Neoplasms of the Skin
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Questions and Answers

What is a key characteristic of seborrheic keratosis?

  • Rapidly changing size and color
  • Keratinocytes with atypia and mitoses
  • Asymmetric pigmented pattern
  • Presence of prominent horn cysts (correct)

    • What best describes the surface appearance of a seborrheic keratosis?

  • Very red, raised and inflamed with scaly edges
  • Flat-topped to exophytic, with a 'stuck-on' appearance (correct)
  • Deeply nodular and sharply demarcated
  • Smooth and flat with a uniform color

    • Which of the following is NOT a typical characteristic of a benign melanocytic lesion?

  • Symmetric shape
  • Homogenous color
  • Distinct border
  • Rapidly changing size (correct)

    • What is the origin of seborrheic keratosis?

    <p>Benign proliferation of keratinocytes (D)</p> Signup and view all the answers

    Which term best describes the appearance of a seborrheic keratosis when viewed from the side?

    <p>Exophytic (B)</p> Signup and view all the answers

    What is an alternative term for nevus?

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

    Regarding the keratinocytes of a seborrheic keratosis, which statement is true?

    <p>They lack atypia and mitoses. (D)</p> Signup and view all the answers

    What is the significance of the 'string sign' in the context provided?

    <p>It is not relevant to the clinical context of seborrheic keratosis (C)</p> Signup and view all the answers

    A melanocytic nevus that involves both the epidermis and dermis is classified as which of the following?

    <p>Compound nevus (C)</p> Signup and view all the answers

    In a benign melanocytic nevus, how do the melanocytes typically change as they descend deeper within the skin?

    <p>Cells become smaller, non-pigmented and less nested. (C)</p> Signup and view all the answers

    Which of the following is a typical characteristic of a benign melanocytic nevus?

    <p>Symmetrical lesion (B)</p> Signup and view all the answers

    According to the text provided, what is the most common subtype of cutaneous melanoma?

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

    Where does superficial spreading melanoma have a predilection in females?

    <p>Lower leg (A)</p> Signup and view all the answers

    If a patient presents with multiple pigmented lesions, which characteristic of a lesion would be of most concern?

    <p>Rapid change in size, shape, and color (C)</p> Signup and view all the answers

    A melanocytic nevus that is confined only to the dermis is referred to as which type of nevus?

    <p>Intradermal melanocytic nevus (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the characteristics of pyogenic granuloma?

    <p>A common benign vascular tumor that arises from excessive granulation tissue and often has a pedunculated appearance. (D)</p> Signup and view all the answers

    What is the primary defect associated with Xeroderma Pigmentosum?

    <p>A deficiency in DNA repair mechanisms, increasing susceptibility to sun-induced DNA damage. (B)</p> Signup and view all the answers

    Which statement regarding infantile hemangiomas is INCORRECT?

    <p>They primarily affect the limbs with less than 10% affecting the head and neck. (A)</p> Signup and view all the answers

    What is the most common location for cherry angiomas?

    <p>Trunk and upper arms. (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic feature of Nevoid Basal Cell Carcinoma Syndrome (Gorlin syndrome)?

    <p>Increased risk of developing melanomas. (D)</p> Signup and view all the answers

    What is the key difference between superficial and deep infantile hemangiomas?

    <p>Superficial hemangiomas have a well-defined bright red appearance, while deep hemangiomas have a bluish hue and indefinite borders. (B)</p> Signup and view all the answers

    Which skin condition is linked to mutations in the CDKN2A genes?

    <p>Dysplastic nevus syndrome. (A)</p> Signup and view all the answers

    What is the typical clinical presentation of a seborrheic keratosis?

    <p>A raised, “stuck-on” brown papule with a waxy appearance. (B)</p> Signup and view all the answers

    What is the most significant prognostic factor for melanoma?

    <p>The depth of invasion of the tumor. (D)</p> Signup and view all the answers

    What is the underlying mechanism of Kaposi sarcoma?

    <p>An infection with the human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus. (D)</p> Signup and view all the answers

    Which of the following statements correctly describes the typical characteristics of a nevus?

    <p>A symmetrical, well-defined lesion with smooth borders and homogeneous color. (A)</p> Signup and view all the answers

    What is a key microscopic feature of basal cell carcinoma on biopsy?

    <p>Basaloid islands with peripheral palisading and mucin. (A)</p> Signup and view all the answers

    What is the term for a common, benign vascular tumor that arises following minor trauma or foreign body insertion?

    <p>Pyogenic granuloma (B)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for the development of infantile hemangiomas?

