
Spitz nevus (spindle cell nevus)
Term
A pre-existing nevus that dev. a rim of hypopigmentation.
Definition
Halo nevi
Term
Aquired brown hyperpigmentation of the face and neck, AKA the mask of pregnancy.
Definition
Melasma
Term
Tx for melasma?
Definition
1)Sun avoidance 2)Bleaching creams containing hydroquinone 3)Azelaic acid during pregnancy
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