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Flashcards in Skin Cancer Deck (48):
0

- Brown "stuck on" papule that well circumscribed
- immature bland basaliloid keratinocytes with hyperkeratotosis acanthosis, keratin filled horn cysts

- seborrheic keratosis
- activating mutation in FGF-3

1

Leser-trelat sign

- Explosive development of brown papules
- Paraneoplastic syndrome

2

- Soft, flesh colored, bag-like polyp
- fibrovascular covered by normal tissue

- acrochondron (skin tag, fibroepithelial)

3

Well demarcated papule with central punctum
- recapitulate hair follicle

- epidermoid cysts ( aka sebaceous cyst)
- cyst will recur if entire lining is not excised

4

Cyst with a stratified squamous cell layer that includes granular layer

Epidermoid cyst
- many call them sebaceous cysts

5

Cyst with a stratified squamous cell layer that doesn't include granular layer

Pilar cyst

6

- Lesion of disorganized keratinocytes in the lower layers of epidermis
- does not involve full thickness of epidermis

- actinic keratosis
- premalignant: can turn into squamous cell carcinoma

7

- Full thickness dysplasia
- irregular hyper chromatic nuclei

Squamous Carcinoma in situ
- excision is curative
- sun exposure is number 1 risk factor

8

- Cup shaped lesion with central crater
- dome shaped nodule with central crater and keratin plug

Keratoacanthoma

9

Most common skin carcinoma
Ulcer with rolled boarder or pink pearly papule with talengectasia
Slow growing, circumscribed

Basal cell carcinoma

10

Gorlin syndrome

- nevoid basal cell carcinoma syndrome
- PTCH mutation (9:22)
- two hit pathology

11

Lentigo vs. freckle

- lentigo: darker, doesn't darken in sun, larger, includes mucous membrane
- freckle: smaller, darkens in sun, lighter, not on mucous membranes

12

Nevi

- p16/INK4a, CDNK2 mutation
- benign
- moles
- melanocytes Nevis: nests of melanocytes in basal epidermis
- compound Nevis: junctional and intra dermal nests of melanocytes

13

Fused nests of atypical melanocytes between rete pegs
Linear lamellar fibrosis of papillary dermis

Dysplastic Nevus

14

Risk factors for malignant melanoma (genetic and environmental)

- CDNK2a gene mutation
- RAS/BRAF and PI3K
- sun exposure, lightly pigmented, giant congenital nevi

15

Atypical melanocytes within epidermis, esp migrating in stratum spinosum, confluent single melanocytes at basal layer

Melanoma-in-situ

16

Dysplastic melanocytes involve epidermis and invade the dermis

Malignant Melanoma

17

Vertical growth down into dermis

- primary prognostic factor
- increases the risk in localized melanoma
- Breslow thickness (measured from granular layer)

18

Tan-brown-red firm papule commonly on extremities
Fibroblasts and foamy histeocytes trap individual collagen bundles at periphery

Benign fibrous histyocytoma

19

Condition involving optic gliomas and pigmented Hartomas in iris, cafe-au-lait spots on skin

Neurofibroma (NF-1: loss of RAS)
AD

20

Cafe-au-lait spots without but no lisch nodules in the iris

NF-2

21

Plexiform rubbery mass

NF tumor

22

Firm solid nodule/plaque on trunk, uniform spindle cells/storiform fascicles invading subcubitus

Dermatofibrosarcoma protuberans
- unlikely to metastasize -> Fibrosarcoma may metastasize

23

Chronic non-healing lesions on trunk
- atypical T cell infiltration with cerebriform nuclei
- beads on a string lining up on DE junction

Mycoses fungoides
- prognosis depends on % body coverage
- moves into blood -> sezary syndrome

24

Dome shaped papules on nodules and forehead
- jigsaw like puzzle islands of basaloid cells with small ductal lumen and surrounding hyaline sheath

Cyclindroma, turban tumors

25

Slow-growing flesh colored papule on head and neck of older adults
- well circumscribed dermal nodule of sebocytes and outer layer if basaloid germanitive cells

Sebaceous Adenoma
- may be associated with HNPCC

26

Solitary asymptomatic skin colored papules on face
- associoated with PTEN mutation

- trichilemmomas

27

Tumor suppressor genes associated with skin cancer (2)

- p53
- PTCH

28

Solar elastosis

- elastic fibers get damaged and become disorganized
- not full thickness

29

Insitu Squamous vs actinic keratosis

- generally size
- squamous cell is also full thickness with basal layer is intact (in situ)

30

Sunlight damage

- UV -> pyrimidine dimers -> p53 activation (most common mutation in people who develop SCC) -> arrest cell division and corrupt cell dies
- chronic immunosuppression increases risk factors
- long term chronic lesion also increases risks

31

Large light pink keratinocytes in well circumscribed cup

- keratoacanthoma

32

BCC transformation

- main issue is damage to local tissue
- BCC rarely metastasize (.5%)

33

BCC pathenogenesis (3 options)

- most are sporadic p53 mutation
- 30% are PTCH
- gorlin syndrome: Nevoid BCC, one hit mutation in all cells

34

Long thin rete pegs, non-nested single large myelocytes

- lentigo

35

BRAF-RAS path mutation

- Nevus
- often accumulates p16 (melanoma have decreased)

36

Nests of melanocytes

Nevus
- junctional-> compound -> intradermal

37

Decreased p16/ increase in RAS -> increase in BRAF

- associated with malignant melanoma

38

17q11
- NF1
- eyes

RAS mutation
- plexiform

39

22q11
- acoustic fibromas

- NF2
- no lisch nodules

40

Mycoses fungoides prognosis

- % body coverage
- stage (patch, plaque, nodule)

41

Pautrier abcess

- mycoses fungoides
- lymphocytes infiltrating

42

Association with lynch syndrome

- sebaceous Adenoma

43

Oncogenes tumor suppressor genes

- oncogenes: Dominant expression, gain of function (kinases, GFs et al)
- tumor suppressors: (p53, PTCH) resistive expression, loss of function

44

Bowen's syndrome

- squamous cell carcinoma in situ
- unlike Actinic keratosis (which rarely transforms), Bowens transforms in 26 % of cases

45

Trt of AK

5-FU: lights up areas affected

46

Eminems CD is Not Killer

Malignant melanoma
- CDNK2a

47

Gore PiTCHed his Nevil scheme in Philadelphia

Nevoid basal cell carcinoma: gorlin syndrome: PTCH: t9;22