Skin Lesions Quiz

Question 1

pearly nodule growing over 18 months on the face?

Answer 1

BCC

proliferation of basal keratinocytes

Question 2

expected BCC immediate treatment?

Answer 2

surgical excision
cryotherapy doesn’t work well
radiotherapy only used if not excisable

Question 3

actinic keratoses treatment?

Answer 3

topical treatment (e.g aldara - immunomodulator, or efudix - cytotoxic)
often too large an area for cryotherapy

Question 4

actinic keratoses?

Answer 4

chronic sun exposed sites

scaly

Question 5

signs of seborrheic keratosis?

Answer 5

well defined
warty surface (dimpled)
middle aged
stuck on appearence

Question 6

what do the 3 types of melanocytic naevus look like?

Answer 6

junctional = flat and brown
compound = raised and brown
intra-dermal = raised and skin coloured

Question 7

enlarging ulcerating lesion growing over last 10-15 years?

Answer 7

neglected BCC

Question 8

how is neglected BCC treated

Answer 8

imaging

radiotherapy usually best option if neglected for so long that its really extensive

Question 9

what does a dysplastic naevus look like?

Answer 9

often just look odd but don’t really change or cause symptoms (pain, itching etc)

Question 10

bowens disease?

Answer 10

derived from keratinocytes

scaly appearence

Question 11

most common site of melanoma in females?

Answer 11

leg

Question 12

bowens disease?

Answer 12

older female legs
history of sun exposure
full thickness dysplasia of keratinocytes in epidermis

Question 13

bowens treatment?

Answer 13

non-surgical
topical creams
cryotherapy

Question 14

which symptom is most important in a melanoma?

Answer 14

evolution

Question 15

what does a blue naevus look like?

Answer 15

dark navy colour, well defined, unchanging mole

long term

Question 16

how do blue naevi develop?

Answer 16

if melanocytes stop in the dermis while migrating to the basal layer and form a naevus

Question 17

SCC clues?

Answer 17

elderly patient
sun exposed site
fast growing (months)
lot of keratin in the middle
rapid growth not present in viral warts or BCC

Question 18

nodular component developing in a pigmented patch which has been present for years?

Answer 18

nodule suggests vertical growth phase

melanoma can now metastasise (cant metastasise in RGP)

Question 19

slow progressing melanoma?

Answer 19

lentigo maligna

very long RGP when then becomes VGP

Question 20

growth time for BCC?

Answer 20

at least 6 months

Question 21

telangectasia?

Answer 21

presence of blood vessels

seen in BCC

Question 22

flat moles which then become raised in a young woman?

Answer 22

normal progression from junctional stage to compound stage
usually happens in young adults
no management or monitoring needed

Question 23

dermatofibroma?

Answer 23

asymptomatic
unchanging
very firm nodule
can be present for years
proliferation of dermal fibroblasts
can be red

Question 24

Basal cell papilloma?

Answer 24

same as seborrheic keratosis
can be black
warty appearence

Question 25

changing lesion, asymmetrical, jaggy border, >6mm, flat?

Answer 25

melanoma

Question 26

flat pigmentation above a well defined lesion?

Answer 26

melanoma

at 12 o clock lesion

Question 27

rolled edge, telangectasia, black, sparing in the middle< pearly?

Answer 27

BCC

Question 28

haemangioma?

Answer 28

benign overgrowth of blood vessels
lots of red lumps on dermatoscope
looks black/dark and irregular from a distance