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Malignant Lesions

Derm

QuestionAnswer
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
Created by: Abarnard