Dermatology Quiz on Skin Lesions
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Questions and Answers

What primarily differentiates lentigo from freckles?

  • Lentigo shows no change in color with sun exposure. (correct)
  • Freckles are a type of benign neoplasm.
  • Lentigo is affected by UV exposure.
  • Freckles have an increased number of melanocytes.
  • Which feature is characteristic of dysplastic nevi compared to regular melanocytic nevi?

  • Presence of atypical features suggesting malignancy. (correct)
  • Increased number of normal melanocytes.
  • Greater uniformity in shape.
  • Higher likelihood of being uniformly colored.
  • What describes the morphology of freckles?

  • Dark raised lesions with irregular borders.
  • Small brown/dark macules that can darken with sun exposure. (correct)
  • Uniform smooth texture with scaling.
  • Benign pigmented lesions with increased melanocyte density.
  • What is a key microscopic feature that helps differentiate lentigo from melanoma?

    <p>Increased melanocytes in the dermal-epidermal junction. (B)</p> Signup and view all the answers

    What genetic alterations are associated with an increased risk of developing melanoma in dysplastic nevi?

    <p>Loss of function mutations in CDKN2A. (D)</p> Signup and view all the answers

    What is the most common location for squamous cell carcinoma to develop?

    <p>Sun-exposed areas such as the face and ears (A)</p> Signup and view all the answers

    Which of the following is a classic pathological finding associated with squamous cell carcinoma?

    <p>Keratin pearls (C)</p> Signup and view all the answers

    Which risk factor is NOT associated with the development of squamous cell carcinoma?

    <p>Low-fat diet (C)</p> Signup and view all the answers

    What effect does chronic immunosuppression have in relation to squamous cell carcinoma?

    <p>It increases the likelihood of several skin cancers, including squamous cell carcinoma. (A)</p> Signup and view all the answers

    What distinguishes basal cell carcinoma from squamous cell carcinoma?

    <p>Basal cell carcinoma has a lower potential for recurrence compared to squamous cell carcinoma. (D)</p> Signup and view all the answers

    What is the primary cause of actinic keratosis?

    <p>Sun exposure (A)</p> Signup and view all the answers

    Which of the following is a characteristic feature of inclusion cysts?

    <p>Cystic expansion of epidermis (D)</p> Signup and view all the answers

    What is the relationship between adnexal tumors and sweat glands?

    <p>Eccrine poroma is commonly found where sweat glands are numerous (B)</p> Signup and view all the answers

    Which of the following features is associated with actinic keratosis?

    <p>Presence of retained nuclei in stratum corneum (D)</p> Signup and view all the answers

    What is a common consequence of torsion in polyps?

    <p>Ischemic necrosis (D)</p> Signup and view all the answers

    Which subtype of melanoma is the most common?

    <p>Superficial spreading melanoma (D)</p> Signup and view all the answers

    What is a key characteristic of nodular melanoma compared to other types?

    <p>It grows vertically and is more aggressive. (C)</p> Signup and view all the answers

    Which of the following describes the ABCDE criteria for melanoma detection?

    <p>Asymmetrical, Irregular border, Color variation, Diameter &gt; 6mm, Evolving overtime (C)</p> Signup and view all the answers

    What is one of the typical appearances of acral lentiginous melanoma?

    <p>Dark, velvety surface and well demarcated (C)</p> Signup and view all the answers

    Which type of melanoma is often referred to as melanoma in situ?

    <p>Lentigo maligna melanoma (A)</p> Signup and view all the answers

    Acanthosis nigricans is most commonly associated with which condition?

    <p>Insulin resistance (C)</p> Signup and view all the answers

    Which of the following is a common location for fibroepithelial polyps?

    <p>Trunk and face (A)</p> Signup and view all the answers

    The Leser-Trélat sign is associated with which skin condition?

    <p>Seborrheic keratosis (A)</p> Signup and view all the answers

    Flashcards

    Freckles definition

    Small, flat, brown spots caused by increased melanin, not affecting melanocyte numbers.

    Lentigo definition

    Benign spots with increased melanocytes; not sun-sensitive like freckles.

    Melanocytic nevi

    Benign growth of melanocytes, often round or oval, uniform color.

