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48 Cards in this Set

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What is keloid?
Cutaneous scar beyond original wound
What is hypertrophic scar?
Raised scar within the boundaries of the wound
Caution in Tx of keloid
Excision results in larger regrowth
Characteristics of keloid
1. early lesion: erythematous ; older lesion: pale
2. firm, variable pruritic
3. in upper back, deltoid, presternal, ear lobes
Characteristics of dermatofibroma
1. usually solitary round firm nodule < 1cm
2. young female
3. lower limbs
Charateristics of dermatofibrosarcoma protuberans
1. slow but aggressive
2. marked recurrence but rarely metastasize
3. solitary or multiple polypoid nodule arising from indurated plaque
What is nevus flammeus
Group of congenital vascular malformation
Give 3 types of nevus flammeus
1. Salmon' patch
2. Port wine stain
3. Stork bite
Significance of Salmon's patch
Present in nearly half of all birth.
Majority fade within 1st year
Where is Salmon' patch likely be?
Back of neck, eyelids, glabella
Characteristics of Port wine stain
1. sharply delineated
2. neck and face
3. darker and thickened with time
What is pyogenic granuloma?
A hemangioma
Characteristics of pyogenic granuloma
1. skin or mucous membrane
2. red polypoid and pedunculated
3. evolve rapidly to maximum size in weeks
4. ulcerated and bleed easily
Give 3 types of angiosarcoma
1. idiopathic cutaneous angiosarcoma
2. angiosarcoma complicating lymphedema
3. post-irradiation angiosarcoma
What is the significance of idiopathic cutaneous angiosarcoma?
Poor prognosis
Does idiopathic cutaneous angiosarcoma have good or poor prognosis?
Poor prognosis
Characteristics of angiosarcoma
1. bluish
2. elder, men, upper face or scalp
What is Langerhan cell histiocytosis
Spectrum of diseases with Langerhan cells
Biochemical hallmark of Langerhan cell
CD1a positive
Biochemical hallmark of mast cells
C-kit positive
How is mast cell disease classified?
1. Cutaneous
2. systemic
3. malignant
Give an example of cutaneous mast cell disease
Urticaria pigmentosa
What is mycoses fungoides?
It's cutaneous lymphoma which has epidermotropic infiltrate by T cells (usually CD 4 )
What is the most common form of cutaneous lymphoma?
Mycoses fungoides
It's the more likely patient of cutaneous lymhoma?
Adult men
Where is usually mycoses fungoides at?
Lower trunk and thigh.
What is the precursor lesion of malignant melanoma?
1. Acquired melanocytic nevus
2. dysplastic nevus
3. congenital nevus
4. lentigo maligna
What are the clinical clues are malignant melanoma?
Asymmetry
Border
Color
Diameter >6mm
Elevation
Classification of malignant melanoma
1. Lentigo maligna melanoma
2. Superficial spreading melanoma
3. Nodular melanoma
4. Acral lentiginous melanoma
Histological features of malignant melanoma
1. melanin
2. melanosomes in EM
3. pleomorphic large polygonal and/or spindle tumour cells with prominent nucleoli
How can malignant melanoma be confirmed?
Immunohistochemical statins
Good and bad prognostic factors of melanoma
Good: female, on limbs, vitiligo (白斑)
Bad: increasing age
What are the 2 criterias of pathological prognostic factors used?
1. Breslow's thickness
2. Clark's level
What is the causative agent of Kaposi's sarcoma?
Human herpvesvirus type 8
How is the causative agent of Kaposi's sarcoma tranmitted?
1. sexual
2. needle share
What are the 4 types of Kaposi's sarcoma?
1. classic
2. African
3. Immunosuppressive therapy associated
4. HIV-associated
What is the endemic Kaposi's sarcoma?
African type Kaposi's sarcoma
What is the epidemic Kaposi's sarcoma?
HIV-associated type Kaposi's sarcoma
Characteristics of Classic type Kaposi's sarcoma
1. male
2. lower limbs
3. chronic lesions
4. patient die of other causes
Characteristics of African type Kaposi's sarcoma
1. male
2. 3 subtypes
What are the 3 subtypes of African type Kaposi's sarcoma?
Nodular: benign, similar to classic type
Aggressive: infiltrative, extensive florid
Lymphadenopathic: children, poor prognosis
Characteristics of immunosuppressive therapy-related type Kaposi's sarcoma
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
Characteristics of HIV-associated type Kaposi's sarcoma
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
What stage will Kaposi's sarcoma come through?
Patch -> plaque -> nodular

Patch stage: promontory sign, lymphoplasmocytic infiltrate

Plaque and nodular stage: interlacing spindle cells
What radiation can give rise to reactive oxygen species?
UVA, UVB
How UVA damage DNA?
ROS production
How UVB damage DNA?
1. ROS production
2. point mutation in p53 in squamous cell carcinoma , less in basal cell carcinoma
Give 1 DNA repair gene and wt disease it plays a role
hMSH2

Role in basal cell carcinoma and melanoma