Term
| What is the most common premalignant skin lesion? |
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Definition
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Term
| Describe the appearance of actinic keratosis? |
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Definition
| scaly erythematous papule on sun exposed areas |
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Term
| What is the likelihood of getting squamous cell carcinoma if you have actinic keratosis? |
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Definition
| pts with an average of 7 AKs have a 10% risk of developing squamous cell carcinoma within 10 years |
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Term
| What situation is leukoplakia-cheilitis most common? |
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Definition
| MC on lower lips in men over 40 |
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Term
| What's the difference between the benign and premalignant types of leukoplakia-cheilitis? |
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Definition
| benign form is related to chronic irritation (lip biting, poor fitting dentures), premalignant type is related to smoking and chronic sun exposure |
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Term
| What is a cutaneous horn? |
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Definition
| hyperkeratotic excrescence, the base of which may be a verruca, seborrheic keratosis |
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Term
| Which malignant lesions do cutaneous horns give rise to? |
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Definition
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Term
| What are the odds that a cutaneous horn is malignant? |
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Definition
| 50% are benign, 30% overlie AK, 20% overlie SCC |
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Term
| What is a keratoacanthoma? |
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Definition
| dome-shaped, skin-colored nodule with a central crater filled with a keratin plug |
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Term
| What is the course of a keratoacanthoma? |
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Definition
| starts as a small papule, grows rapidly over 6-8 weeks, then may involute spontaneously, leaving a scar |
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Term
| Is a congenital melanocytic nevus premalignant? |
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Definition
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Term
| What are the characteristics of a congenital melanocytic nevus? |
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Definition
| pigmented, soft, infiltrated, and hairy |
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Term
| What is a "bathing trunk" nevus? |
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Definition
| a large congenital melanocytic nevus on the trunk |
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Term
| If you have a congenital melanocytic nevus greater than 20 cm then what are the chances it will develop into a melanoma? |
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Definition
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Term
| Describe the melanomas associated with congenital melanocytic nevi? |
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Definition
| greatest risk of melanoma in axial location with satelitte lesions. May be associated with neurocutaneous melanocytosis |
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Term
| How do you detect if a congenital melanocytic nevus has transformed into a melanoma? |
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Definition
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Term
| What is the risk of transformation for small (<2) and medium (2-20cm) congenital melanocytic nevi? |
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Definition
| extremely low; same risk as acquired nevi |
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Term
| What is Hutchinson's freckle? |
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Definition
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Term
| What is lentigo maligna? What is it's appearance? |
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Definition
| melanoma in situ; unevenly pigmented macule with an irregular border |
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Term
| What are the most common locations for lentigo maligna? |
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Definition
| in sun-exposed areas, most commonly the face in elderly persons |
|
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Term
| What is the course for a lentigo maligna? |
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Definition
| may extend peripherally and after many years develop a nodularity signifying change into a lentigo maligna melanoma |
|
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Term
| What percent of lentigo maligna's become full blown melanomas? |
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Definition
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Term
| What are some other names for dysplastic nevus syndrome? |
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Definition
| atypical mole syndrome or B-K mole syndrome (if familial) |
|
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Term
| What are the symptoms of dysplastic nevus syndrome? |
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Definition
| presence of numerous atypical nevi (clinically and histologically), nevi often found in unusual sites (scalp, behind ears), atypical pattern: >50 nevi, variable sizes, irregular color, erythema, irregular borders |
|
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Term
| What is the significance of having dysplastic nevus syndrome? |
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Definition
| increased risk of developing malignant melanoma, either from a dysplastic nevus, or de novo |
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Term
| T/F Members of melanoma-prone families with dysplastic nevi are several hundred times more likely to develop MM than the general population. |
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Definition
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Term
| How many americans will develop skin cancer in their lifetime? |
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Definition
|
|
Term
| What is the most common cancer in humans? |
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Definition
|
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Term
| What is the % breakdown of the major types of non melanoma skin cancer? |
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Definition
| 74% basal cell carcinoma, 25% squamous cell carcinoma |
|
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Term
| What is the most impportant etiologic factor for skin cancer? |
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Definition
|
|
Term
| What is the most common type of skin cancer? |
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Definition
|
|
Term
| Where is basal cell carcinoma most commonly located? |
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Definition
| areas of chronic sun exposure, head and neck most commonly (except superficial basal cell carcinoma mainly seen on the trunk) |
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Term
| T/F Basal cell carcinoma rarely metastasizes. |
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Definition
| true; but is locally invasive and can be highly destructive |
|
|
Term
| What phenotype puts you at highest risk for basal cell carcinoma? |
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Definition
| fair skin, blue eyes, blonde hair |
|
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Term
