Epidermal Tumours

Question 1

example of a benign epidermal tumour

Answer 1

seborrheic keratosis (basal cell papilloma)

proliferation of epidermal keratinocytes

Question 2

where is seborrheic keratosis commonly found?

Answer 2

ageing skin on face and trunk

Question 3

presentation of seborrheic keratosis

Answer 3

well-defined
small
cysts/ warty
stuck on appearance- greasy hyperkeratotic surface
leser-trelat sign (eruptive appearance)

Question 4

management of seborrheic keratosis

Answer 4

reassurance but can use cryotherapy if troublesome

Question 5

examples of precancerous dysplasias in the skin?

Answer 5

Bowen’s disease
actinic keratosis
viral lesions

Question 6

what is Bowen’s disease?

Answer 6

squamous carcinoma in-situ

Question 7

presentation of Bowen’s disease

Answer 7

scaly patch/plaque often found on legs

Question 8

diagnosis of Bowen’s disease

Answer 8

diagnostic biopsy

Question 9

management of Bowen’s disease

Answer 9

imiquimod cream

Question 10

what is actinic keratosis

Answer 10

precursor of SCC

Question 11

presentation of actinic keratosis

Answer 11

scaly lesions are found on sun-exposed sites such as the head/neck

Question 12

where are viral lesions often found?

Answer 12

anogenital skin

Question 13

cause of viral lesions

Answer 13

HPV 16

Question 14

invasive malignancies that are non-melanoma

Answer 14

basal cell carcinoma
squamous cell carcinoma
Kaposi’s sarcoma
miscellaneous tumours

Question 15

genetic association with BCC

Answer 15

PTCH1

Question 16

presentation of BCC

Answer 16

sun-exposed sites

picket fence pearly border

Question 17

sub-types of BCC

Answer 17

nodular
superficial
infiltrative

Question 18

presentation of nodular BCC

Answer 18

pearly nodule with blood vessels

Question 19

presentation of superficial BCC

Answer 19

slow growing
scaly
erythematous plaque that has pearly whipcord margin

Question 20

presentation of infiltrative BCC

Answer 20

wavy, scar-like plaque with indistinct borders

Question 21

management of BCC

Answer 21

vismodegib
excision
imiquimod
cryotherapy

Question 22

presentation of SCC

Answer 22

hyperkeratotic wart/crusted lump/ ulcer

Question 23

presentation of Kaposi’s sarcoma

Answer 23

purple lesions that arise in HIV and imunosuppressed- transplant

Question 24

what can miscellaneous tumours arise from?

Answer 24

sweat glands
smooth muscle
arrector pili
lymphatics
Langerhans
Merkel cells (viral cancer)
subcutaneous fat

Question 25

risk factors for skin cancer

Answer 25

``` sun exposure genetic predisposition immunosuppression environmental carcinogens phototoxic drugs ```

Question 26

how is sun exposure a risk factor?

Answer 26

p53 mutations UVB causes direct DNA damage UVA cause indirect oxidative damage

Question 27

examples of genetic predispositions

Answer 27

xeroderm pigmentosum albinism (defect in tyrosine leading to no melanin and lack of pigment) Gorlin's syndrome recessive dystrophic epidermolysis bullosa

Question 28

what is Gorlin's syndrome

Answer 28

AD condition with multiple BCC's

Question 29

examples of phototoxic drugs

Answer 29

``` voriconazole thiazide diuretics NSAIDs anti-TNF azathioprine ```