Benign and Malignant Skin Tumors Flashcards Preview

Disease & Defense - Unit 3 > Benign and Malignant Skin Tumors > Flashcards

Flashcards in Benign and Malignant Skin Tumors Deck (27):
1

What is the cell type of origin for each of the following skin growths?Hemangioma, Cherry angioma – Kaposi’s Sarcoma – Port Wine Stain - Sebaceous Gland – Sebaceous Hyperplasia – Nevus sebaceous- Acrochordon  – Dermatofibroma - Seborrheic keratosis – Actinic keratosis – Basal cell carcinoma – Squamous cell carcinoma

Endothelial Cells: Hemangioma, Cherry angioma, Kaposi’s Sarcoma, Port Wine StainSebaceous Gland: Sebaceous Hyperplasia, Nevus sebaceousNot sure what cells lead to AcrochordonFibroblast: DermatofibromaKeratinocyte: Seborrheic keratosis, Actinic keratosis, Basal cell carcinoma, Squamous cell carcinoma

2

Which skin tumors are malignant or have malignant potential?

Kaposi’s Sarcoma, Actinic keratosis, Basal cell carcinoma, Squamous cell carcinoma

3

Describe clinical features of infantile hemangiomas. 

Infantile Hemangioma:  Strawberry (capillary) hemangiomas. They appear by 2 months of age, with 1/3 present at birth. They grow rapidly over the first year of life, then they involute slowly at about 10% per year, so that 50% have resolved by age 5 and 90% have resolved by age 9.

4

Name a congenital vascular malformation? 

Port wine stain

5

Understand how to differentiate/diagnose benign and malignant melanocytic tumors. Differentiate between nevi and melanoma

ABCD(E)Asymmetry, Border irregularity, Color variegation and Diameter greater than 6mm). Many people also look at E for evolution or change.A new tool used in diagnosing melanoma is looking for the “Ugly Duckling”, or the mole(s) that look different from their neighboring moles

6

Describe clinical features of different types of nevi and melanoma

The superficial spreading and nodular types of melanoma together account for approximately 80% of all melanomas. Both types occur most commonly in patients with lighter skin phenotypes, and may occur anywhere, but have a predilection for the upper back in men and women and the lower legs in women.Risk factors for developing these variants of melanoma include a family history of melanoma (with or without the presence of multiple dysplastic nevi), the presence of numerous common acquired nevi, and a history of blistering sunburns.The other subtypes of melanoma, lentigo maligna melanoma and acral lentiginous melanoma, are not correlated with intense, intermittent sun exposure.Lentigo maligna melanoma accounts for approximately 5% of all melanomas and is most commonly seen at sites of maximum sun exposure in patients with obvious photodamage, e.g., the face, hairless (bald") scalp extensor forearms and upper trunk.Acral lentiginous melanomas comprise 3-8% of all melanomas and by definition arise on the volar skin of the palms or soles and the nailbeds. Acral lentiginous melanomas have no known correlation with sun exposure and are the most common form of melanoma in African-Americans and Hispanics."

7

Recognize the risk factors for melanoma

Fair skin. A history of sunburn Excessive ultraviolet (UV) light exposure. Living closer to the equator or at a higher elevation. Having many moles or unusual moles. A family history of melanoma. Weakened immune system.

8

Know the difference in Breslow depth and Clark's level used in staging of melanoma as important prognostic factors of melanoma

Breslow depth is the maximal thickness of tumor invasionClark level, describes how far a melanoma has penetrated into the skin instead of actually measuring it.The Breslow measurement of thickness is the most important factor in determining prognosis of melanoma

9

Understand the components of melanoma prevention

Limit Ultraviolet (UV) Exposure• Protect Your Skin With Clothing• Wear a Hat• Use Sunscreen• Wear Sunglasses• Seek Shade• Protect Children• Avoid Harmful Chemicals eg. arsenic

10

Recognize the risk factors for non-melanoma skin cancer.

• Ultraviolet (UV) Light• Fair Skin• Gender: Men are 2 times as likely as women to have basal cell cancers and 3 times as likely to have squamous cell cancers of the skin. • Chemicals Exposure to large amounts of arsenic, industrial tar, coal, paraffin• Radiation• Having had a skin cancer• Phototherapy Psoralen and ultraviolet light treatments (PUVA) • Genetic Skin Diseases eg. Basal Cell Nevus Syndrome and Xeroderma pigmentosum• Immunosuppression • HPV Infection • Smoking: Smoking is a risk factor for squamous cell skin cancer, but not for basal cell cancer.

11

Understand the components of non-melanoma skin cancer prevention.

