Dermatology Quiz on Skin Lesions and Carcinoma

Study Notes

Dermatological Lesions

Macule: Flattened lesion under 1 cm, not palpable (example: Vitiglio).
Papule: Elevated lesion under 1 cm, flat-topped (example: psoriasis).
Nodule: Rounded elevation, approximately 2 cm, characterized by swelling.
Vesicle: Clear fluid-filled blister up to 6 mm, elevated.

Basal Cell Carcinoma

Caused by chronic, intermittent UV exposure.
Appears as a pearly papule or nodule, often located above the upper lip near the nose.
Carries a 0.05% risk of metastasizing, but can grow rapidly.
Proliferation of basophilic cells from the basal epidermis infiltrates the dermis.
Cells resemble those of the stratum basale found in normal skin.
Management: Options include curettage, electrodissection, excision, and imiquimod cream.

Malignant Melanoma

Risk factors include blistering sunburns in childhood, excessive sun exposure, and having a family history of melanoma.
Individuals with light hair and pale eyes are at higher risk.
Characterized by new or changing moles, especially dysplastic nevi that meet A-E criteria.
Malignant melanocytes proliferate laterally along dermal-epidermal junctions initially, without metastasis.
Vertical growth phase: Malignant cells invade deeper into the dermis, indicating metastasis risk.
Prognostic Factor: Depth of melanoma is the single most significant factor.
Management: Complete excision of the primary lesion; sentinel lymph node biopsy may be indicated for thick or ulcerated melanomas.
Immunotherapy: Considered an adjuvant systemic therapy.
Evidence indicates UV exposure increases melanoma risk; however, there is no evidence that sunscreen prevents it.
Recommended precautions include protective clothing, shade, and avoiding sun exposure during peak hours (10 AM - 4 PM).

Primary Varicella (Chickenpox) and Candidiasis (Yeast Infection)

Chickenpox: Characteristic lesions resemble "dew drops on a rose petal," may lead to complications like VZV pneumonia.
Candidiasis:
- Normal skin flora becomes pathogenic when overgrown.
- Risk factors include diabetes, obesity, and occupations with high skin moisture (e.g., bartenders).
- Intertriginous Candidiasis: Erythema and pustules in body folds.
- Thrush: Appears as creamy white papules and plaques on the oral mucosa.
- Only 20 of 160 Candida species infect humans; Candida Albicans is the most common.
- Correct identification of Candida species is essential for treatment.
- Triggers: Antibiotics, corticosteroids, poorly fitted dentures, poor hygiene, and excessive alcohol can lead to yeast infections.
- Treatment: Topical azoles, nystatin powder or cream; for oral infections, use nystatin mouth rinse or clotrimazole lozenges.
- Candida Auris: An emerging, serious threat in healthcare settings; poses risk mainly to immunocompromised individuals, not healthy individuals.

Dermatological Lesions

Macule: Flattened lesion under 1 cm, not palpable (example: Vitiglio).
Papule: Elevated lesion under 1 cm, flat-topped (example: psoriasis).
Nodule: Rounded elevation, approximately 2 cm, characterized by swelling.
Vesicle: Clear fluid-filled blister up to 6 mm, elevated.

Basal Cell Carcinoma

Caused by chronic, intermittent UV exposure.
Appears as a pearly papule or nodule, often located above the upper lip near the nose.
Carries a 0.05% risk of metastasizing, but can grow rapidly.
Proliferation of basophilic cells from the basal epidermis infiltrates the dermis.
Cells resemble those of the stratum basale found in normal skin.
Management: Options include curettage, electrodissection, excision, and imiquimod cream.

Malignant Melanoma

Risk factors include blistering sunburns in childhood, excessive sun exposure, and having a family history of melanoma.
Individuals with light hair and pale eyes are at higher risk.
Characterized by new or changing moles, especially dysplastic nevi that meet A-E criteria.
Malignant melanocytes proliferate laterally along dermal-epidermal junctions initially, without metastasis.
Vertical growth phase: Malignant cells invade deeper into the dermis, indicating metastasis risk.
Prognostic Factor: Depth of melanoma is the single most significant factor.
Management: Complete excision of the primary lesion; sentinel lymph node biopsy may be indicated for thick or ulcerated melanomas.
Immunotherapy: Considered an adjuvant systemic therapy.
Evidence indicates UV exposure increases melanoma risk; however, there is no evidence that sunscreen prevents it.
Recommended precautions include protective clothing, shade, and avoiding sun exposure during peak hours (10 AM - 4 PM).

Primary Varicella (Chickenpox) and Candidiasis (Yeast Infection)

Chickenpox: Characteristic lesions resemble "dew drops on a rose petal," may lead to complications like VZV pneumonia.
Candidiasis:
- Normal skin flora becomes pathogenic when overgrown.
- Risk factors include diabetes, obesity, and occupations with high skin moisture (e.g., bartenders).
- Intertriginous Candidiasis: Erythema and pustules in body folds.
- Thrush: Appears as creamy white papules and plaques on the oral mucosa.
- Only 20 of 160 Candida species infect humans; Candida Albicans is the most common.
- Correct identification of Candida species is essential for treatment.
- Triggers: Antibiotics, corticosteroids, poorly fitted dentures, poor hygiene, and excessive alcohol can lead to yeast infections.
- Treatment: Topical azoles, nystatin powder or cream; for oral infections, use nystatin mouth rinse or clotrimazole lozenges.
- Candida Auris: An emerging, serious threat in healthcare settings; poses risk mainly to immunocompromised individuals, not healthy individuals.

Description

Test your knowledge on dermatological lesions and basal cell carcinoma with this comprehensive quiz. Explore the characteristics and examples of different skin lesions like macules, papules, nodules, and vesicles. Learn how UV exposure contributes to the development of basal cell carcinoma.