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Malignant Lesions
Derm
Question | Answer |
---|---|
Most common variant of BCC | nodular BCC |
pearly white or pink, translucent, dome-shaped papule with overlying random telangiectasias: | nodular BCC |
least aggressive variant of BCC | superficial BCC |
Superficial BCC: May resemble: | psoriasis, eczema, seborrheic keratosis, Bowen’s disease, or tinea corporis |
Least common type of BCC | Morpheaform BCC |
Morpheaform BCC: tx of choice | MMS |
Actinic keratosis on lower lip = | actinic cheilitis |
Actinic keratosis tx: | 5-FU (Efudex), Imiquimod (Aldara), cryotherapy, or ED&C |
Actinic keratosis: more likely to progress to SCC if on: | the ears or lower lip |
Actinic keratosis: Cutaneous horns should: | ALWAYS be biopsied. |
SCC prevalence | 20% of all skin ca |
SCC tx | ED&C, excision, and MMS for recurrent or high-risk lesions. |
SCC in situ = | Bowens dz |
Keratoacanthoma epi: | M>F, usually patients >50 YO. |
Atypical nevus: mild/mod/severe | mild: observe; mod: excise; severe: tx like melanoma |
Malig melanoma appearance: | can be flat, raised, nodular, or ulcerated. Color is variable. |
most important prognostic indicator in malig melanoma: | Breslow level |
Breslow level is: | depth of lesion measured in mm from the top of the clinical lesion to the bottom of the lesion in the tissue specimen. |
Clarks level: | level of anatomic invasion and is important, especially in areas with thinner skin like the eyelids, ears, and genitals. |
Malig melanoma: most common COD: | CNS mets |
Melanoma in situ = | Lentigo Maligna |
Superficial Spreading MM: | asymmetric, flat, larger than 6mm; spread laterally, may dev nodules |
Most common type of MM, | Superficial Spreading MM (70-80% of all melanoma) |
Superficial Spreading MM: Most common in: | Caucasians; usually seen on the trunk and extremities. |
Acral Lentiginous MM: epi | Most common MM in Asian-Americans / AA (>50% of all melanoma in these pops); Least common type of MM in Caucasians; 7% of all MM; M>F |
Topical immune response modifier (ie, for malignant melanoma): | Imiquimod (Aldara) |
BCC type: ulcer w/rolled border, covered w/crust = | ulcerating |
BCC type: infiltrating ca; white sclerotic patch w/ill-defined borders = | sclerosing |
BCC type: erythematous, sl scaly, thin plaques, w/fine rolled/pearly border = | superficial |
BCC type: thick hard area of variegated pigmentation = | pigmented |
Flesh-colored, pink or yellow-brown lesion with rough, sandpaper feel, at sun-exposed areas | Actinic Keratosis |
Non-pruritic, raised, warty brown-black plaques, stuck onto skin feel greasy | Seborrheic keratosis |
Raised pearly-borders, telangiectasia, central ulcer | Basal cell Ca |
Congenital Melanocytic Nevus: Increased risk of malignant melanoma in: | lesions larger than 20 cm |
Most common variant of BCC | nodular BCC |
pearly white or pink, translucent, dome-shaped papule with overlying random telangiectasias: | nodular BCC |
Superficial BCC: May resemble: | psoriasis, eczema, seborrheic keratosis, Bowen dz, or tinea corporis |
Actinic keratosis on lower lip = | actinic cheilitis |
Actinic keratosis: more likely to progress to SCC if on: | the ears or lower lip |
Actinic keratosis: Cutaneous horns should: | ALWAYS be biopsied |
SCC in situ = | Bowen dz |
Malig melanoma appearance: | can be flat, raised, nodular, or ulcerated. Color is variable. |
Malig melanoma: most common COD: | CNS mets |
Melanoma in situ = | Lentigo Maligna |
Superficial Spreading malig melanoma: | asymmetric, flat, larger than 6mm; spread laterally, may dev nodules |