Skin Cancer Quiz: BCC and Melanoma
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Questions and Answers

What is the most common subtype of BCC?

  • Pigmented
  • Superficial
  • Nodular (correct)
  • Morpheaform
  • Which of the following is NOT a clinical subtype of BCC?

  • Keratoacanthoma (correct)
  • Superficial
  • Nodular
  • Infiltrative
  • What is the primary cause of BCC?

  • Exposure to UV light (correct)
  • Genetic predisposition
  • Smoking
  • Viral infection
  • What is the most effective treatment for morpheaform BCC?

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

    Which of the following is a risk factor for BCC?

    <p>Heavy sun exposure in youth (C), Use of tanning beds (D)</p> Signup and view all the answers

    What is the most common site for BCC?

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

    What is NOT a characteristic of nodular BCC?

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

    Which treatment option is best for superficial BCC lesions below the neck?

    <p>Topical 5-fluorouracil ointment (C)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for squamous cell carcinoma (SCC)?

    <p>Frequent use of sunscreen (C)</p> Signup and view all the answers

    What is the most common site for superficial SCC?

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

    What is the single most important prognostic factor for melanoma?

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

    Which of the following is NOT a characteristic of a melanoma according to the "ABCDE" criteria?

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

    What is the typical treatment for Kaposi sarcoma?

    <p>Radiation, chemotherapy, and antivirals (C)</p> Signup and view all the answers

    What is the primary benefit of Mohs micrographic surgery (MMS) compared to standard excision?

    <p>Superior tumor margin analysis (D)</p> Signup and view all the answers

    Which of the following is an indication for Mohs micrographic surgery?

    <p>Lesions on the eyelid (B)</p> Signup and view all the answers

    What is the main difference between a shave biopsy and an excisional biopsy?

    <p>Shave biopsy removes only the top layer of skin, while excisional biopsy removes the entire lesion. (C)</p> Signup and view all the answers

    Which of the following is a type of skin cancer that can arise from actinic keratosis (AK)?

    <p>Squamous cell carcinoma (SCC) (A)</p> Signup and view all the answers

    Which of the following types of skin cancer is the least common?

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

    What is the most common cause of Impetigo?

    <p>Both Staphylococcus aureus and Streptococcus pyogenes (C)</p> Signup and view all the answers

    What is the classic presentation of "Anthony's Fire" rash?

    <p>Large, painful, raised lesions with a shiny appearance (C)</p> Signup and view all the answers

    What is the most common treatment for a lipoma?

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

    Which of the following is a common risk factor for pressure ulcers?

    <p>Long periods of immobility (B)</p> Signup and view all the answers

    What is the most common treatment for stage I pressure ulcers?

    <p>Repositioning and pressure reduction (D)</p> Signup and view all the answers

    Which of the following is a characteristic of Vitiligo?

    <p>Loss of pigmentation in the skin (D)</p> Signup and view all the answers

    What is a common symptom of secondary syphilis?

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

    What is the most common type of photosensitivity reaction?

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

    What is the most common treatment for syphilis?

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

    What is the risk of developing melanoma in individuals with large or giant congenital nevi greater than 20 cm?

    <p>5-10% (C)</p> Signup and view all the answers

    Which characteristic is NOT associated with atypical nevi?

    <p>Diameter less than 5mm (D)</p> Signup and view all the answers

    In individuals at increased risk for melanoma, how many standard nevi does a patient typically have to possess to warrant concern?

    <p>50 nevi (A)</p> Signup and view all the answers

    What is the most important determinant of survival in melanoma?

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

    Where are atypical nevi most commonly located on the body?

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

    What is one reason for performing a biopsy before surgical removal of a lesion?

    <p>To determine if excision is necessary (A)</p> Signup and view all the answers

    Which type of infection is characterized by a collection of pus in the dermis or subcutaneous space?

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

    What is a potential risk factor for developing an abscess?

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

    In which situation should a patient be cautious when undergoing a skin biopsy?

    <p>Presence of a local infection (D)</p> Signup and view all the answers

    Which of the following is a common characteristic of cellulitis?