    <p>Male gender (A)</p> Signup and view all the answers

    Which of the following is a key characteristic associated with seborrheic keratosis?

    <p>The presence of horn cysts and a string sign. (C)</p> Signup and view all the answers

    Which subtype of melanoma is most prevalent in dark-skinned races?

    <p>Acral lentiginous melanoma (D)</p> Signup and view all the answers

    What histopathologic feature distinguishes melanoma from a nevus?

    <p>Mitotic activity (C)</p> Signup and view all the answers

    Which feature is a characteristic of melanoma compared to a nevus?

    <p>Prominent pagetoid spread (D)</p> Signup and view all the answers

    Which histopathologic feature is considered most crucial for melanoma prognosis?

    <p>Depth of invasion (D)</p> Signup and view all the answers

    BRAF V600E mutation is most commonly associated with which condition?

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

    Which type of treatment may be beneficial for patients with unresectable melanoma?

    <p>BRAF kinase inhibitors (D)</p> Signup and view all the answers

    What indicates pagetoid spread in melanoma?

    <p>Upward intraepidermal spread of melanocytes (C)</p> Signup and view all the answers

    Which type of skin cancer is most commonly diagnosed?

    <p>Basal cell carcinoma (D)</p> Signup and view all the answers

    What is actinic keratosis primarily related to?

    <p>Chronic sun exposure (D)</p> Signup and view all the answers

    What percentage of actinic keratosis lesions might progress to squamous cell carcinoma if left untreated?

    <p>10% (D)</p> Signup and view all the answers

    Which of the following is a characteristic of squamous cell carcinoma in situ (SCCIS)?

    <p>Full-thickness involvement of the epidermis (B)</p> Signup and view all the answers

    What is the most common cause of squamous cell carcinoma?

    <p>Exposure to UV light (B)</p> Signup and view all the answers

    In which condition is squamous cell carcinoma more likely to occur?

    <p>In immunosuppressed individuals (D)</p> Signup and view all the answers

    Which type of UV radiation is primarily responsible for sunburn?

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

    Which of the following characteristics is typically associated with invasive squamous cell carcinoma?

    <p>May present as infiltrative to indurated lesions (B)</p> Signup and view all the answers

    What is a common feature of invasive squamous cell carcinoma compared to basal cell carcinoma?

    <p>It is more likely to metastasize (D)</p> Signup and view all the answers

    What is a common characteristic feature of basal cell carcinoma?

    <p>Pearly or shiny papules (C)</p> Signup and view all the answers

    Which statement accurately describes basal cell carcinoma?

    <p>It is the most prevalent type of skin cancer. (A)</p> Signup and view all the answers

    Which of the following features is NOT associated with basal cell carcinoma?

    <p>Excessive itchiness (B)</p> Signup and view all the answers

    What role does sun exposure play in basal cell carcinoma?

    <p>It is a primary factor in its pathogenesis. (B)</p> Signup and view all the answers

    Which of the following statements about actinic keratosis is true?

    <p>About 10% may transform into squamous cell carcinoma if untreated. (A)</p> Signup and view all the answers

    What is a typical appearance of a pigmented basal cell carcinoma?

    <p>Gray, blue, or almost black lesions (C)</p> Signup and view all the answers

    What is a critical factor in the progression of actinic keratosis?

    <p>Chronic exposure to ultraviolet light (D)</p> Signup and view all the answers

    Which feature indicates that basal cell carcinoma is locally aggressive?

    <p>It can invade surrounding tissues. (A)</p> Signup and view all the answers

    Which of the following statements about seborrheic keratosis is correct?

    <p>It is a common, benign neoplasm of older persons. (B)</p> Signup and view all the answers

    What is a significant risk factor associated with the development of skin cancers?

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

    Which of the following best describes actinic keratosis?

    <p>A precursor lesion that may lead to squamous cell carcinoma. (A)</p> Signup and view all the answers

    Which environmental factor is most significantly implicated in the development of skin cancers?

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

    Which characteristic is typically associated with squamous cell carcinoma compared to basal cell carcinoma?

    <p>It can arise from actinic keratosis. (D)</p> Signup and view all the answers

    Which type of melanocytic nevus is confined to the dermis?

    <p>Intradermal nevus (B)</p> Signup and view all the answers

    What is the most common subtype of cutaneous melanoma?

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

    Which feature is indicative of a benign melanocytic nevus?

    <p>Symmetry of the lesion (B)</p> Signup and view all the answers

    What type of characteristic do deeper melanocytes exhibit in a benign nevus?