    Dysplastic nevi

    Atypical moles, with a higher risk of becoming melanoma (skin cancer).

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    Skin cancer risk and Dysplastic nevi

    Dysplastic nevi often precede melanoma, with age being a significant risk factor.

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    Inclusion cyst definition

    An inclusion cyst is a cystic lesion formed by invagination and expansion of epidermis or hair follicles.

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    Actinic keratosis cause

    Actinic keratosis is a precancerous skin condition caused by sun exposure. It involves growth of atypical epidermal keratinocytes.

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    Actinic keratosis morphology

    Actinic keratosis appears as round, red/brown papules or plaques, typically on sun-exposed areas of the skin.

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    Fibrovascular polyp cause

    Fibrovascular polyps, which are common during pregnancy, are caused primarily by hormonal changes and are often associated with obesity and diabetes.

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    Adnexal tumor characteristics

    Adnexal tumors are benign tumors that arise from skin appendages like sweat glands. They are typically flesh-colored and may appear as solitary or multiple papules/nodules.

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    Squamous Cell Carcinoma (SCC)

    A type of skin cancer arising from squamous cells in the epidermis, often found in sun-exposed areas like face, lips, and hands.

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    SCC Risk Factors

    Factors increasing SCC risk include prolonged sun exposure, immunosuppression (transplant, HIV, steroids), chronic skin inflammation (burns, ulcers), and arsenic exposure.

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    SCC Appearance

    SCC typically presents as red, scaling plaques with sharp borders, which may ulcerate, produce keratin, and bleed.

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    Basal Cell Carcinoma (BCC)

    The most common skin cancer, characterized by slow growth and rarely metastasizing. It usually occurs in sun-exposed areas.

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    BCC Key Point

    BCC has the lowest potential for recurrence and metastases, often detected early and easily removed.

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    Melanoma

    A highly malignant skin cancer with varied subtypes.

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    ABCDE (Melanoma)

    A diagnostic feature set used to recognize melanoma: asymmetry, irregular borders, color variation, diameter > 6mm, and evolving overtime.

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    Superficial Spreading Melanoma

    The most common type (75%) of melanoma, characterized by a slow-growing, flat, spreading pattern.

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    Nodular Melanoma

    A fast-growing, aggressive type of melanoma (15-30%) with a raised, vertical growth pattern.

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    Lentigo Maligna Melanoma

    A slow-growing melanoma type that originates as a dark spot (lentigo) confined to epidermal layers, progressing to the dermis.

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    Acanthosis Nigricans

    A skin condition characterized by dark, thickened plaques in skin folds, often linked to insulin resistance.

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    Fibroepithelial Polyp

    Common, soft, flesh-colored skin tumors with a stalk, often found on the neck, trunk, face, or intertriginous areas.

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    Leser-Trelat Sign

    A sudden appearance of multiple seborrheic keratosis (skin lesions), often associated with internal malignancies.

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    Study Notes

    Disorders of Hyperpigmentation (1/2)

    • Freckles: Small brown/dark macules (flat). Darken in sun exposure. Increased melanin. Normal melanocyte number/density.

    • Lentigo: Benign pigmented lesion. Increased number of melanocytes in the basal layer of epidermis. Not affected by UV/sun exposure. Morphology: small, flat, uniform brown, tan or black coloration. Smooth with no scaling or thickening. Commonly on sun-exposed areas (face, hands, forearms). Increased melanocytes at dermal-epidermal junction. No nesting or clustering of melanocytes (distinguishes from melanoma). Hyperpigmentation due to increased melanin production.

    • Melanocytic Nevi: Benign neoplasm of melanocytes. Tan/brown pigmented lesions. Uniform color. Often round or oval shape.

    Disorders of Hyperpigmentation (2/2)

    • Hemosiderin Hyperpigmentation: Brownish skin discoloration. Caused by deposition of hemosiderin (breakdown of hemoglobin). Induration, scaling or atrophy in chronic cases. Occurs in lower extremities (ankles and shins). Symmetrical involvement is common. Secondary to chronic venous insufficiency (CVI). Extravasation of RBCs into the dermis. Macrophages phagocytose hemosiderin. Diagnosis: Clinical based on pigmentation associated with CVI or trauma. Dermoscopy: Hemosiderin deposition. Benign. Indicates underlying venous pathology. Chronic may lead to permanent discoloration or venous ulcers.

