10 Epithelial Pathologies Flashcards by Jordan Sanger

What is this?

acquired melanocytic nevus

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What is this?

basal cell carcinoma

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What results from UV radiation and is most common of all cancers?

Basal cell carcinoma

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What is a common pathology in elderly that presents as flat tan to brown macules?

Seborrheic keratosis

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What is this?

Amalgam tattoo (ha! and you thought it was oral melanoacanthoma)

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What is this?

erythroplakia

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What is technical term for a birth mark?

congenital melanocytic nevus

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A cousin of the ephilis, what is this?

oral melanotic macule

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An ephilis on the vermillion border.

What is a Labial melanotic macule?

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What are risk factors for melanoma?

fair complexion
light hair
sunburns easily
blistering sunburns as child
hx of melanoma
hx of congenital nevus

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What is this?

Seborrheic keratosis

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What is this?

basal cell carcinoma

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What could this be?

Heck’s disease (multifocal epithelial hyperplasia)

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Which five types of HPV mostly cause condylomas?

HPV 6, 11, 16, 18, 31

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What mostly causes oral melanoacanthoma and where is it typically found in the mouth?

trauma, found on buccal mucosa

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What viruses causes Squamous papilloma?

HPV 6, 11

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Give a differential diagnosis.

Squamous papillom
Veruccous vulgaris
Condyloma accuminatum
Verucciform xanthoma

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Define stage 2 SCCA.

tumor is more than 2cm but less than 4cm across, no infected nodes or mets

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What is this? What features might give it away?

Basal cell carcinoma. Rolled borders and telangiectatic blood vessels.

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What are six etiologies of leukoplakia?

tobacco
alcohol
sanguinaria
UV radiation
microorganisms
trauma

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Biopsy shows it’s caused by HPV 2, 4 & 40. What is this?

Verruca vulgaris

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If there are scattered red patches that cannot be removed or identified, what is this termed?

erythroplakia

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Sudden appearance of many seborrheic keratosis and pruritis is associated with what other finding?

internal malignancies (condition called Leser-Trélat sign)

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What is this? What increases your risk for this in childhood?

Basal cell carcinoma. Frequent sunburns and freckles increases risk

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What is this?

Actinic cheilosis

An oral melanotic macule looks like \_\_\_\_\_\_\_\_, so if you can't confidently identify it you should biopsy the site.

OMM looks like early melanoma (don't be fooled!)

Give a differential diagnosis.

1. squamous papilloma 2. verruca vulgaris 3. condyloma acuminatum 4. verruciform xanthoma

How do you define leukoplakia?

An _intraoral white plaque_ that _cannot be wiped off_ and _cannot be identified_ as any well known entity.

These don't get darker with sun exposure. What are they?

Actinic lentigo

Define a stage 1 SCCA.

tumor size is 2cm or less, and there aren't any infected lymph nodes or metasteses

What would you ask this person?

Do you use smokeless tobacco?

What type(s) of HPV cause Mulitfocal Epithelial Hyperplasia?

HPV 13, 32

Doesn't darken with sun exposure. Is there risk for malignant transformation?

No. Actinic lentigo has no risk of malignant transformation

What is this?

(Smokeless) tobacco pouch keratosis

Occurred after pregnancy. What is this called?

Melasma

What is the real name for snuff dipper's cancer?

Verrucous carcinoma

What type(s) of HPV cause Condyloma Acuminatum?

Most commonly HPV 6, 11. High risk for HPV 16, 18, 31

These get darker with sun exposure. What are they?

Ephilis (freckles)

It's black so what do you think it is?

Melanoma

Define stage 3 SCCA.

Tumor is more than 4cm across; OR the tumor is any size and a lymph node is involved

Mostly affecting the mandibular vestibule and gingiva. What is this?

Verrucous carcinoma

If this could be wiped off, what could it be?

* materia alba * chemical burn * thermal burn * pseudomembranous candidiasis * sloughing from toothpaste

What is this?

nicotine stomatitis

Similar to seborrheic keratosis, what is this?

Dermatosis papulosa nigra

What is this?

melanoma

What likely causes verucciform xanthoma?

trauma (NOT a virus)

Not an amalgam tattoo. Where do these lesions typically occur?

Blue nevi typical on the palate

What system do you use to help identify melanoma?

ABCDE: asymmetry, border irregularity, color variation, diameter \>6mm, and evolving lesions

Your patient is concerned about this turnign into cancer. What do you tell her?

Melasma has no risk of malignant transformation

What is the diagnosis? What are the red spots?

Nicotine stomatitis, red spots are inflamed minor salivary glands

What are 12 possible contributing factors to squamous cell carcinoma?

1. tobacco 2. alcohol 3. betel quid 4. phenolic agents 5. radiation 6. iron deficiency 7. vitamin-A deficiency 8. syphilis 9. oncogenic viruses 10. immunosuppression 11. oncogenes, and tumor suppressor genes 12. 13.

Where are the two most common sites for squamous cell carcinoma?

Tongue and floor of mouth

What causes melasma?

Hormonally-driven hyperpigmentation of the sun exposed areas of the face

What is caused by HPV 13 and 32?

Multifocal epithelial hyperplasia (heck's disease)

What causes this?

Long-term UV exposure

An acquired melanocytic nevus is a proliferation of cells from what?

The neural crest

Cannot be wiped off. What is it?

leukoplakia

This pt chews betel quid. What is this pathology?

oral submucous fibrosis

How long should it take for this to resolve if habit is ceased?

2 weeks

Caused by HPV 16, 18, 31. What is it?

condyloma accuminatum

What are the two directional growth patterns of melanoma?

Radical and vertical

What three sites are most common to find this?

Floor of mouth, ventral tongue, soft palate

Define stage 4 SCCA

Any tumor \>4cm, any tumor in a node \>6cm, and mets present

What type(s) of HPV cause Verruca Vulgaris?

HPV 2, 4, 6, 40

This man cannot open his mouth any further than what is shown because his tissue isn't elastic enough. What is his condition?

oral submucous fibrosis

What is this?

Basal cell carcinoma

If not melanoma, what could this be?

Oral melanoacanthoma

What are some pathologies most likely to progress into verrucous carcinoma?

1. Proliferative verrucous leukoplakia 2. nicotine stomatitis 3. erythroplakia 4. oral submucous fibrosis 5. erythroleukoplakia 6. granular leukoplakia 7. actinic cheilosis

Pt smokes tobacco. Based on location, what do you think this is?

Squamous cell carcinoma (tongue is most common place to find it)

On the hard palate. What could this be?

Blue nevus | (less likely an amalgam tattoo)

Biopsy shows it's caused by HPV 6 & 11. What is this?

Squamous papilloma

What is the major causative factor for melanoma?

Acute UV radiation exposure