    <p>Smaller and nonpigmented (B)</p> Signup and view all the answers

    In which location is superficial spreading melanoma most commonly found in females?

    <p>Lower leg (D)</p> Signup and view all the answers

    What histological feature of a benign melanocytic nevus indicates maturation of melanocytes?

    <p>Larger superficial cells (A)</p> Signup and view all the answers

    Which statement describes a characteristic that is NOT typical of an atypical nevus?

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

    What histopathologic feature differentiates melanoma from a benign nevus regarding maturation?

    <p>Melanoma does not mature with depth (C)</p> Signup and view all the answers

    Which subtype of melanoma is most commonly found in individuals with darker skin tones?

    <p>Acral lentiginous melanoma (A)</p> Signup and view all the answers

    Which of the following features indicates the presence of pagetoid spread in melanoma?

    <p>Upward spread of melanocytes in the epidermis (B)</p> Signup and view all the answers

    What is the most significant prognostic factor in melanoma among the given options?

    <p>Depth of invasion (C)</p> Signup and view all the answers

    What cytological feature is typically absent in a benign nevus compared to melanoma?

    <p>Cytologic atypia (C)</p> Signup and view all the answers

    Which BRAF mutation is commonly associated with melanoma?

    <p>BRAF V600E (A)</p> Signup and view all the answers

    Which of the following treatments is most effective for patients with unresectable melanoma?

    <p>BRAF kinase inhibitors like Vemurafenib (A)</p> Signup and view all the answers

    How do melanocytes appear in melanoma compared to a benign nevus?

    <p>They show abnormal distribution in melanoma (C)</p> Signup and view all the answers

    Which of the following characteristics is typical of basal cell carcinoma?

    <p>Pearly or shiny papules (B)</p> Signup and view all the answers

    What histologic feature is characteristic of basal cell carcinoma?

    <p>Nests of basaloid cells (C)</p> Signup and view all the answers

    Which statement accurately reflects the prognosis of basal cell carcinoma?

    <p>Locally aggressive but rarely metastasizes (A)</p> Signup and view all the answers

    How does sun exposure contribute to the development of basal cell carcinoma?

    <p>It induces changes in the skin's DNA (B)</p> Signup and view all the answers

    Which of the following options describes the appearance of 'pigmented' basal cell carcinoma?

    <p>Gray, blue, or almost black (D)</p> Signup and view all the answers

    Which lesion is characterized by flat-topped to exophytic papules that are often described as 'warty'?

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

    What is the risk of untreated actinic keratosis transforming into squamous cell carcinoma?

    <p>Approximately 5% to 15% (D)</p> Signup and view all the answers

    What is a key histological feature of seborrheic keratosis?

    <p>Prominent horn cysts (C)</p> Signup and view all the answers

    Which of the following is NOT a clinical feature of basal cell carcinoma?

    <p>Rapidly growing nodular lesions (D)</p> Signup and view all the answers

    What role do genetic factors play in basal cell carcinoma?

    <p>They may enhance the effects of sun exposure (D)</p> Signup and view all the answers

    Which of the following describes the key differences in the behavior of keratinocytes in seborrheic keratosis compared to malignant lesions?

    <p>Lack of atypia and mitoses (A)</p> Signup and view all the answers

    What color range do seborrheic keratoses typically exhibit?

    <p>Light tan to dark brown/gray (B)</p> Signup and view all the answers

    Which clinical characteristic is associated with benign melanocytic lesions?

    <p>Homogeneous color (D)</p> Signup and view all the answers

    Which of the following terms describes a common benign skin lesion derived from melanocytes?

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

    What is a notable characteristic of keratinocytes within seborrheic keratosis?

    <p>Absence of mitotic figures (B)</p> Signup and view all the answers

    Which benign skin lesion is described as potentially being pigmented and raised?

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

    What is a common clinical presentation of squamous cell carcinoma (SCC)?

    <p>Red papule, nodule, or plaque (B)</p> Signup and view all the answers

    What characteristic microscopically differentiates invasive squamous cell carcinoma from squamous cell carcinoma in situ?

    <p>Presence of prominent keratin pearls (C)</p> Signup and view all the answers

    What is the primary mechanism contributing to the development of squamous cell carcinoma?

    <p>Exposure to UV light causing DNA damage (C)</p> Signup and view all the answers

    In which patient population is the risk of developing squamous cell carcinoma heightened?

    <p>Immunosuppressed patients, such as organ transplant recipients (B)</p> Signup and view all the answers

    Which feature is specifically associated with the appearance of squamous cell carcinoma in situ (SCCIS)?

