precancerous/malignancies

Question 1

MCC skin cancer

Answer 1

UV sunlight radiation

Question 2

which type of rays cause sunburn?

cancer?

Answer 2

UVB

UVA

Question 3

greatest risk factor for cancer?

Answer 3

hx of sunburns early in life

Question 4

actinic keratosis

Answer 4

• aka solar or senile keratosis
• appears on sun exposed areas
• precursor to squamous cell carcinoma

Question 5

AK tx?

Answer 5

• crytotherapy
• curettage
• photodynamic therapy
• topical 5-flurouracil
• Topical Imiquimod

Question 6

when should you biospy a suspected AK?

Answer 6

• ulcerated, painful, bleeding

- indurated lesion

Question 7

MC skin cancer?

Answer 7

basal cell carcinoma, related to sun exposure, low metastasis risk

Question 8

BCC types

Answer 8

Papular or nodular
Translucent or “pearly”
Ulcer with a rolled border (rodent ulcer)
Superficial multicentric BCC’s- thin plaques

Question 9

sclerosing BCC

Answer 9

Infiltrating type

Whitish sclerotic patch with ill-defined borders

Question 10

superficial BCC

Answer 10

Not associated with sun exposure
Superficial lesions on the trunk, multiple
Erythematous, scaly patches

Question 11

Mohs is used mainly for…

Answer 11

BCC

Question 12

Basal Cell Nevus Syndrome(Gorlin Syndrome)

Answer 12

Multiple nevoid BCC
Mandibular keratocysts (jaw cysts)
Congenital skeletal abnormalities (ribs)
Ectopic calcifications (intracranial)
Plantar and palmar pits

Question 13

Squamous cell carcinoma

Answer 13

Malignant tumor of the epithelial keratinocytes commonly seen on head, neck, mouth

Question 14

HPV may be associated with…

Answer 14

SCC

Question 15

any skin lesion or scab that doesn’t heal for >1 month, think….

Answer 15

SCC

Question 16

Erythroplasia of Queyrat

Answer 16

• glans penis

- same as Bowen’s disease but metastasize more frequently

Question 17

highly differentiated SCC

Answer 17

• not as likely to metastasize
• firm/hard
• shows sings of keratinization
• indurated papule/nodule

Question 18

poorly differentiated SCC

Answer 18

Fleshy, hemorrhagic
Red
Polygonal, irregular, cauliflower-like
More likely to see metastasis

Question 19

MC malignant melanoma

Answer 19

Superficial Spreading Melanoma (SSM)

slow growing

Question 20

malignant melanoma can metastasize to the…

Answer 20

bone, lungs, liver, brain

Question 21

2nd MC melanoma

Answer 21

nodular melanoma

8x MC in japanese

Question 22

PE findings for superficial spreading melanoma

Answer 22

Flattened papule→ plaque → one or more nodules
Dark brown, black, with pink, gray, blue-gray hue haphazard pattern
5-8mm early- 8-12 mm late
Asymmetrical, oval with irregular borders, indentations and notches

Question 23

PE findings for nodular melanoma

Answer 23

“blueberry-like” nodule
Ulcerated or thick plaque
Uniformly dark blue, black, or “thunder cloud gray”

Question 24

least common melanoma

Answer 24

Lentigo Maligna Melanoma (LMM)

on sun exposed areas

Question 25

Acral Lentiginous Melanoma

Answer 25

• arises on soles of feet, pal, fingernail

- no trauma to the nail think of this

Question 26

Kaposi Sarcome

Answer 26

• common in HIV patients
• Ecchymotic purple-brownish macule
• treat underlying HIV

Question 27

Mycosis Fungoides (Cutaneous T-cell lymphoma)

Answer 27

• malignancy of helper T cells (CD4+)

- more common in blacks 2:1

Question 28

how to dx mycosis fungoides

Answer 28

multiple biopsies

-may present as eczema or psoriasis

Question 29

Acanthosis Nigricans

Answer 29

• benign condition associated w/diabetes
• velvety skin changes of axilla and neck
• may be associated with internal malignancyof stomach, liver, and ovaries