Non-melanomatous skin lesions Flashcards

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1
Q

what are seborrheic keratosis?

A

benign proliferation of epidermal keratinocytes
stuck on greasy hyperkeratotic surface
common on face and trunk in ageing skin

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2
Q

what occurs with seborrheic keratosis?

A

epidermal acanthosis
hyperkeratosis
horn cysts

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3
Q

what do seborrheic keratosis look like on histology?

A

massive thickening of prickle layer with groups of keratinocytes?
circles that look like onions

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4
Q

what are the 3 subtypes of BCC?

A

nodular
superficial
infiltrative

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5
Q

how do BCCs develop?

A

basal cells sprout from the epidermis and groups of cells invade into dermis
peripheral palisading

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6
Q

do BCCs spread?

A

no

slow growing so can divide and grow but don’t metastasise

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7
Q

which type of BCC is most dangerous?

A

infiltrative
may infiltrate tissues or spread along nerves
poorly defined

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8
Q

physical appearance of BCC?

A

shiny/pearly

arborizing vessels

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9
Q

what is palisading?

A

cells line up in a palisade (Picket fence) around the edge of the lesion
seen in nodular BCC

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10
Q

what are superficial BCCs confused with?

A

eczema as they are almost flat and crusty and are poorly defined

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11
Q

how do superficial BCCs grow?

A

spread along the base of epidermis and can have gaps so are poorly defined

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12
Q

what does morphoeic look like?

A

lots of fibroblasts and collagen

looks like a scar

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13
Q

where are BCCs usually derived from?

A

hair follicle

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14
Q

what is bowens disease?

A

in situ SCC

usually in older females legs

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15
Q

what does bowens disease look like?

A

scaly patch/plaque
irregular border
no dermal invasion
yellowish crust sometimes

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16
Q

what happens in bowens?

A

some cells keratinise prematurely - dysplasia

17
Q

when does bowens disease become dangerous?

A

when the dysplasia crosses the basement membrane

18
Q

who/where is actinic keratoses (AK) usually seen?

A

on sun exposed (hands, scalp) skin in people with lots of outdoor sun exposure

19
Q

what are AK?

A

premalignant dysplasia of epidermis

SCC precursors

20
Q

what do AK look like?

A

small crusty lesions

21
Q

AK histology?

A

parakeratin - epidermis is turning over too quickly as turning malignant
nuclei retained in keratin layer
squamous dysplasia

22
Q

name some viral lesions that are precancerous?

A

erythroplasia of Queryat-penile bowens

associated with HPV

23
Q

which HPV is associated with dysplasia?

A

16

24
Q

common site of SCC?

A

sun exposed sites

25
Q

occasional SCC sites?

A

chronic ulcers
burns sites
chronic lupus

26
Q

rare site of SCC?

A

XP

EB

27
Q

how do SCC behave?

A

locally invasive
metastases risk but not always
scalp, ear, nose = more likely to spread
can spread via lymphatic, vascular or perineural

28
Q

SCC histology?

A

groups of squamous/atypical cells invading the dermis

29
Q

peri/intra neural spread?

A
peri = spread around/with the nerves
intra = invades the nerve and spreads with it
30
Q

peri/intra neural spread?

A
peri = spread around/with the nerves
intra = invades the nerve and spreads with it
31
Q

what do merkel tumours look like?

A

sheets of dense neuroendocrine cells/tumour

32
Q

what is the leser trelat sign?

A

eruptive appearance of many seborrheic kertoses