Common Skin Tumours (Pmus Year 3) Part Ii

Front 1

What is keloid?

Back 1

Cutaneous scar beyond original wound

Front 2

What is hypertrophic scar?

Back 2

Raised scar within the boundaries of the wound

Front 3

Caution in Tx of keloid

Back 3

Excision results in larger regrowth

Front 4

Characteristics of keloid

Back 4

1. early lesion: erythematous ; older lesion: pale
2. firm, variable pruritic
3. in upper back, deltoid, presternal, ear lobes

Front 5

Characteristics of dermatofibroma

Back 5

1. usually solitary round firm nodule < 1cm
2. young female
3. lower limbs

Front 6

Charateristics of dermatofibrosarcoma protuberans

Back 6

1. slow but aggressive
2. marked recurrence but rarely metastasize
3. solitary or multiple polypoid nodule arising from indurated plaque

Front 7

What is nevus flammeus

Back 7

Group of congenital vascular malformation

Front 8

Give 3 types of nevus flammeus

Back 8

1. Salmon' patch
2. Port wine stain
3. Stork bite

Front 9

Significance of Salmon's patch

Back 9

Present in nearly half of all birth.
Majority fade within 1st year

Front 10

Where is Salmon' patch likely be?

Back 10

Back of neck, eyelids, glabella

Front 11

Characteristics of Port wine stain

Back 11

1. sharply delineated
2. neck and face
3. darker and thickened with time

Front 12

What is pyogenic granuloma?

Back 12

A hemangioma

Front 13

Characteristics of pyogenic granuloma

Back 13

1. skin or mucous membrane
2. red polypoid and pedunculated
3. evolve rapidly to maximum size in weeks
4. ulcerated and bleed easily

Front 14

Give 3 types of angiosarcoma

Back 14

1. idiopathic cutaneous angiosarcoma
2. angiosarcoma complicating lymphedema
3. post-irradiation angiosarcoma

Front 15

What is the significance of idiopathic cutaneous angiosarcoma?

Back 15

Poor prognosis

Front 16

Does idiopathic cutaneous angiosarcoma have good or poor prognosis?

Back 16

Poor prognosis

Front 17

Characteristics of angiosarcoma

Back 17

1. bluish
2. elder, men, upper face or scalp

Front 18

What is Langerhan cell histiocytosis

Back 18

Spectrum of diseases with Langerhan cells

Front 19

Biochemical hallmark of Langerhan cell

Back 19

CD1a positive

Front 20

Biochemical hallmark of mast cells

Back 20

C-kit positive

Front 21

How is mast cell disease classified?

Back 21

1. Cutaneous
2. systemic
3. malignant

Front 22

Give an example of cutaneous mast cell disease

Back 22

Urticaria pigmentosa

Front 23

What is mycoses fungoides?

Back 23

It's cutaneous lymphoma which has epidermotropic infiltrate by T cells (usually CD 4 )

Front 24

What is the most common form of cutaneous lymphoma?

Back 24

Mycoses fungoides

Front 25

It's the more likely patient of cutaneous lymhoma?

Back 25

Adult men

Front 26

Where is usually mycoses fungoides at?

Back 26

Lower trunk and thigh.

Front 27

What is the precursor lesion of malignant melanoma?

Back 27

1. Acquired melanocytic nevus
2. dysplastic nevus
3. congenital nevus
4. lentigo maligna

Front 28

What are the clinical clues are malignant melanoma?

Back 28

Asymmetry
Border
Color
Diameter >6mm
Elevation

Front 29

Classification of malignant melanoma

Back 29

1. Lentigo maligna melanoma
2. Superficial spreading melanoma
3. Nodular melanoma
4. Acral lentiginous melanoma

Front 30

Histological features of malignant melanoma

Back 30

1. melanin
2. melanosomes in EM
3. pleomorphic large polygonal and/or spindle tumour cells with prominent nucleoli

Front 31

How can malignant melanoma be confirmed?

Back 31

Immunohistochemical statins

Front 32

Good and bad prognostic factors of melanoma

Back 32

Good: female, on limbs, vitiligo (白斑)
Bad: increasing age

Front 33

What are the 2 criterias of pathological prognostic factors used?

Back 33

1. Breslow's thickness
2. Clark's level

Front 34

What is the causative agent of Kaposi's sarcoma?

Back 34

Human herpvesvirus type 8

Front 35

How is the causative agent of Kaposi's sarcoma tranmitted?

Back 35

1. sexual
2. needle share

Front 36

What are the 4 types of Kaposi's sarcoma?

Back 36

1. classic
2. African
3. Immunosuppressive therapy associated
4. HIV-associated

Front 37

What is the endemic Kaposi's sarcoma?

Back 37

African type Kaposi's sarcoma

Front 38

What is the epidemic Kaposi's sarcoma?

Back 38

HIV-associated type Kaposi's sarcoma

Front 39

Characteristics of Classic type Kaposi's sarcoma

Back 39

1. male
2. lower limbs
3. chronic lesions
4. patient die of other causes

Front 40

Characteristics of African type Kaposi's sarcoma

Back 40

1. male
2. 3 subtypes

Front 41

What are the 3 subtypes of African type Kaposi's sarcoma?

Back 41

Nodular: benign, similar to classic type
Aggressive: infiltrative, extensive florid
Lymphadenopathic: children, poor prognosis

Front 42

Characteristics of immunosuppressive therapy-related type Kaposi's sarcoma

Back 42

1. less male predominance
2. appear short time after therapy
3. may regress spontaneous, may be more aggressive than classic one
4. die if widespread

Front 43

Characteristics of HIV-associated type Kaposi's sarcoma

Back 43

1. most common in homosexual or bisexual men
2. multiple, involve mucosal surface and internal organ
3. can be chronic, rapid , or regress spontaneously
4. pt die from complication

Front 44

What stage will Kaposi's sarcoma come through?

Back 44

Patch -> plaque -> nodular

Patch stage: promontory sign, lymphoplasmocytic infiltrate

Plaque and nodular stage: interlacing spindle cells

Front 45

What radiation can give rise to reactive oxygen species?

Back 45

UVA, UVB

Front 46

How UVA damage DNA?

Back 46

ROS production

Front 47

How UVB damage DNA?

Back 47

1. ROS production
2. point mutation in p53 in squamous cell carcinoma , less in basal cell carcinoma

Front 48

Give 1 DNA repair gene and wt disease it plays a role

Back 48

hMSH2

Role in basal cell carcinoma and melanoma