    <p>Slightly scaly pink plaque without ulceration (D)</p> Signup and view all the answers

    What type of UV radiation is primarily responsible for tanning and photoaging of the skin?

    <p>UVA radiation (B)</p> Signup and view all the answers

    What is a distinguishing histological feature of non-invasive squamous cell carcinoma (SCCIS)?

    <p>Full thickness involvement of the epidermis (D)</p> Signup and view all the answers

    Which characteristic is least likely to be observed in invasive squamous cell carcinoma (SCC)?

    <p>Well-defined edges with no induration (B)</p> Signup and view all the answers

    Study Notes

    Neoplasms of the Skin

    • Benign skin growths have varying cellular origins, including keratinocytes, melanocytes, and blood vessels. Examples of these include nevi, seborrheic keratosis, and pyogenic granulomas. Students should be able to describe the clinical presentation and histopathologic findings of these growths.

    • Skin cancers, such as basal cell carcinoma, squamous cell carcinoma, and melanoma, have distinct presentations. Understanding precursor lesions (like actinic keratosis), risks factors, and hereditary syndromes is crucial.

    • Ultraviolet light and other environmental factors play a role in the development of skin cancers. Exposure to UV light can cause thymine dimers in skin cells. If these dimers are not excised or corrected, resulting DNA damage can lead to cancer.

    Seborrheic Keratosis

    • Seborrheic keratosis is a common benign skin neoplasm, found more frequently in older adults.

    • Clinical descriptions include flat-topped to exophytic papules, a "warty" appearance, and a "stuck-on" texture. Variations in pigmentation (light tan/pink to dark brown/gray), but usually no true pigment pattern, occur.

    • Key characteristics include the finding of a benign proliferation of keratinocytes. They often present with horn cysts and string signs.

    Nevi

    • Nevi, also known as moles, are various congenital or acquired skin lesions. They are typically pigmented and raised and can involve different skin tissue types.

    • Histological descriptions vary based on the sections affected. The epidermis, both the epidermis and dermis, or only the dermis can be involved in the lesion's placement. Junctional nevi involve only the epidermis, compound nevi involve both epidermis and dermis, and intradermal melanocytic nevi involve only the dermis.

    • Nevi are characterized by melanocytes that mature as they descend through skin layers. They demonstrate symmetric growth, mature melanocytes, and lack of atypia. Mitosis is rare.

    Melanoma

    • Melanoma is a type of skin cancer with several subtypes. Its prognosis is heavily influenced by the depth of invasion. This is a significant indicator that is frequently used for prediction of 10yr survival rates.

    • Characteristics of benign pigmented lesions include symmetry, evenly colored borders, a uniform color, and a diameter smaller than a pencil eraser. Lesions that change in size, shape, or color, or begin to bleed or scab are indicators for concern, often signifying an early stage of melanoma. Note the presence of ABCDE's of melanoma.

    Basal Cell Carcinoma

    • Basal cell carcinoma (BCC) is the most common skin cancer.

    • Common presentations include "pearly" or shiny papules and nodules on sun-exposed skin, with possible telangiectasias and ulceration. These lesions may bleed easily.

    • A significant histologic feature of BCC is nests of basaloid cells with stromal clefting. It rarely metastasizes.

    Actinic Keratosis

    • Actinic keratosis (AK) is a premalignant skin lesion. Increased risk arises from chronic sun exposure.

    • Features of this lesion include solar elastosis, parakeratosis, and atypia of basal keratinocytes. Approximately 10% may progress to squamous cell carcinoma if left untreated.

    Pyogenic Granuloma

    • Pyogenic granuloma (PG) is a common, benign vascular tumor.
    • Locations frequently include the face, and extremities, resulting in the development of bright red, soft nodules that are pedunculated.
    • Treatment often involves excision or electrodessication.

    Infantile Hemangiomas

    • Infantile hemangiomas are the most common vascular tumor in infants.

    • The lesion's course often involves growth to a peak, followed by growth cessation, and eventual involution. These lesions may have a superficial or deep origin. Common sites include the head and neck.

    Kaposi Sarcoma

    • Kaposi sarcoma is characterized by bluish discolorations of the skin, which commonly affects the trunk and upper arms. It's associated with HHV-8.

    Angiosarcoma

    • Angiosarcoma is another vascular tumor presenting as a nodular lesion.

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    JD Neoplasms of the Skin PDF

    Description

    Explore the various benign and malignant skin neoplasms, including their cellular origins, clinical presentations, and histopathologic findings. Learn about conditions such as seborrheic keratosis and different types of skin cancers, as well as the role of environmental factors in their development.

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