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

Flashcards

Actinic Keratosis

A precancerous skin lesion, often linked to prolonged sun exposure. A small percentage may progress to squamous cell carcinoma if left untreated.

Squamous Cell Carcinoma (SCC)

A type of skin cancer that originates in the squamous cells of the epidermis. It typically appears as a scaly, reddish plaque or nodule.

Squamous Cell Carcinoma in situ (SCCIS)

A type of skin cancer that originates in the squamous cells of the epidermis. It is characterized by abnormal keratinocytes, involving the full thickness of the epidermis, and mitosis throughout the epidermis.

Invasive Squamous Cell Carcinoma

A type of skin cancer that originates in the squamous cells of the epidermis and has spread to the dermis or subcutis. It is characterized by atypical keratinocytes proliferating and invading deeper tissue.

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Compound Melanocytic Nevus

A benign melanocytic nevus (mole) where the melanocytes are located within the epidermis and dermis.

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Intradermal Melanocytic Nevus

A benign melanocytic nevus (mole) where the melanocytes are located only within the dermis.

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Benign Melanocytic Nevus

A benign skin growth characterized by a symmetrical shape, mature melanocytes, minimal cell abnormalities, and rare cell division.

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Melanoma

A type of skin cancer that develops from melanocytes, which are the cells that produce pigment.

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Superficial Spreading Melanoma

The most common type of melanoma, accounting for nearly 70% of cases.

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Nodular Melanoma

A type of melanoma that appears as a raised nodule.

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Lentigo Maligna Melanoma

A type of melanoma that occurs mainly on the trunk of the body.

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Acral Lentiginous Melanoma

A type of melanoma that often occurs in the hands, soles of feet, and mucous membranes.

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Seborrheic Keratosis

A flat, wart-like growth on the skin that is usually harmless. It can be light tan/pink to dark brown/gray, but doesn't have a true pigment pattern.

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String Sign

A characteristic feature of seborrheic keratoses where the keratinocytes are arranged in a rope-like pattern.

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Seborrheic Keratosis

A common, benign growth of skin cells (keratinocytes) that often occurs on the face, neck, and upper chest.

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Nevus

A benign, non-cancerous growth of skin tissue (derived from melanocytes) that often appears as a brown, flat or raised spot.

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Seborrheic Keratosis: Atypical Features

These cells do not show any signs of cancer, such as abnormal growth (atypia) or increased cell division (mitoses).

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Seborrheic Keratosis: String Sign

The cells in seborrheic keratosis are arranged in a characteristic rope-like pattern, suggesting a "string" appearance.

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Benign Pigmented Lesions

These are benign proliferations of melanocytes.

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Nevus

A type of benign skin lesion that is often brown and may be flat or raised.

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What is Acral Lentiginous Melanoma?

Acral lentiginous melanoma (ALM) is a subtype of melanoma that primarily occurs in darker-skinned individuals.

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What is Pagetoid Spread?

Pagetoid spread describes the upward migration of melanoma cells within the epidermis, spreading horizontally and creating a characteristic pattern.

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How does a melanoma cell compare to a nevus cell in terms of maturation?

Melanoma cells don't mature deeply as they grow, maintaining an immature appearance, unlike nevi.

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How do mitoses affect melanoma prognosis?

The presence of mitoses (cell division) in melanoma indicates a higher risk of aggressive growth.

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Which histopathologic feature of melanoma is most crucial for prognosis?

The depth of invasion, measured using the Breslow thickness, is the most critical factor determining melanoma prognosis.

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What is the significance of the BRAF V600E mutation in melanoma?

BRAF V600E is a common genetic mutation found in melanoma, which can be targeted by specific therapies.

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How are BRAF inhibitors used in melanoma treatment?

BRAF inhibitors like Vemurafenib and Dabrafenib are used to target specific melanoma mutations, potentially benefiting patients with metastatic or unresectable melanoma.

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Which skin cancer is most commonly diagnosed via biopsy?

The most common type of skin cancer, Basal Cell Carcinoma (BCC) is typically diagnosed through a biopsy.

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What is Basal Cell Carcinoma?

Basal Cell Carcinoma (BCC) is a type of skin cancer that arises from the basal layer of the epidermis. It is characterized by slow growth and rarely metastasizes. BCC is commonly found on sun-exposed areas of the body and often presents as a pearly or shiny papule with telangiectasias (tiny dilated blood vessels).

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How do you recognize BCC under a microscope?

The histological appearance of BCC reveals nests of basaloid cells. These cells are small and have a dark-staining nucleus, resembling the basal layer of the epidermis.

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What do you see in a BCC biopsy?

BCC is characterized by nests of basaloid cells with a darkly stained nucleus.

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What is Actinic Keratosis (AK)?

Actinic keratosis (AK) is a precancerous skin lesion caused by sun exposure. It typically appears as a rough, scaly, or crusty patch on the skin. AK can transform into squamous cell carcinoma (SCC) if left untreated.

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How does Actinic Keratosis look under a microscope?

The histological appearance of AK reveals abnormal cells with atypical features. The severity of these changes can vary, and some AKs may have more concerning features.

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Does Actinic Keratosis always turn into cancer?

