5: Pathology of non-pigmented lesions

Question 1

What is a common benign epidermal tumour with a raised, stuck-on appearance?

Answer 1

Seborrhoeic keratosis

Question 2

Name three precancerous dysplasias which can develop into SCCs.

Answer 2

Actinic keratoses

Bowen’s disease

Viral warts

Question 3

What are the two common non-pigmented malignant lesions?

Answer 3

Basal cell carcinomas

Squamous cell carcinomas

Question 4

What benign lesion is common in aging skin?

What are they made of?

Answer 4

Seborrhoeic keratoses

Keratinocytes

Question 5

How would you describe a seborrhoeic keratosis?

Answer 5

Brown

Stuck-on appearance

Pitted / warty surface

Well-defined borders

Question 6

What sign of internal malignancy involves the eruption of loads of seborrhoeic keratoses?

Answer 6

Leser-Trelat sign

Question 7

What are seborrhoeic keratoses also known as?

Answer 7

Basal cell papilloma

Question 8

What is the malignant version of a seborrhoeic keratosis?

Answer 8

Basal cell carcinoma

Question 9

Where do basal cell carcinomas appear?

Answer 9

Sun-exposed skin

Question 10

What are the three types of basal cell carcinoma?

Answer 10

Nodular

Superficial

Morphoeic (infiltrative, spread deep to the epidermis)

Question 11

Which type of BCC is the most important to identify?

Answer 11

Infiltrative / morphoeic

Question 12

What do BCCs look like?

Answer 12

Slow-growing

Pearly

Telangectasia

Question 13

Do BCCs commonly metastasise?

Answer 13

No

Question 14

How can BCCs kill / cause serious disability?

Answer 14

Infiltrating organs & structures e.g ears, eyes, brain

Question 15

Which form of skin cancer has three common precursor dysplasias?

Answer 15

Squamous cell carcinoma

Question 16

Where is Bowen’s disease commonly found?

Answer 16

Legs

Question 17

Where are actinic keratoses commonly found?

Answer 17

Sun exposed skin:

Scalp, face, neck, dorsal hands

Question 18

Where are viral lesions commonly found?

Answer 18

Anogenital surfaces

Question 19

Which process do SCC precursor lesions go through?

Answer 19

Dysplasia

i.e abnormal epithelial growth, “atypia”

Question 20

Bowen’s disease is essential SCC __-__.

Answer 20

in-situ

Question 21

What does Bowen’s disease look like?

Answer 21

Scaly erythematous patches / plaques with an irregular border

Question 22

Does Bowen’s disease invade the dermis?

Answer 22

No, epidermal lesion

plaques are flat

Question 23

Bowen’s disease is most commonly seen in (men / women).

Answer 23

women

Question 24

Bowen’s disease is often mistaken for which kind of skin disease?

Answer 24

Inflammatory skin disease

Question 25

Name a SCC precursor caused by UV exposure, commonly seen on the scalp, face and hands.

Answer 25

**Actinic keratosis**

Question 26

What are actinic keratoses also known as?

Answer 26

**Solar keratoses** cuz of sun exposure

Question 27

What happens histologically in actinic keratosis?

Answer 27

**Rete ridges become elongated**

Question 28

Do actinic keratoses invade the dermis?

Answer 28

**No**

Question 29

Which infectious agent causes lesions which may turn into SCCs?

Answer 29

**Viruses** most commonly HPV

Question 30

What is **erythroplasia of Queryat?**

Answer 30

**Penile Bowen's disease**

Question 31

Which virus is usually responsible for lesions which may turn into SCCs?

Answer 31

**Human papilloma virus**

Question 32

The viral lesion on slide 33 resembles which other SCC precursor?

Answer 32

**Bowen's disease**

Question 33

What are the treatment options for SCC precursors (actinic keratoses, Bowen's disease and viral lesions)?

Answer 33

**Cryotherapy** **Topical treatments**

Question 34

What are the common sites for **SCCs**?

Answer 34

**Sun-exposed skin** (face, ears, dorsal surface of hands)

Question 35

On which chronic skin diseases can SCCs arise?

Answer 35

**Leg ulcers** **Burns**

Question 36

Which genetic condition involves DNA repair failure and predisposes patients to SCCs?

Answer 36

**Xeroderma pigmentosum**

Question 37

What is the prognosis for BCCs and SCCs?

Answer 37

**Generally good**

Question 38

What are the two main factors influencing SCC prognosis?

Answer 38

**Thickness** **Vascular/lymphatic involvement**

Question 39

What are sites for SCCs associated with poor prognosis?

Answer 39

**Scalp** **Nose** **Ears**

Question 40

What structures can SCCs travel along to invade other tissues?

Answer 40

**Nerve fibres**

Question 41

What pressure receptor / mechanoreceptor cells can become malignant?

Answer 41

**Merkel cell carcinoma**

Question 42

Merkel cell carcinoma is the cutaneous equivalent of which lung cancer?

Answer 42

**Small cell carcinoma**

Question 43

Which T-cell lymphoma presents like eczema but doesn't clear up with topical steroids?

Answer 43

**Mycosis fungoides**