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Derm 3
Exam Review
| Question | Answer |
|---|---|
| >40 yrs (not like nevi, first three decades), new nevus at age 50 (think melanoma) | seborrheic keratosis |
| do not use liquid nitrogen for | dermatosis papulosa nigra (hypopigmentation) |
| electrodessication first line for | dermatosis papulosa nigra |
| small white, gray SK pepper dorsal feet, ankles older fair-skinned invidiuals | stucco keratoses |
| freeze, curette, electrodessicate | tx for stucco keratoses |
| pedunculated around neck, groin, eyelid, brown | acrochordons (skin tag), like acanthosis nigricans (marker for insulin resistance) |
| skin tag, what tx and labs? | snipping, liquid N, electrodessication, fasting blood glucose |
| single red papule | cherry angioma (not go away, harmless, more over yeas, trunk) |
| what you have on your leg (benign spindle cell, wad of scar, darking common, dimple with pinch) | dermatofibroma |
| tx for solar lentigines | (due to sun exposure), bleach cream, liquid N, chemical peels |
| ABCDE of melanoma | asymmetry, border, color, diameter, evolving |
| sebacious gland overgrowth (YELLOW color, tan, umbilicated center, mulitple papules around follicle) | sebarceous hyperplasia |
| solitary, friable, pearly translucent, telangiectasia, biopsy/referral | BCC |
| keloid tx | intralesional steroid is best. (NOT excision alone, it will reaccur even larger) |
| overgrowth of scar tissue beyond orignal scar, upper trunk, earlobe | keloid |
| mobile nodule, hair follciles not oil glands, debris (oil, skin) collects in sac (foul smelling) | epidermal inclusion cyst |
| epidermal inclusion cyst remvoal? | surgical excision DO NOT REQUIRE ABx (abscess if traumatized - incision/drain) |
| tiny epidermoid cyst, face, easily extracted no scar,face bumps on children go away, TX? | milia (nick the surface, petrolatum) |
| nodule on scalp | pilar cyst (excise) |
| fat under skin, (autosomal dominant), multiple and benign in early adulthood | lipoma |
| waxy, crumbly, stuck on | seborrheic keratoses |
| firm papule on leg with rim of pigmentation | dermatofibroma |
| definitive tx for epidermal inclusion cysts | excision * Not aspiration or popping |
| elective removal of benign lesions in darker skin types (skin tags, DPN) | electrodessication or snip (not liquid N) |
| SCC | shave biopsy reveals keratinocytes,keritin pearls, PINK/TAN nodule/plaque, central ulcer and crusted top (friable), firm with palpation, sun exposed (higher rate of metastisis) |
| SCC tx/bowen's tx | surgical removal, excision (documened with clear margins) - SCC, currette/dessication (bowne's); 5FU, imiquimod |
| SCC causes | UV exposure, (non sun exposed = chemical carcinoma - arsenic) |
| SCC in situ, keratinocyte atypia confined to epidermis | bowen's disease |
| higher rates of SCC metatisis | large, deep, bone, scalp, nose, lips, scars, burns, genitalia, HIV, arsenic |
| first step to SCC, sun exposure, arise from keratinocytes, increased age, fair skin, sun-exposed sites (damaged skin), "sandpaper", | actinic keratosis *easy bruising = purura |
| UV damage, small brown macules | lentigines |
| actinic keratosis tx | liquid N cryotherapy, currettage, shave, topical photodynamic |
| actinic keratosis associated with | actinic cheilitis on lips, gritty, biopsy to rule out cancer |
| actinic keratosis - when should they have skin exams> | 6-12 mon (broad A, UV B, use >30 SPF, every 2hrs, use a self-tanning product) |
| indurated erythematous lesions with keritin are __ until proven otherwise | SCC |
| SCC dx | shave biopsy |
| radiation therapy is a good choice for sugrical candidates | SCC if surgical excision doesn't work |
| shave biopsy shows basaloid cells, celft formation, palisading, fibromyxoid stroma | basal cell carcinoma |
| basal cell carcinoma | surgical removal treatment of choice, electrodies, curettage, radiation can be used, imiquimod, FU |
| MCC cancer | basal cell, nonkeratinizing keratinocytes in basal layer, UV damage, |
| head, neck most common type | nodular basal cell carcinoma |
| pink, translucent color, patch (scaly), like SCC | superficial basal cell carcinoma |
| microscopically ulcerated, crusting over | ulcerated BCC |
| BCC characteristics with dark pigment | pigmented BCC |
| white and bound down or scar like areas. | morpheaform BCC |
| superficial histological analysis of tumor margins, recurrance rates are lower with>>, if you have morpheaform, on face, | Moh's MMS |
| T/F BCC is locally invasive, metastisis rare, risk for melanoma, f/u 6mon-1yr | true |
Created by:
jamieseals
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