    <p>Diffuse swelling and warmth (B)</p> Signup and view all the answers

    What should a patient do after an incision and drainage (I&D) procedure for an abscess?

    <p>Apply heat or warm compresses (C)</p> Signup and view all the answers

    Which of the following is a common treatment for cellulitis?

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

    What distinguishes erysipelas from cellulitis?

    <p>Erysipelas is caused by beta-hemolytic streptococcus (A)</p> Signup and view all the answers

    Flashcards

    Basal Cell Carcinoma (BCC)

    Most common skin cancer, often caused by UV light, primarily in fair-skinned individuals over 40.

    Risk Factors for BCC

    Includes fair skin, light-colored eyes, red hair, and prolonged sun exposure.

    Clinical Subtypes of BCC

    Includes superficial, nodular, pigmented, and morpheaform types.

    Nodular BCC

    Most common subtype, characterized by smooth, pearly nodules with telangiectasia.

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    Pigmented BCC

    A BCC subtype that appears brown, blue or black, and can become ulcerated.

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    Morpheaform BCC

    A subtype also known as sclerosing BCC, presenting as indented, ill-defined plaques.

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    Diagnosis of BCC

    Clinical assessment confirmed by microscopy and biopsy.

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    Treatment Options for BCC

    Includes excision, cryosurgery, electrosurgery, and topical treatments for superficial cases.

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    Congenital Nevus

    Large or giant moles (> 20 cm) that have a risk of melanoma.

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    Atypical Nevi

    Benign melanocytic moles with features resembling melanoma, increased melanoma risk present.

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    Ugly Duckling Sign

    Clinical sign indicating the nevi that look different from others on the patient.

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    Biopsy of Suspicious Lesions

    Avoid superficial shave biopsy for pigmented lesions suspected of melanoma; depth matters.

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    Breslow Depth

    Tumor thickness of melanoma; key determinant for survival outcomes.

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    Skin Biopsy

    Procedure to obtain tissue for histologic examination.

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    Abscess

    Collection of pus in dermis or subcutaneous space.

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    Incision & Drainage (I&D)

    Surgical procedure to remove pus from an abscess.

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    Cellulitis

    Diffuse infection of dermis and subcutaneous tissue.

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    Erysipelas

    Superficial cellulitis caused by beta-hemolytic streptococcus.

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    Melanomas

    Skin tumors requiring large surgical margins after biopsy.

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    Bacterial infections

    Infections caused by bacteria, such as abscess or cellulitis.

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    Risks for Abscess

    Factors like skin disruption, edema, and obesity increase abscess risk.

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    Squamous Cell Carcinoma (SCC)

    A common skin cancer often arising from actinic keratosis, presenting as solitary or multiple lesions.

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    Treatment for In Situ SCC

    In situ SCC is treated with imiquimod, 5-fluorouracil, or electrodessication.

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    Mohs Micrographic Surgery (MMS)

    A surgical technique that conserves healthy tissue while ensuring complete tumor removal.

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    ABCDE Criteria

    A guideline for identifying melanoma: Asymmetry, Border irregularity, Color variation, Diameter, and Evolving shape.

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    Kaposi Sarcoma

    A tumor linked to HSV-8 infection, appearing as purple or brown patches, particularly in immunocompromised individuals.

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    Sentinel Lymph Node Biopsy

    A procedure to identify the first lymph node to which cancer cells are most likely to spread.

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    Anthony’s Fire Rash

    A rash with pain and malaise, often affecting lower limbs and face, caused by infections like cellulitis.

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    Impetigo

    A contagious bacterial skin infection primarily in children causing honey-colored crusts after vesicles.

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    Lipoma

    A benign, soft, round, lobulated tumor made of fatty tissue, often found on neck or trunk.

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    Epidermal Inclusion Cyst (EIC)

    A benign cyst from hair follicles, often expressible with foul-smelling contents.

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    Pressure Ulcer

    Injury caused by pressure on the skin, categorized by stages from superficial redness to full thickness.