Approximately 10% of AKs can progress to squamous cell carcinoma over time if left untreated. It is important to monitor AKs and seek treatment to prevent the development of more serious skin cancers.

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Is Basal Cell Carcinoma life-threatening?

While BCC is the most common type of skin cancer, it is generally considered less aggressive than melanoma. Although it may invade surrounding tissues, metastatic spread to distant organs is rare.

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What causes Basal Cell Carcinoma?

The risk of developing BCC is significantly increased by sun exposure. Genetics may also play a role, with some individuals having an increased susceptibility to this type of skin cancer.

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Xeroderma Pigmentosum

A rare genetic disorder causing a deficiency in DNA repair, leading to increased sensitivity to sunlight and a high risk of skin cancers.

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Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)

A syndrome characterized by multiple basal cell carcinomas (BCCs), odontogenic keratocysts, and skeletal abnormalities. It is associated with a mutation in the PTCH gene.

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Dysplastic Nevus Syndrome

A genetic condition that causes unusual moles (nevi) and a significantly increased risk of melanoma. It is often associated with mutations in the CDKN2A gene.

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Pyogenic Granuloma

A common benign vascular tumor that develops on the skin, often after minor trauma or exposure to foreign bodies. It appears as a bright red, soft nodule.

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Infantile Hemangioma

The most common vascular tumor of infancy, typically appearing within weeks of birth. It's more common in Caucasian girls, premature infants, and those with placental abnormalities.

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Superficial Infantile Hemangioma

A type of infantile hemangioma characterized by small, well-defined, bright red nodules that resemble strawberries. They are raised and soft to the touch.

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Deep Infantile Hemangioma

A type of infantile hemangioma located deeper in the dermis or subcutaneous fat. It appears as a bluish, poorly defined, firm nodule.

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Mixed Infantile Hemangioma

A type of infantile hemangioma that combines features of both superficial and deep hemangiomas.

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Cherry Angioma

A common, benign vascular tumor in adults, typically appearing as small, dome-shaped, red papules. They are most common on the trunk and upper arms.

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Kaposi's Sarcoma

A type of cancer that affects blood vessels and lymph vessels. It typically presents as purplish or brown patches on the skin. It can be associated with the HHV-8 virus.

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Basal Cell Carcinoma

A common type of basal cell carcinoma, a slow-growing skin cancer. It typically appears as a pearly or waxy bump with small blood vessels.

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Why are Melanoma more worrisome than Nevi?

Melanomas are of most concern due their high chances of spreading, unlike benign nevi.

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How does a melanoma cell differ from a nevus cell in terms of maturation?

Melanoma cells don't mature deeply as they grow, retaining an immature appearance. This is unlike nevi, which mature with depth.

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What is Basal Cell Carcinoma (BCC)?

A type of skin cancer that originates in the basal layer of the epidermis, often caused by sun exposure. It's characterized by slow growth and rarely spreads to other parts of the body. It usually appears as a pearly or waxy bump, often with small blood vessels.

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What are the histological features of a Basal Cell Carcinoma biopsy?

Basal cell carcinoma is characterized by nests of basaloid cells that are small and have a dark-staining nucleus, resembling the basal layer of the epidermis.

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What are the histological features of an Actinic Keratosis biopsy?

It involves an accumulation of abnormal cells with varying levels of atypia, which can range from mild to severe.

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Why is treating Actinic Keratosis important?

If left untreated, about 10% of actinic keratoses can transform into squamous cell carcinoma.

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What is a Seborrheic Keratosis?

It is a common, benign growth of skin cells. It typically appears as a brown, flat or raised spot, often with a ‘stuck-on’ appearance.

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What are the distinct histological features of a Seborrheic Keratosis?

They are characterized by a rope-like pattern of cells, also known as 'string sign'.

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What are Nevi or Moles?

They are benign proliferations of melanocytes, which are the cells that produce pigment.

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What is Actinic Keratosis?

A precancerous skin lesion often caused by prolonged sun exposure. About 10% may progress to squamous cell carcinoma if untreated.

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What is Squamous Cell Carcinoma (SCC)?

A type of skin cancer arising from the squamous cells of the epidermis. It's often found in sun-damaged areas, scars, or sites with chronic infection. SCC is more likely to spread (metastasize) than BCC.

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What is Squamous Cell Carcinoma in situ (SCCIS)?

A type of skin cancer that originates in the squamous cells of the epidermis but hasn't yet invaded deeper tissue.

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What is Invasive Squamous Cell Carcinoma?

This type of SCC has spread beyond the epidermis and into the dermis or subcutis. It's characterized by abnormal keratinocytes invading deeper layers.

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What are the main differences between UVB and UVA radiation?

UVB radiation is strongly linked to sunburn, while UVA radiation contributes to tanning and premature aging.

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How does UVB radiation damage skin cells?

UVB radiation can directly damage DNA within keratinocytes, which are skin cells, increasing the risk of skin cancer.

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What is the main cause of SCC?

Exposure to UV light is the most common trigger for SCC development.

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Who is at higher risk for developing SCC?

SCC is more likely to develop in individuals with weakened immune systems, such as transplant recipients, and those with genetic disorders like xeroderma pigmentosum.

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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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