19. Skin Pathology

Question 1

What is the name of the APCs within the epidermis?

Answer 1

Langerhan’s cells

Question 2

What is the origin of melanocytes?

Answer 2

Neural crest

Question 3

What is the function of melanocytes?

Answer 3

Produce melanin which they transfer to adjacent squamous cells
Protects nuclei of squamous cells from UV damage

Question 4

What name is given to moles?

Answer 4

Melanocytic naevi

Question 5

Why is a basal cell carcinoma called that?

Answer 5

Neoplasm is of small dark cells that look like basal cells in the epidermis

Question 6

What does ‘palisading’ refer to in a basal cell carcinoma?

Answer 6

Cells and nuclei are arranged parallel

Question 7

What is a basal cell carcinoma that erodes local structures known as?

Answer 7

‘Rodent ulcer’

Question 8

What is a specific feature of squamous cell carcinomas?

Answer 8

Keratin production

Question 9

What risk factors are associated with an increased risk of non-melanoma skin cancer?

Answer 9

Skin type
UV exposure
Age
Radiation treatment
Immunosuppression
Rarely genetic

Question 10

What type of NMSC is an immunosuppressed person more likely to get?

Answer 10

Squamous cell

Question 11

What is Marjolin’s ulcer?

Answer 11

SCC found at the edge of old scars, burns and ulcers

Question 12

What are genetic causes of SCCs?

Answer 12

Albinism

Xeroderma pigmentosum

Question 13

Name a genetic cause of BCC?

Answer 13

Basal cell naevus syndrome

Question 14

What are dysplastic epidermal lesions?

Answer 14

Squamous lesions that show dysplasia

Question 15

Give 2 examples of dysplastic epidermal lesions

Answer 15

actinic/solar keratosis

Bowen’s disease

Question 16

What is actinic keratosis?

Answer 16

Often seen in elderly

Epidermis shows dysplasia in sun exposed areas

Question 17

What is Bowen’s disease

Answer 17

In-situ SCC in non-sun exposed sites

Question 18

How are NMSCs treated?

Answer 18

Surgical or dermabrasion (AK)
Cryotherapy
Topical treatment
appraise other lesions
Moh's micrographic surgery

Question 19

What’s is Moh’s micrographic surgery?

Answer 19

Small pieces of tumour taken out until margins are clear

Question 20

What is an ephelis?

Answer 20

Freckle

Localised area of increased melanin production

Question 21

What is a benign lentigo?

Answer 21

Flat lesion with increased numbers of melanocytes in basal layer

Question 22

What is a melanocytic naevus?

Answer 22

Clonal proliferation of melanocytes in nests

Evolves over time

Question 23

What is a naevus?

Answer 23

Hamartoma of a skin element

Found at birth or early in life

Question 24

Where can malignant melanoma arise apart from skin?

Answer 24

Eye
Meninges
Mucosa
Genitourinary tract

Question 25

Melanomas can also be non-pigment producing. T/F?

Answer 25

True: amelanotic

Question 26

What are satellite nodes?

Answer 26

Malignant melanoma spreads within the skin

Question 27

Where do malignant melanoma mets commonly go?

Answer 27

Liver, lung, brain

Question 28

What is the difference between Breslow thickness and Clarke's level of invasion?

Answer 28

Breslow measures the thickness of the lesion | Clarke measures the layer of skin

Question 29

What are the histological classifications of malignant melanoma?

Answer 29

Superficial spreading Nodular Acral Lentigo maligna

Question 30

Where is acral melanoma found?

Answer 30

Palms and soles

Question 31

What is lentigo maligna?

Answer 31

Flat, irregular, pigmented lesion Caused by proliferation of atypical junctional melanocytes Chronic sun exposed skin (faces of elderly) Can evolve to in situ malignant melanoma

Question 32

How are pigmented lesions assessed?

Answer 32

Dermoscopy

Question 33

Why should suspected melanoma not be shaved, punched or incised?

Answer 33

Could cause an in situ melanoma to break the basement membrane

Question 34

When should a sentinel node biopsy be done?

Answer 34

Only when the node is clinically involved

Question 35

What is the target of Vemurafenib?

Answer 35

B-RAF

Question 36

What is the target of Ipilimumab?

Answer 36

CTLA-4