Cns 30, Skin Tumors

Front 1

what is the breslow thickness for melanocyte prognosis?

Back 1

1. <0.75 mm, about 100% survive
2. >1.5 mm, about 50% 5 yr SR

Front 2

what is the clark's level of invasion for melanocyte prognosis

Back 2

I: confined to epidermins
II: invades papillary dermis
III: filling papillary dermis
IV: invades retincular dermis
V: invades subcut fat

Front 3

in melanocyte prognosis:
1. is ulceration good or bad?
2. is mitosis good or bad?
3. is tumor infiltrating lymphocytes good or bad?

Back 3

1. bad
2. bad, high mitosis implies mets
3. good, implies immune response

Front 4

what is radial growth phase of melanocytes?

Back 4

spread along dermis epidermal junction laterally-theoretically, NO chance of mets. (in-situ)

Front 5

what is vertical growth phase of melanocytes?

Back 5

tumor cells grow down deeper into dermis. RISK of METS

Front 6

how does melanoma spread?

Back 6

1. directly within skin (satellite lesion)
2. mets to LN (centinal node)
3. mets via blood (liver, lung, brain)

Front 7

how is melanocyte treated?

Back 7

1.primary excision with margins (don't bx, shave, punch it)
2. sentinal node bx
3. treat mets

Front 8

what are 5 melanocyte subtypes?

Back 8

1. superficial spreading (most common)
2. nodule (invasive)
3. lengigo meliga: sun exposed fair skin
4.acral lentiginous: under nails, palms, soles (dark skin)

Front 9

4 factors to raise clinical suspicious of melanoma?

Back 9

Asymmetry
Border irregular
Color abnormal
Diameter > 0.5 cm

Front 10

mutation in familial dysplastic naevus syndrome?

Back 10

p16, chromosome 9 carries 100% lifetime risk of malignancy (rare)

Front 11

amelanotic melanoma?

Back 11

doesn't produce pigment

Front 12

features of dysplastic naevus:

Back 12

1. sporadic or inherited
2. larger than ordinary naevi
3. irregular margins
4. irregular pigment
5. in syndrome, may have multiple

Front 13

benign melanocytes:

Back 13

1. freckle: sun, melanin
2. benign lentigo: not sun and more melanocytes
3. naevus: nest of melanocytes (congenital or acquired)

Front 14

two types of BCC?

Back 14

1. nodular (invasive)
2. superfical/multifocal

Front 15

clinical association of BCC and mets?

Back 15

1. xeroderma pigmentosa
2.immunosuppression
*rarely met

Front 16

BCC appearence:

Back 16

pearly papules, rolled borders
"rodent ulcers" ulcerations
rarely mets, though locally aggressive

Front 17

RF for SCC, BCC, malignant melanoma:

Back 17

fair skin + sun
*note melonoma is short intense exposure
*SCC, BCC are lifetime exposure

Front 18

SCC appearence:

Back 18

sharply defined red scaly patches, hyerkeratotic
*mets more common when associated with (burns, tobacco, xeroderma pigmentosa, immunosuppression)

Front 19

pre-malignant epithelial tumors:

Back 19

1. bowens (red scaly patches, not sun exposed)
2. actinic keratosis (scaly red papules or macules)

Front 20

What does SPAIN stand for in regards to actinic keratosis?

Back 20

Sun-exposure
Parakeratosis
Atypic keratinocytic
Inflammation (in superficial dermis)
Not full thickness

Front 21

what are the benign epithelial tumors?

Back 21

1. seborrhoeic keratosis (stuck on)
2. keratoacanthoma (sun, saucer filled with keratin)
3. verruca (HPV 16)
4. fibroepithelial polyp (on a stalk)

Front 22

what is the pathogenesis of serorrhoeic keratosis?

Back 22

may be associated with internal malignancy-tumor releases TGFa
"Leser Trelat"