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Derm 3

Exam Review

>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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