Trigger - Pigmented, Precancerous lesions Flashcards
(44 cards)
only used w immunocompetent ppl w NON hypertrophic AK on face/scalp
imiquimod
Solar keratosis Neoplastic condition in which precancerous epithelial lesions are found on sun-exposed areas of the body.
Actinic keratosis
pt presents w flat scaly papules/plaques that range between 2-6mm. They are yellow/white in color with ill defined border and scaling on an erythematoius base.
Give dx and treatment
actinic keratosis
Tx:
FIRST VISIT = lesion targeted cryosurgery (can also do currettage or shave excision)
Second visit
1. 5 FU or imiquimod (if ok w SE)
2. Diclofenac (if not ok w above SE)
3. laser ablation/chemical peel/derm abrasion/cryopeeling/PDT (if wants one time in office tx and doesnt want topical therapy)
FU Q 3-6 mo with aggresive sun exposure therapy!!!!
what can you NOT use in patients with actinic keratosis who are immunocompromised or have hypertrophic AK.
imiquimod
used for NON-hypertrophic AK on face/scalp
dermoscopy shows erythema w pseudo network around hair follicles and linear-wavy vessels
actinic keratosis
also follicles w yellow keratotic plugs
causes neutrophil-mediated cytotoxicity that eliminates remaining tumor cells
ingenol mebutate (picato)
used in actinic keratosis
Malignant cutaneous epithelial cells, MC on sun-exposed areas.
SCC
what is the MC skin cancer in AA
SCC
this is more frequent and aggressive in immunosuppressed individuals and are prevalent in organ transplant recipients and HIV/AIDS patients
SCCIS
confined to epidermis
dermoscopy shows red vessels with dots that have shiny white structures and are crusty/crystalline
SCC
Dermoscopy shows red vessels with shiny structures and brown/gray dots in a linear arrangement
Pigmented SCC
A soft, fleshy papule that bleeds easily and is found on non-sun exposed areas such as trunk, LE, genitalia.
Dx and tx
undifferentiated SCC
histopathology of biopsy shows pleomorphic/hyperchromatic squamous cells with variable nuclear size
SCC
tx: excision w narrow margins (3-5mm)
this can be either mohs or standard surgical excision
a variant of SCC that grows rapidly
keratoacanthoma
can be solitary or multiple and involutes over time
histology shows craterioform endophytic nodule with well differentiated keratinocyes and a central keratin plug.
keratoacanthoma
MC subtype of basal cell carcinoma
nodular
Histology shows pleomorphic squamous cells with cariable nuclear sizes
SCC
give the treatment for the following:
1. SCC
2. high risk SCC
3. superficial SCC
4. SCC in someone who is NOT a surgical candidate
5. Well differentiated SCC or large ulcerative/nodular BCC
- Mohs/Excision w 3-5 margins
- Excision w 6mm margins if Mohs cannot be done
- electrodissection and curettage x 3 w margins of 3-4mm
- imiquimod, 5-FU, electrochemo, intralesional interferon-alpha, photodynamic therapy
- wide local excision w 2-5 cm margins!
A patient has a translucent and pearly papule with well defined borders. it is smooth and has telangiectasis on the surface
nodular BCC
A patient has a translucent, pearly lesion with a central ulcer. what is likely diagnosis
ulcerating BCC
A patient has a 4mm white/pink plaque with ill defined borders that has telangectasis and looks similar to a scar. What is the likely diagnosis
sclerosing BCC
A patient has a thin plaque that is pink/red in color with intermittent scaling throughout. what is it
superficial multicentric BCC
A patient has a firm papule that is smooth with a pearly surface and has stippled globules of pgment throughout its surface. what is it
pigmented BCC
