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Session 2 CM derm10

CM- Derm -10- Cutaneous Malignancies

intraeptihelial keratinocyte neoplasia precurson to squamous cell carcinoma found on sun exposed skin: face, posterior neck, bald scalp, arms, hands, and lips actinic keratosis
How does actinic karatosis appear as pink or red macules with adherent scale feels rough when palpated has variant cutaneous horn thick elongated scale
how do you treat actinic keratosis stop sun exposure liquid nitrogen if a few thin ones multiple ones can be treated by topical creams or photodynamic therapy
What are the creams used to treat multiple actinic keratosis spots topical 5-fluorouracil- burns and cause redness topical imiquimod
What is the prognosis of indiviuals with actinic keratosis in regards to squamous cell carcinoma 20% will develop squamous cell carcinoma somewhere
what number of actinic keratoses will transform into squamous cell carcinoma 1 in 1000
how many actinic keratoses remit spontaneously 25%
second most common type of skin cancer, cancer of cells that compose most of the epidermis. typically caused by sun damage Squamous cell carcinoma
Where does squamous cell carcinoma typically present head and neck but may also occur on lips, genitals and non exposed skin
type of squamous cell carcinoma confined to epidermis distinguished by full thickness atypia of the epidermis Bowen's disease or SCC in situ
What is the treatment for SCC in situ topical chemotherapy/immunomodulators destructive modalities excision
SCC that is marked by crateriform growth, growth is rapid and were originally thought to be benign keratoacanthoma (SCC-KA type)
What is the classic description of a SCC hyperkeratotic, flesh colored or pink papules may have ulceration and crusting
What are the risk factors that increase SCC sun exposure: UVB is carcinogenic fair skin, blue eyes, freckling arsenic exposure hydrocarbon exposure infrared and xray radiation chronic, non healing wounds immunosuppression HPV
What are the metastasis rates for SCC Typical Lower lip Scar or non healing ulcer penis/vulva Typical 8% lower lip 16-40% scar or non healing ulcer 25% penis/vulva 60%
with SCC of the lip which lip is typically affected what is the metastasis rate and what is it associated with Typically affect lower lip metastasis of 15-40% associated with sun exposure and smoking
What is the treatment for superficial SCC Superficial SCC liquid nitrogen, electrodissection and curettage topical imiquimod cream
What is the treatment for larger or more aggressive SCC's excisional surgery- especially crappy for snuff dipping could lose your whole freaking jaw radiation therapy
Cancer that arises from the pluripotent cells in the basal layer of the epidermis or follicular structures basal cell carcinoma
What is the most common skin cancer and most common malignancy in humans basal cell carcinoma
Where is basal cell carcinoma most common head and neck
What percent of basal cell carcinomas metastasize less than 1%
what are the 5 most common characteristics of basal cell carcinoma 1. an open sore 2. a reddish patch 3. a shiny bump 4. nodular (most common) 5. morpheaform
How does open sore characterize basal cell carcinoma an open sore that doesn't heal is very common sign of an early basal cell carcinoma. It will ooze bleed and crust remains open for three or more weeks
how does a reddish patch indicate basal cell carcinoma it will be a reddish patch that frequently occur on chest, shoulders, arms or legs. sometimes the patch crusts it may also itch or hurt but may not
how does a shiny bump indicate possible basal cell carcinoma the shiny bump or nodule is pearly or translucent and is often pink red or white. The bump can also be tank black or brown and can be confused with a mole
What is the classic basal cell carcinoma presentation nodule; pink growth with a slightly elevated border and a crusted indentation in the center. As the growth enlarges tiny blood vessels may develop on the surface
what is the morpheaform presentation of basal cell carcinoma a scar like area which is white yellow or way and often has poorly defined borders. The skin itself appears shiny and taut this warning sign can indicate aggressive tumor
What is the treatment for Basal Cell Carcinoma superficial BCC: liquid nitrogen electrodessication and curettage topical imiquimod cream Larger and more aggressive BCC excisional surgery radiation therapy
What are the indications that BCC is candidate for Mohs micrographic surgery recurrent tumor aggressive histolog tumor size greater than 2cm ill-defined clinical margins high risk areas (perioral, periorbital, nasolabial, nasal ala) tissue conservation
Tumor arising from melanocytes 1/5 of patients develop metastatic disease incidence of 15 per 10000 melanoma
What are the ABCDE's of melanoma A= Asymetry B= borders irregular C= Color D= Diameter >5mm E= evolution/exposure or enlargment/elevation
What are the 4 types of melanoma superficial spreading melanoma nodular melanoma lentigo maligna melanoma acral lentiginous melanoma
Most common type of melanoma, onset 30-50yrs slow horizontal growth phase followed by rapid vertically oriented growth phase 1/3 aris in pre existing nevus Superficial spreading melanoma
Where is superficial spreading melanoma most common in men and women men: back Women: lower legs
What fraction of superficial spreading melanomas developed from a pre-existing nevus 1/3
Second most common type of melanoma arises in sixth decade of life nodular melanoma
Where do you generally find nodular melanoma trunk, head, neck
Which sex has more nodular melanoma men have it more than women
blue to black nodule that grows rapidly over months nodular melanoma
This melanoma generally develops in the 7th decade of life occurs on chronically sun-damaged sin more common on face (nose and cheek) lentigo maligna melanoma
How does lentigo maligna melanoma develop slowly growing asymmetric black macule with slow evolution over many years
This is a relatively uncommon melanoma occurs on palms and sole or around nails, represents 70% of melanomas in dark skinned races Acral lentiginous melanoma
Melanoma with a faster progression than others killed bob marley acral lentiginous melanoma
What are the followin clarks levels of invasion level 1 2 3 4 5 1= confined to epidermis 2= invasion of papillary dermis 3= tumor fills papillary dermis 4= invasion of superficial reticular dermis 5= invasion of fat layer
what are the 10 year survival rates for clarkes levels 2 3 4 5 2=93% 3=71% 4=59% 5=36%
this procedure is performed when tumor thickness is >1mm sentinel lymph node biopsy
how does sentinel lymph node biopsy work you inject technetium sulfur colloids that get taken up around tumor and transported to lymphatics concentrates in sentinel lymph node. You then resect the radioactive lymph node. if that lymph node has cancer you do a general lymph node disection
what are the treatments for melanoma excision, sentinel node biopsy, interferon alpha, melanoma vaccines, pallative surgery, chemotherapy
Created by: smaxsmith