Dermatology Final Set 1

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Seborrheic Keratoses - elderly pts on chest, face, arms, back; Tx - freeze, shave, curettage if irritated (under breast / armpit)

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Seborrheic Keratoses- elderly pts on chest, face, arms, back; Tx - freeze, shave, curettage if irritated (under breast / armpit)

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Skin Tags - Acrochordons; Tx - snip, electrodessicate

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Melanocytic Nevi

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Junctional Nevi - prolif. cells derived from melanocytes: along DEJ

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Junctional Nevi - prolif. cells derived from melanocytes: along DEJ

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Compound Nevi

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Intradermal Nevi - resolved jointional component + left only intradermal

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Halo Nevi

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Halo Nevi

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Congenital Melanocytic Nevus (CMN): 4-6% develop melanoma w/ in a Giant CMN

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Blue Nevus - can become malignant / ulcerate (very rare)

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Blue Nevus - can become malignant / ulcerate (very rare)

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Becker’s nevus - in puberty: hyperpigmentation + hypertrichosis; on chest, upper back, shoulder of males; NO POTENTIAL for malignant change

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Dermatofibroma - small + firm; can be flat/papule on LE (2-3mm); Dimple sign when lateral pressure applied; Tx - excise or leave it

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Atypical Nevi - loss of normal symmetry, marked variation in color - "fried egg" look, histologically diff from melanoma; Tx - full thickness excision w/ 0.2cm margin of normal skin

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Solar Lentigines - increase in # of melanocytes (UV induced) + does not increase in pigmentation

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Dermatofibroma - small + firm; can be flat/papule on LE (2-3mm); Dimple sign when lateral pressure applied; Tx - excise or leave it

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Basal Cell Carcinoma - locally invasive + rarely metastasizes; from sun damage; MOST COMMON skin cancer; Sx - pearly papule w/ telangiectasis; Tx - biopsy, excision, cryotherapy, electrodessication + curettage, scrape + burn, Moh's Sx, topical (aldara)

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Basal Cell Carcinoma - locally invasive + rarely metastasizes; from sun damage; MOST COMMON skin cancer; Sx - pearly papule w/ telangiectasis; Tx - biopsy, excision, cryotherapy, electrodessication + curettage, scrape + burn, Moh's Sx, topical (aldara)

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Basal Cell Carcinoma - locally invasive + rarely metastasizes; from sun damage; MOST COMMON skin cancer; Sx - pearly papule w/ telangiectasis; Tx - biopsy, excision, cryotherapy, electrodessication + curettage, scrape + burn, Moh's Sx, topical (aldara)

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Squamous Cell Carcinoma - more aggressive + likely to metastasize; Sx - ill-defined red lesion + rough surface

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Squamous Cell Carcinoma - more aggressive + likely to metastasize; Sx - ill-defined red lesion + rough surface

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Squamous Cell Carcinoma - more aggressive + likely to metastasize; Sx - ill-defined red lesion + rough surface

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Verrucous Carcinoma - SCC variant that can occur on feet

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Keratoancanthoma - skin colored dome + keratin filled plug; on sunexposed skin; 10% can become SCC

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Keratoancanthoma - skin colored dome + keratin filled plug; on sunexposed skin; 10% can become SCC

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Porokeratosis of Mibelli - atrophic patch w/ coranoid lamella; disorder or keratinization

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Disseminated Superficial - most common porokeratosis

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Porokeratosis Palmar et Plantar Disseminata: can develop BCC/SCC in lesion

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Punctate Porokeratosis: can become malignant

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Porokeratosis Plantaris Discretum - may be painful; NOT TRUE POROKERATOSIS

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Arsenic Porokeratosis - DDx pitted keratolysis

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Superficial Spreading Melanoma - slowly enlarging papule; MOST COMMON.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Superficial Spreading Melanoma - slowly enlarging papule; MOST COMMON.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Superficial Spreading Melanoma - slowly enlarging papule; MOST COMMON.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Superficial Spreading Melanoma - slowly enlarging papule; MOST COMMON.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Nodular melanoma - pigmented papule; enlarges + ulcerates; looks like non-healed skin ulcer.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Nodular melanoma - pigmented papule; enlarges + ulcerates; looks like non-healed skin ulcer.
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Back 40

Acral Lentiginous Melanoma- most common in ethnic skin; non-hair bearing skin - nails, palms, soles
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Acral Lentiginous Melanoma- most common in ethnic skin; non-hair bearing skin - nails, palms, soles
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Lentigo Maligna - irregular shape on sunexposed (face); biopsy - incisional, excisional, punch; DO NOT SHAVE
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Lentigo Maligna - irregular shape on sunexposed (face); biopsy - incisional, excisional, punch; DO NOT SHAVE
ABC's of Melanoma:
A)Asymmetry
B)Borders + blood
C)Color - black, blue, red, brown
D) Diameter > 6 mm
E) Elevation

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Melanoma Metastasis: Tx - chemotherapy

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Bowen’s or SCC in situ - indurated plaque w/ scale; persistently erythematous. PREMALIGNANT

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Bowen’s or SCC in situ - indurated plaque w/ scale; persistently erythematous. PREMALIGNANT

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Actinic Keratoses - elderly pts on sunexposed + fair skin; 2-5% become SCC. PREMALIGNANT

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Actinic Keratoses - elderly pts on sunexposed + fair skin; 2-5% become SCC. PREMALIGNANT

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Cutaneous Horn

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Mycosis Fungoides (MF) or CTCL
- low-grade Cutaneous T-cell lymphoma; Does not respond to steroids; Tx - Topical, PUVA, UVB, Oral Retinoids, interferons, topical nitrogen mustard, chemo.
Survival Rates:
-12yr: skin patches + plaques
-5yr: tumor stage dz
-3yr: nodes + viscera
DDx: Psoriasis
Sezary's = subtype of MF: erythroderma, lymphadenopathy, and abn. circulating mononuclear cells; Resistant to Tx

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Mycosis Fungoides (MF) or CTCL

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Sezary’s