| What is the most common form of Basal cell carcinoma? |
|
Definition
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|
Term
| What is teh appearance of nodular or classic form of basal cell carcinoma? |
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Definition
| translucent papule or nodule on face with rolled, pearly borders and telangiectasias |
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Term
| Where are superficial BCC most commonly seen? |
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Definition
|
|
Term
| What is the appearance of superficial basal cell carcinoma? |
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Definition
| erythematous scaly plaque |
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Term
| Name some different types of basal cell carcinoma. |
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Definition
| cystic basal cell carcinoma, pigmented BCC, superficial BCC, nodular (classic) |
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Term
|
Definition
| intraepithelial squamous cell carcinoma or squamous cell carcinoma in situ |
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Term
| Describe the appearance of Bowen's disease. |
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Definition
| reddish-brown scaling plaques, most common on trunk. May have central clearing or sharp border |
|
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Term
| Does Bowen's disease have the potential for invasion and becoming a squamous cell carcinoma? |
|
Definition
|
|
Term
| What is erythroplasia of Queyrat? |
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Definition
| a special form of Bowen's involving the genital mucosa; usually red, velvety plaques |
|
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Term
| What premalignant conditions can squamous cell carcinoma arise from? |
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Definition
| actinic keratoses, bowen's or de novo in sun-exposed areas |
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Term
| Squamous cell carcinoma has a higher potential for metastasis if... |
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Definition
| chronic scars/ulcers, radiation-damaged area, high risk areas such as lips/ears, immunosupprsesed patients |
|
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Term
| What is the appearance of squamous cell carcinoma? |
|
Definition
| scaly, red indurated plaques, becomes larger and ulcerated over time |
|
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Term
| How many people in the US develop melanoma annually? |
|
Definition
|
|
Term
| Early detection of melanoma leads to a cure rate of ___% in low risk lesions (Breslow depth <1mm) |
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Definition
|
|
Term
| What are the risk factors for melanoma? |
|
Definition
| family history of dysplastic nevi or melanoma, lightly pigmented skin, tendency to burn, inability to tan, red hair color, DNA repair defects (e.g. xeroderma pigmentosum) |
|
|
Term
| What are the environmental risk factors of melanoma? |
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Definition
| intense intermittent sun exposure, sunburn, live in region closr to equator |
|
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Term
| What phenotypic expression of genetic/environmental factors put you at risk for skin cancer? |
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Definition
| melanocytic nevi (increased total number, multiple atypical, giant congenital), ephelides, personal history of melanoma |
|
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Term
| What are the five basic types of malignant melanoma? |
|
Definition
| lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma, amelanotic melanoma |
|
|
Term
| What percent of melanoma is lentigomaligna melanoma? |
|
Definition
|
|
Term
| Which type of melanoma is the slowest growing and has the best prognosis? |
|
Definition
|
|
Term
| What percent of melanoma is superficial spreading melanoma? |
|
Definition
|
|
Term
| Where does superficial spreading melanoma usually occur? |
|
Definition
| intermittently sun exposed areas (upper back of men, legs of women) |
|
|
Term
| Describe the appearance of superficial spreading melanoma. |
|
Definition
| pigmented elevated lesion with irregular outline, induration, variegation of color, +/- ulceration and bleeding |
|
|
Term
| T/F Superficial spreading melanoma most often occurs in older individuals. |
|
Definition
| false; younger individuals |
|
|
Term
| Which type of melanoma has the worst prognosis? |
|
Definition
|
|
Term
| Describe the appearance of nodular melanoma. |
|
Definition
| deeply pigmented nodule with variable color-brown, gray, red-blue-black |
|
|
Term
| What percent of melanomas are nodular melanoma? |
|
Definition
|
|
Term
| Waht is the MC type of melanoma in African-americans and jappanese individuals? |
|
Definition
| acral lentiginous melanoma |
|
|
Term
| What percent of melanoma is acral lentiginous melanoma? |
|
Definition
|
|
Term
| Describe the appearance of acral lentiginous melanoma. |
|
Definition
| darkly pigmented lesions becoming verrucous and ulcerative |
|
|
Term
| Wh are common places for acral lentiginous melanoma to occur? |
|
Definition
| palms, soles, thumb, big toe |
|
|
Term
| How do you diagnose amelanotic melanoma? |
|
Definition
| must biopsy the lesion; because there is no pigment it is very difficult to diagnose clinically |
|
|
Term
| When should melanoma be suspected? |
|
Definition
| in all darly pigmented lesions, especially those with asymmetry, border irregularity, color variation, diabeter > 6mm, and evolving |
|
|
Term
| What are the levels of Clark's scheme? |
|
Definition
| I= intraepidermal, II= into the papillary dermis, III=through the papillary dermis, IV= into the reticular dermis, V= invasion of the subcutaneous fat |
|
|
Term
| How do you measure the thickness of a melanoma? |
|
Definition
| breslow scale (measure from granular layer of epidermis to deepest melanoma cells in dermis) |
|
|
Term
| What clinical factors indicate a worse prognosis of melanoma? |
|
Definition
| ulceration, higher age, males |
|
|
Term
| What is significance of paget's disease of the breast? |
|
Definition
| represents an underlying intraductal mammary carcinoma in 100% of patients affected |
|
|
Term
| What is extra-mammary paget's disease? |
|
Definition
| paget's disease of non-mammary origin occurring in other apocrine-gland bearing areas (axillae, ano-genital areas) |
|
|
Term
| Describe teh appearance of extra-mammary paget's disease? |
|
Definition
| erythematous patch or plaque often misdiagnosed as pruritus ani/scroti, tinea, intertrigo |
|
|
Term
| After making a diagnosis of extramammary paget's, it is important to... |
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Definition
| perform a thorough search for internal malignancy because extra-mammary paget's can be primary to skin or be associated with an underlying neoplasm, usually of apocrine, GI or GU origin |
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|
Term
| Describe the lesions of cutaneous T cell lymphoma. |
|
Definition
| patches and plaques usually reddish/brown, scaly, poikilodermatous (atrophy, telangiectasias, hyperpigmentation) and kidney bean shaped |
|
|
Term
| Where does mycosis fungoides typically manifest? |
|
Definition
| covered areas (buttocks, thighs, abdomen, breasts) (tumors more common on head and neck) |
|
|
Term
| End stage (T4) mycosis fungoides can be described as... |
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Definition
|
|
Term
| What is the triad of sezary syndrome? |
|
Definition
| triad of erythroderma, lymphadenopathy, and neoplastic T cells (sezary cells) in the blood, skin, and lymph nodes |
|
|
Term
| What is the prognosis of sezary syndrome? |
|
Definition
| overall 5 year survival of 25% |
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