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27 Cards in this Set

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Seborrheic Keratosis
-Verrucous surface/warty, commonly darkly pigmented, stuck on appearance. -Onset in 30s, unknown cause -Rx=observation, liquid Nitrogen, surgery, laser. Called Dermatosis Papulosa Nigra when many dark ones on darker skinned ppl think Morgan Freedman *Sign of Leser-Trelat(paraneoplastic sign)=explosive onset of itchy seborrheic keratosis in older adult and usu. sign of adenocarcinoma of stomach.
Achrochordons "skin tags"
papilomatous, pedunculated "bag like tumor attached by stalk" lesions that are flesh colored. Located on friction areas( neck, axilla, groin, inframammary) Middle age onset. assoc w/ SK maybe also colonic polyps.Rx=snip or cryotherapy
Brown, firm nodules located on extremities. See dimple sign on compression wo>men. May be exaggerated response to injury.
Soft, flesh colored papule may be solitary or multiple. Rx=excision Neurofibromatosis (Von Recklinghausen's Dz) has cafe au lait spots and internal NF
Fatty tumor, single or multiple soft round mobile, non-tender, subQ tumor Grows Slowly Rx=excision. DDx includes epidermal inclusion cyst
Epidermal Inclusion Cyst
Cyst derived from epidermal part of hair follicle. filled w/ keratin and lipid debris. M>wo. Can see opening of hair follicle. Caused by acne, trauma. Can get infected if ruptures. In DDx w/ Lipoma. Gardner's Syndrome-multiple EICs and osteoma, fibroma, lipoma, leiomyomas, colorectal polyps.
Pilar Cyst
from hair on scalp. Similar to epidermal inclusion cyst but from different part of hair follicle.
Fibroblastic response to injury includes hyperplastic scar that extends beyond site of injury. More common in dark skinned ppl. Found on sternum, neck, ears, back legs. Rx= intralesional steroids, cryotherapy
Becker's Nevus
Non-melanocytic nevus. hairy brown patch around shoulder. M>W. thickens and grows hair at puberty. Excise.
Ephiledes (Freckles)
light brown macules, familial, cheeks, Fade in winter. Rx= sun protection
Solar Lentigo
Localized melanocytic prolif. "Liver spots" from chronic life time exposure to sun. Darker than freckles and dont fade as much in the winter. *Peutz-Jeghers Syndrome is AutoDom., lentigines on lips, oral mucosa and backs of hands and feet. Presents w/ abd pain, intenstinal polyposis. Rarely converts to adenocarcinoma.
Developmental Defect
Melanocytic Nevus
* can transfer into melanoma like Mole, Junctional nevus, intradermal nevus,cmpd nevus, nevus spilus, blue nevus, congenital nevus, halo nevus, dysplastic nevus
Non-melanocytic Nevus
for example like Becker's nevus (hairy patch on shoulder), epidermal nevus, basal cell nevus, nevi comidonicus
Junctional Nevus
Melanocytes at dermis-epidermal junc. Macules of varying brown color, round oval smooth borders Diappear >60 years
intradermal Nevus
melanocytes in Dermis only. Papules of varying light color, round dome shaped w/ smooth borders, appear in 20s or 30s and dont diappear ever. Have Hair. Not malignant.
Cmpd Nevus
melanocytes in both dermis and Epidermis-Dermis junc. papules of varying brown color round dome shaped w/ smooth borders elevated. appear in 20s or 30s and dont diappear ever.
Nevus Spilus
Speckled patch usu. acquired in childhood. Rarely turns to melanoma.
Blue Nevus
Small well circumscribed blue nodule. Melanocytes very deep in dermis. May be Malignan variant
Congenital Nevus
Flat at birth , thickened w/ age. PREMALIGNANT
Halo Nevus
hypopigmented halo around pigmented papule or macule. Immune system attacks melanocytes surrounding mole. Associated w/ vitiligo (over reacting immune sys) and metastatic melanoma (immune system trying to kill melanoma). Benign in kids. suspicious in adults.
Dysplastic nevi
Large w/ irregular pigmentation and border. Increased RISK OF MELANOMA if multiple or if +family Hx
Basal Cell Carcinoma
Course: slow growing and dbles in size every 5 hrs. see in old ppl, rarely metastasize but locally destructive. Cause: UV radiation, arsenic exposure, genetic cond, radiation. Subtypes: Nodulo-ulcerative (pearly translucent shiny flesh colored papule w/ telangiectaisa and have cntral ulceration or rodent ulcer) Superficial (red scaly macules or plaques may look like eczema, tinea, actinic keratosis) Morpheaform/Infiltrative (scar-like plaques that grow) Pigmented (colorful variant of nodular subtype confused w/ Sk or Melanoma. Gooy look)<=ON TEST pigmented BCC. Rx=radiation, electrodesiccation, topical chemo, excision
Actinic Keratosis
Red scaly macules on sun damaged skin w/ "sand paper" feel. PRECURSOR to SCC
Squamous Cell Carcinoma
older pts, thicker than actinic keratosis and not BCC b/c not shiny or gooey. sun exposed skin. ulcerative or hyperkeratotic papules/nodules/tumors at high risk for METASTASIS. Risks=UV light, arsenic exposure, ionizing radiation, tars and oils, chronic inflammation, immunosuppresssion. Rx=radiation, lymph node dissection, chemo maybe otherwise treat as BCC.
Bowen's Dz.
"SCC in Situ" looks like superficial BCC and eczema. Red Scaly plaque usually solitary but may be multiple. Less aggressive and have INCREASED incidence of INTERNAL MALIGNANCY
Malignant Melanoma
incidence increasing faster than any other CA. Asymmetry Border irregularity Color variegated Diameter Evolution Family hx (ABCDEF) Earliest sign= Pruritus, tendernes, bleeding, ulceration. Risk=UV light, many nevi or congenital nevi, dysplastic nevus syndrome, family Hx. Types: Superficial spreading (flat), nodular, acral Lentiginous, Lentigo Maligna (in sun exposed areas large irregular and out of solar lentigo esp. in face). Prognosis based on BRESLOWs thickness, ulceration, location. Tx= wide local excision, sentinal node biopsy in which you inject dye and see which node it goes to and take it out, immunotherapy