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38 Cards in this Set
- Front
- Back
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What are thick/scaley lesions that are caused by chronic cumulations of sun damage?
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Actinic keratosis
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What will 13-20% of actinic keratoses do within 10 yrs?
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Become invasive
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In what population are Actinic keratoses mostly seen?
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Elderly in hot sunny climates
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How are Invasive cancers derived from Actinic keratoses different from Melanomas?
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Melanomas are more from sun BURNS; Actinic keratosis is from chronic CUMULATIVE wear
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What is seen histologically in Actinic keratoses?
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Varying grades of Dysplasia from low grade to in situ
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What is full thickness dysplasia in an Actinic keratosis actually called?
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Carcinoma in situ
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And what is invasive actinic keratosis actually called?
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Squamous cell carcinoma
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What is the most common cause of SCC then?
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UV radiation
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What are 4 other carcinogens that can lead to SCC of the skin?
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-HPV
-Irradiation -Arsenic -Lichen sclerosus |
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How do the lesions in SCC compare to those in Actinic keratosis?
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AK = more white/regular
SCC = red plaques with scallop borders |
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Do SCC lesions tend to metastasize?
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No
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What genetic disorder is characterized by early onset of major problematic SCC lesions?
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Xeroderma pigmentosa
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What SCC lesions tend to be more aggressive?
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-Lip
-Ear -Caused by HPV |
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What is a lesion that is thought to be a well-differentiated SCC that develops very quickly but then resolves spontaneously?
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Keratoacanthoma
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In what patients are multiple Keratoacanthomas often seen?
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Immunosuppressed AIDS PATIENTS!
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What is the hallmark feature that we see in Keratoacanthomas?
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CRATERS
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In what syndrome are Keratoacanthomas often also seen?
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Muir Torre
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So what are 2 lesions associated with Muir torre?
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-Sebaceous adenomas (multiple)
-Keratoacanthomas |
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What is the most COMMON malignancy of the skin?
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Basal cell carcinoma
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What is the most common cause of basal cell carcinoma?
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Chronic sun exposure
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What is typically required for metastasis of EITHER Basal or Squamous cell carcinoma?
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Immunocompromised states
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What is a slightly nonPC term for BCC's? Why?
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Rodent tumors - they tend to eat away at patients skin
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What is the clinical HALLMARK of BCC?
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Pearly appearance!!
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What is Mopheaform BCC?
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A type that grows deeper and more widely so you have to be more careful with it.
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What type of skin cancer is seen in the elderly, often with ulcerations, and on the head or neck?
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Merkel cell carcinoma
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What are Merkel cells?
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Epidermal cells of neural crest origin
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Why are Merkel cell carcinomas important to be aware of, if they are so rare?
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They are RAPIdLY progressive with POOR prognosis!
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What stain/pattern helps to diagnose Merkel cell carcinoma?
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CK-20 shows a perinuclear DOT pattern
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What is the most common type of primary cutaneous lymphoma to be seen on the skin?
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Mycosis fungoides
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What type of lymphoma is Mycosis fungoides?
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T-cell
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What defines Cutaneous lymphoma as PRIMARY?
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Skin involvement for only 6 months
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What does Mycosis fungoides mimic? Why?
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Inflammatory conditions - it progresses through phases of Patch, plaque, and nodules
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Where do the lesions in Mycosis fungoides tend to be seen?
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In areas of double clothing
-under bra straps etc |
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What is the characteristic gross finding of the skin with mycosis fungoides?
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Cigarette paper wrinkling! Atrophic and fine
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Is mycosis fungoides more chronic or aggressive?
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Chronic
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How is Mycosis fungoides staged?
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By the degree of BSA covered with lesions
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What is the leukemic phase of Mycosis fungoides, after it is not just skin involvement?
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Sezary syndrome
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What is the hallmark microscopic finding in mycosis fungoides?
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Band infiltrates of LYMPHS with Exocytosis
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