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Y2 DERMATOLOGY > skin tumours > Flashcards

skin tumours Flashcards

1
Q

how are meloncytes formed

A

early in embryogenesis melanoblasts migrate from the neural crest to skin, uveal tract and leptomeninges and once they settle in the skin they form melanocytes

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2
Q

what os the melanocyte:basal keratinocyte ratio

A

1:5 - 1:10

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3
Q

what is the function of the MC1R protein

A

determines the balance of pigment in skin and hair

  • MCR1 turns phaeomelanin into eumelanin
  • one defective copy of MC1R causes freckling
  • two defective copies causes red hair and freckles
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4
Q

what are freckles

A

called ephilides

- patchy increase in melanin pigmentation

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5
Q

what are ‘age’ or ‘liver’ spots called

A

actinic lentigines

- increase in melanin and basal melanocytes

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6
Q

how does acquired nave come about

A

during infancy the melanocytes:keratinocyte ratio breaks down at a number of cutaneous sites which allows the formation of simple nave

  • very common benign lesions
  • low malignant potential
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7
Q

what are junctional naevus

A

melanocytes proliferate with clusters of cells at DEJ

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8
Q

what are compound naevi

A

junctional clusters and groups of cells in dermis

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9
Q

what are intradermal navei

A

all junctional activity has ceased entirely dermal

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10
Q

what is dysplastic navei

A
  • generally >6cm diameter
  • variegated pigment
  • boarder asymmetry
  • architectural atypic and cellular atypia
    • unlike melanoma epidermis isn’t effected
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11
Q

what are halo naevi

A

Have peripheral halo of depigmentation. They show inflammatory regression and are overrun by lymphocytes

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12
Q

what are blue naevi

A

entirely dermal and consist of pigment rich dendritic spindle cells. The cellular variant may have mitoses and mimic melanoma

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13
Q

what is the aetiology of malignant melanoma

A
  • sunburn
  • UV exposure
  • genetic risk
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14
Q

what features would make you suspect a melanoma

A
  • change in shape
  • new pigmented lesion develops in adulthood
  • irregular pigmentation
  • bleeding
  • development of nodules
  • ulceration
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15
Q

what are the 4 main types of melanoma

A
  • superficial spreading (commonest on trunks and legs)
  • aural/mucosal lentiginous ( acral and mucosal)
  • lentigo maligna (sun damaged face/neck/scalp)
  • nodular (varied site but often trunk)
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16
Q

what does a melanoma prognosis depend on

A
  • Breslows depth and ulceration (Breslow = deepest tumour from granular layer)
17
Q

how do you treat a melanoma

A
  • primary excision to give clear margins
  • some also receive a sentinel node biopsy
  • if SN positive then you need a regional lymphadenectomy
  • chemo, immunotherapy, genetic therapy
18
Q

what is BRAF

A
  • wild type BRAF is a weak cytosolic proto-oncogene
  • if mutated drives cell proliferation regulating MEK and ERK
  • range of drugs developed to interfere with this pathway
19
Q

what are some precancerous dysplasia

A
  • Bowens disease
  • Actinic keratosis
  • Viral lesions
20
Q

what are some invasive malignancies

A
  • basal and squamous cell carcinoma
21
Q

what is seborrhoea keratosis

A

benign proliferation of epidermal keratinocytes common on the face and trunk. It has a stuck on appearance-greasy hyperkeratotic surface
- epidermal acanthuses, hyperkeratosis, horn cysts

22
Q

what are the 3 main subtypes of basal cell carcinoma

A
  • nodular
  • superficial
  • infiltrate (morphoeic)
23
Q

what are features of basal cell carcinoma

A
  • may infiltrate tissues widely
  • prominent desmoplastic fibrous stroma
  • margins are poorly defined
  • may spread along nerves
  • resection may be challenging
24
Q

what do precursors of squamous cell carcinomas show

A

dysplasia

25
Q

what is Bowens disease

A
  • squamous cell carcinoma in situ
  • scaly patch/plaque
  • irregular border
  • no dermal invasion
26
Q

what are features of actinic keratosis.

A
  • very common
  • sun exposed skin
  • variable epidermal dysplasia
  • severely atypical lesions are bowenoid
27
Q

what is the commonest clinical setting for squamous carcinoma of the skin

A
  • elderly
  • sun exposed sites eg face, ears
  • UV implicated

Y2 DERMATOLOGY (21 decks)

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