Derm Cancers 1

Question 0

Mast cells, basophils

Answer 0

Type 1 immunology

Question 1

skin colored, erythematous or yellowish

Answer 1

Squamous Cell Carcinoma (SCC)

Question 2

Type 1 Immunology

Answer 2

• IgE (ER)
• Mast cells, basophils
• e.g. Hives

Question 3

cytotoxic

Answer 3

Type II immunology

Question 4

Immune complex

Answer 4

Type III immunology

Question 5

Type III imm

Answer 5

• immune (antigen-ab) complex
• platelet damage, vascular permiability
• vasculitis

Question 6

cell-mediated immunity

Answer 6

Type IV

poison ive

Question 7

blistering diseases

Answer 7

defect in Basement Membrane Zone (BMZ)

Question 8

what affects mucous membrane and causes pustules?

Answer 8

candida

Question 9

SK Tx

Answer 9

• reassure
• cosmetic:cryotherapy, curettage with electo…., shave
• excisional biopsy

Question 10

• greasy
• stuck on
• tan to black
• 2mm-3cm
• trunk but anywhere

Answer 10

Seborrheic Keratosis (SK)

Question 11

• tan to black papule
• irregular but well-circumscribed
• 2mm-3cm

Answer 11

Seborrheic Keratosis (SK)

Question 12

• suddenly many SK

- with many skin tags

Answer 12

Lesler-Trelat sign

Question 13

• sign of internal malignancy
• many skin tags
• suddenly many SK

Answer 13

Lesler-Trelat sign

Question 14

• rapid growth (4-6 wks)
• biologically Benign but histologically SQUAMOUS CELL melanoma
• resolves on its own within 6 months
• round flesh colored nodule

Answer 14

keratoacanthoma

Question 15

flesh colored, round nodule

rapid

Answer 15

keratoacanthoma

Question 16

keratoacanthoma

Answer 16

• flesh colored, round nodule
• rapid (4-6 wks)
• resolves within 6 months
• resembles SCC

Question 17

• benign but often precursor to SCC
• <1 mm - several cm
• skin colored, white or light (can be pink)
• scale or rough patch
• FELT more easily

Answer 17

Actinic Keratosis (AK)

Question 18

Actinic Keratosis (AK) Tx

Answer 18

5-FU cream/imiquimod
cosmetic: cryotherapy, curettage, shave, biopsy
chem peels

Question 19

benign precursor to SCC

sun exposure

Answer 19

Actinic Keratosis (AK)

Question 20

• firm/hard nodule/papule, often depressed center
• “Pearly” “waxy”, rolled borders
• teleangiectasias
• few mm-1 cm
• pink/red, pale yellow, translucent

Answer 20

Basal Cell Carcinoma (BCC)

Question 21

Basal Cell Tx

Answer 21

• biopsy if ? ab Dx
• refer to derm for any skin cancer
• cosm: cryotherapy, curettage/electrodessication, excisional biopsy
• MOHS
• 5 FU, Imiquimod

Question 22

• HEAD and FACE lesions most likely to metastasize

- low risk for met

Answer 22

SCC

Question 23

What condition can often lead to SCC

Answer 23

Actinic Keratosis (AK)

Question 24

SCC Tx

Answer 24

- surgical resection (cure >90%) - MOHS if > 2cm and recurrent - Cosm: cryotherapy, curettage/electro - If metastasized: radiation, chemo

Question 25

Melanoma Tx

Answer 25

- wide surgical excision with margins - elective lymph node dissection - Chemo: DTIC Dacarbazine - Immuno: interferon-alpha - Gene therapy - F/u q 3 months

Question 26

dermis

Answer 26

- contains vessels, nerves, appendages - 1mm-4 mm - collagen, elastic fibers, ground substance

Question 27

- 1st as flat/slightly raised discolored patch - IRREGULAR borders (vs. nodular is more regular) - tan, brown, red, blue white - RADIAL before VERTICAL - in previously benign mole

Answer 27

Superficial Spreading Melanoma

Question 28

- long horizontal growth, then RAPID vertical - flat or mildly raised, mottles (spots) - older ppl, sun-exp - in situ turned invasive - shades of brown - subtype of MM

Answer 28

Lentigo Maligna

Question 29

- rapid vertical growth (wks to months) - little/no radial growth - inflamed/friable nodule - black or any color - looks like superficial spreading melanoma

Answer 29

Nodular Melanoma

Question 30

most aggressive form of melanoma

Answer 30

nodular melanoma

Question 31

what looks like Superficial Spreading Melanoma?

Answer 31

Nodular Melanoma

Question 32

rapid vertical growth (wks to months)

Answer 32

Nodular melanoma

Question 33

ABCDs of melanoma

Answer 33

- assymetry - border, irregular - color, uneven - diameter >6 mm - other: color spreads into surrounding skin, new nodule, inflammation beyond mole, tender, itch, bleeding, oozing

Question 34

sampling of melanoma

Answer 34

!!! ALWAYS require a FULL thickness biopsy!!! | !!! do NOT cauterize or shave !!!

Question 35

- localized erythematous PATCH or plaque on TRUNK > 5 cm - itchy - Sezary cells later - Tx: refer to oncology/derm

Answer 35

Mycosis Fungoides (AKA Cutanious T Cell Lymphoma)

Question 36

- may appear in previously benign mole - horizontal before vertical invasion - irregular borders

Answer 36

Superficial Spreading Melanoma

Question 37

Felt easier than seen

Answer 37

Actinic Keratosis | Scale or dry rough patch