    • Post-Inflammatory Hyperpigmentation (PIH): Acquired hyperpigmentation after skin injury or inflammation. Abnormal distribution of melanin in epidermis or dermis (skin's inflammatory response). Morphology: Hyperpigmented macules or patches with irregular borders. Color ranges: light brown-black (epidermal)or blue-gray (dermal). Epidermal PIH: Fades over months to years. Dermal PIH: More persistent and harder to treat.

    Disorders of Hypo-pigmentation

    • Albinism (Oculocutaneous Albinism (OCA)): Family of genetic disorders. Autosomal recessive. Absent/reduced melanin synthesis in melanocytes. Normal number of melanocytes. Most common forms: decrease tyrosinase activity. Hypopigmentation of hair, skin, eyes. White hair, pink skin color, blue eyes. Increased risk of sunburns, Increased risk of skin cancer, No UV light protection.

    • Vitiligo: Acquired, localized pigment disorder. Autoimmune destruction of melanocytes.

    • Idiopathic Hypomelanosis (IGH): Benign condition. Asymptomatic depigmented (white) macules/patches. No clinical signs of inflammation (warmth). Treatment: steroids, immunosuppressants. Dark skinned individuals: Obvious areas of depigmentation. Light skinned individuals: Failure to tan in localized region.

    Other Disorders of Skin Pigmentation

    • Multiple small, round or oval, hypopigmented macules. Seen in middle-aged and older adults. Results from chronic sun exposure and aging.
    • Affects sun-exposed areas of skin. Hypopigmented macules (lighter than surrounding skin). Smooth surface with no scaling or atrophy.

    Benign Epithelial Tumors

    • Seborrheic Keratosis: Common benign tumors. Proliferation of immature keratinocytes. Arise spontaneously. Commonly on the trunk. Flat, well-demarcated, round or oval. Dark, velvety surface, appear "stuck on."

    • Acanthosis Nigricans: Hyperpigmented (dark) plaques on skin. Intertriginous sites (folds). Associated with insulin resistance. Often seen in obesity, diabetes. Rarely associated with malignancy.

    Other Skin Tumors

    • Pityriasis Alba: Common, benign, self-limiting skin condition characterized by hypopigmented, scaly patches primarily in children and adolescents. Often in the face (cheeks) and neck, arms, and trunk. Form of atopic dermatitis associated with xerosis (dry skin. Hypopigmented light colored patches. Initially pink or red, fading to pale white over time. Fine scaling. Round, oval irregular shape (0.5-2cm). Lesions persist weeks to months, gradual repigmentation. Associated with atopic dermatitis and xerosis. Increased transepidermal water loss, dryness, and mild inflammation.

    Premalignant and Malignant Epidermal Tumors

    • Actinic Keratosis: Premalignant skin lesions, caused by sun exposure. Growth of atypical epidermal keratinocytes; can lead to squamous cell carcinoma. Round, red/brown papules or plaques. Sun-exposed areas.

    • Squamous Cell Carcinoma (SCC): 2nd most common skin cancer. Arises from squamous cells in the epidermis. Occurs in sun-exposed areas (face, lips, ears, hands). DNA damage by UV light. Common in older adults (>75). Less than 5% metastasize to regional nodes. Rarely metastasize beyond nodes. Red, scaling plaques with sharp borders. More advanced lesions: ulcerate, keratin production. May crust or bleed. Risk factors: Sun exposure. Chronic immunosuppression. Organ transplants, HIV, long-term glucocorticoids. Chronic skin inflammation. Burns, chronic ulcers, and draining sinus tracts. Arsenic exposure.

    • Basal Cell Carcinoma (BCC): Most common skin cancer. Slow growing. Rarely metastasizes. Most are found early and excised. Occur in sun-exposed areas. Lowest potential for recurrence or metastases. Pearly papules or nodules. May have telangiectasia on surface.

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    Description

    Test your knowledge on dermatological conditions and skin lesions. This quiz covers critical differences between lentigo, freckles, and various types of skin cancers, including squamous cell carcinoma and basal cell carcinoma. Understand key microscopic features and genetic risks associated with skin anomalies.

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