Cutaneous Malignancies

Question 1

What features help clinically diagnose malignancy the best?

Answer 1

Asymmetric
Borders uneven
Color uneven
Diameter Increases

Question 2

What are testing options to help diagnose?

Answer 2

Full thickness biopsy
sentinel node biopsy
DO NOT DO A SHAVE BIOPSY

Question 3

What are treatment options for Cutaneous malignancies?

Answer 3

Surgical removal
PD1 Blockade
CTLA4 Blockade
Dabrafenib + Trametinib
Vemurafenib + Cobimetinnib
Imatinib
Talimogene
Interferon

Question 4

What are common PD1 Blockade drugs?

Answer 4

Nivolumab and Pembrolizumab

Question 5

What is a common CTLA4 Blockade drug?

Answer 5

Ipilumumab

Question 6

When is Dabrafenib + Trametinib used?

Answer 6

if BRAF mutation present

Question 7

When is Vemurafenib + Cobimetinib used?

Answer 7

if BRAF mutation is present

Question 8

What is Imatinib used?

Answer 8

if C-Kit mutation is present

Question 9

What are the major causes of Squamous Cell Cancer?

Answer 9

Sunlight and organ-transplant secondary to long term use of immunosuppressant drugs

Question 10

How does Squamous Cell Cancer present?

Answer 10

Start out looking like Ulcer that does not heal or continues to grow

Question 11

How do you diagnose Squamous Cell cancer?

Answer 11

Biopsy

Question 12

How do you treat Squamous Cell Cancer?

Answer 12

Remove

Question 13

What is the most common form of skin cancer?

Answer 13

Basal Cell Carcinoma

Question 14

How does Basal Call Carcinoma present?

Answer 14

Lesions appear waxy and shiny like a pearl with telangiectasias

Question 15

How do you diagnose Basal Cell Carcinoma?

Answer 15

Shave biopsy

Question 16

What drugs are used in addition to resection for basal cell carcinoma?

Answer 16

Imiquimod or topical 5-FU

Question 17

What areas is the use of Mohs Micrographic surgery best for?

Answer 17

delicate areas like the eyelid or ear

Question 18

What population is Kaposi Sarcoma more commonly seen with?

Answer 18

Older men of Mediterranean origin

Question 19

What is the most common cause of Kaposi Sarcoma?

Answer 19

AIDS, HHV8

Question 20

How does Kaposi sarcoma present?

Answer 20

Reddish/purple lesion due to increased vascularity

Question 21

What other regions of the body besides the skin can Kaposi Sarcoma be found?

Answer 21

GI and Lungs

Question 22

What CD4 count does Kaposi Sarcoma commonly present in?

Answer 22

<100

Question 23

How is Kaposi Sarcoma treated?

Answer 23

ART therapy: as CD4 count improves Kaposi will resolve
Intralesional injections of Vincristine or Inteferon
Chemo with liposomal Doxorubicin for extensive disease

Question 24

What are Actinic Keratoses?

Answer 24

Premalignant skin lesions form high-intensity sun exposure in fair-skinned people

Question 25

How do you treat Actinic Keratoses?

Answer 25

Removal with curettage, cryotherapy, laser or topical 5-FU before transformation to squamous cell cancer

Question 26

What local immunostimulant is useful in Actinic Keratoses?

Answer 26

Imiquimod

Question 27

How does Ingenol Mebutate aid in treating Actinic Keratoses?

Answer 27

induces death in fast-growing cells

Question 28

What are Seborrheic Keratoses?

Answer 28

Hyperpigmented lesions ("Liver spots") that appear "stuck on" and are common in older adults

Question 29

How do you treat Seborrheic Keratoses?

Answer 29

Removal with cryotherapy, surgey or laser