Limit Ultraviolet (UV) ExposureProtect Your Skin With Clothing• Wear a Hat• Use Sunscreen• Wear Sunglasses• Seek Shade• Protect Children• Avoid Other Sources of UV Light• Avoid Harmful Chemicals• HPV vaccine• Don’t smoke

12

Describe the clinical features of actinic keratosis.

Actinic keratosis (also known as solar keratosis) is a pre-cancerous problem caused by too much sun. It causes small, rough spots that may be pink-red or flesh-colored. They often appear on the face, ears, back of the hands, and arms of middle-aged or older people with fair skin.Actinic keratoses are slow growing. They do not usually cause any symptoms other than the papules on the skin. While they can turn into skin cancer, that does not happen very often.

13

Describe the clinical features of basal cell carcinoma.

Basal cell carcinomas often appear as flat, firm, pale areas or as small, raised, pink or red, translucent, shiny, waxy areas that may bleed after minor injury. You might see one or more abnormal blood vessels, a depressed area in the center, or blue, brown, or black areas. Large BCCs may have oozing or crusted spots. About 3 out of 4 skin cancers are basal cell carcinomas.They usually begin on areas exposed to the sun such as the head and neck. Basal cell carcinoma was once found mostly in middle-aged or older people.  Basal cell carcinoma tends to grow slowly. It is very rare for a basal cell cancer to metastasize. After treatment, basal cell carcinoma can recur in the same place on the skin. Within 5 years of being diagnosed with basal cell cancer, 35% to 50% of people develop a new skin cancer.

14

Describe the clinical features of squamous cell carcinoma.

Squamous cell carcinoma may appear as growing lumps, often with a rough surface, or as flat, reddish patches that grow slowly. Both BCCs and SCCs may develop as a flat area showing only slight changes from normal skin.This type of cancer begins in the upper part of the epidermis and accounts for about 1 to 3 out of 10 skin cancers. SCCs also appear on sun exposed skin such as the face, ear, neck, lips, and backs of the hands. SCC can also begin within scars, skin ulcers or other areas of chronic injury. Squamous cell carcinomas are more likely to invade fatty tissues just beneath the skin. They are also slightly more likely to spread to lymph nodes or distant parts of the body than are basal cell carcinomas, although this is still not common. SCCs occur much more commonly in immunosuppressed patients, especially organ transplant patients.

15

What is this?What are its clinical features?

Cherry angioma • Distribution- primarily truncal• Typically multiple- up to many hundreds• Primary lesion 1-4 mm in size• bright red, smooth-topped papules• occasionally pedunculated

16

What is this?

Kaposoi's Sarcoma Endothelial malignancy triggered by HHV-8• Slowly progressive• Incidence 0.05 per 100,000 population in the USA Subtypes• Classic – Occurs primarily in elderly men of Eastern European descent• Lymphadenopathic – Aggressive form primarily in equatorial Africa – Affects young men and is rapidly fatal• AIDS – Associated – Occurs more frequently in homosexual patients with AIDS – Incidence is declining with better anti-retroviral therapy against HIV

17

What is this?

Infantile hemangioma

18

What is this?

Port wine stain

19

What is this?Clinical features? 

Nevus sebaceous Clinical: A hamartoma that most commonly presents as a papillomatous, yellow-orange linear plaque on the face or scalp. Lesions on the scalp are associated with alopecia. Rapid growth occurs at puberty with enlargement of sebaceous glands and epidermal hyperplasia.

20

What is this?

Sebaceous Hyperplasia  • Common benign tumor of oil gland• Increasing frequency after middle age• Sunlight induced?• Distribution- face>trunk>extremities• Primary lesion- 1-6 mm yellowish-white papule (globules) with central dellMay be component of Muir-Torre syndrome

21

What is this?

acrochordon

22

What is this?

Dermatofibroma

23

What is this?

Seborrheic KeratosisClinical: Seborrheic keratoses are oval, slightly raised, light brown to black papules or plaques. They rarely exceed 3 cm in diameter and are most commonly located on the chest and back. They are also commonly found on the scalp, face, neck and extremities, but spare the palms and soles. The onset is usually in the fourth or fifth decade with a gradual increase in number. Some patients may have hundreds of lesions.

24

What is this?

Junctional nevus:The nevus cells are at the dermal epidermal junction just above the basement membrane zone of the epidermis; the clinical correlate is a darkly pigmented flat or minimally elevated nevus.

25

What is this?

Compound nevi:When the nests are present at the dermal epidermal junction and within the dermis

26

What is this?

Dysplastic nevi

27

What are these?

Basal cell, squamous cell, melanoma skin cancers