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    Vitiligo

    A skin condition resulting in white patches due to the loss of melanocytes.

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    Melasma

    Benign hyperpigmentation appearing as dark patches on the skin, often due to hormonal changes.

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    Photosensitivity Reactions

    Abnormal skin reactions to sunlight, including sunburn-like rashes and photoallergic responses.

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    Syphilis

    A sexually transmitted infection marked by painless sores and a secondary rash on the trunk and extremities.

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    Parkland Formula

    Fluid resuscitation formula for burn victims: 4ml/kg x % TBSA.

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    Study Notes

    Dermatology 3 - CAM I

    • Course instructor: Professor Jacobus, MSBS, PA-C
    • Course offered by: South College
    • Course description: Dermatology focus including etiology, epidemiology, clinical features, differential diagnosis, and management of selected skin disorders.

    Instructional Objectives

    • Students will identify and describe the etiology, epidemiology, clinical features, differential diagnosis, and management of selected skin disorders.

    Topics

    • Neoplasms
    • Bacterial Infections
    • Others

    Malignant Neoplasms

    • Basal Cell Carcinoma (BCC)
    • Squamous Cell Carcinoma (SCC)
    • Melanoma
    • Kaposi Sarcoma

    Basal Cell Carcinoma (BCC)

    • Most common skin cancer
    • Onset typically after age 40, more common in females
    • Etiology: primarily caused by ultraviolet light (UVB)
    • Occurs most frequently on fair-skinned individuals (types I-III)
    • Risk factors include light-colored eyes, red hair, prolonged sun exposure, northern European ancestry, and heavy sun exposure in youth
    • Clinical sub-types include superficial, nodular, pigmented, morpheaform
    • Histologic sub-types include superficial, nodular, micronodular, infiltrative
    • Slow-growing, often asymptomatic, may show bleeding/scab, sensitivity to nerve involvement

    Basal Cell Carcinoma (BCC) - Diagnosis and Treatment

    • Diagnosis is often clinical, confirmed by biopsy
    • Treatment typically includes excision with primary closure, cryosurgery, electrosurgery, Mohs surgery, topical treatments such as 5-fluorouracil ointment and imiquimod (for superficial lesions below neck)

    Nodular BCC

    • Most frequent subtype (80%)
    • Skin-colored, reddish, or translucent (pearly)
    • Well-defined, firm, smooth papule or nodule with telangiectasias
    • May show erosions, melanin stipples, or ulceration. Rolled border
    • Examples provided in images

    Pigmented BCC

    • Brown, blue, or black
    • Hard, firm
    • Round or oval, possibly ulcerated
    • Differential diagnosis from melanoma is vital

    Morpheaform BCC

    • 5-10% of total BCC cases
    • Smooth, flesh-colored, or light erythematous papules or plaques
    • Atrophic, ill-defined borders
    • Scar-like appearance

    Squamous Cell Carcinoma (SCC)

    • More common in individuals over 55 and females
    • Risk factors include sun exposure, light-colored skin, poor tanning, outdoor occupations, immunosuppression, chronic inflammation, industrial carcinogens
    • Types include solitary or multiple macules, papules, plaques, ulcers; hyperkeratotic or scaling
    • Can arise from actinic keratosis (AK)
    • Rapid evolution can occur

    Squamous Cell Carcinoma (SCC) - Treatment

    • Treatment for in situ SCC includes imiquimod or 5-fluorouracil, curettage, and electrodessication
    • Management for invasive SCC involves excision or Mohs surgery

    Superficial SCC

    • Most frequent site is the trunk
    • Presentation includes slightly scaly macules, patches, or thin plaques, and light red to pink coloration.
    • Telangectasias may be present
    • Differential diagnosis may include actinic keratosis (AK)

    Melanoma

    • Most common malignant skin tumor
    • Leading cause of death related to skin disease
    • Relatively least common skin cancer
    • Lifetime risk of 2% (Caucasians), 0.1-0.5% (non-Caucasians)
    • Etiology and pathogenesis remain largely unknown, likely due to ultraviolet (UV) radiation exposure
    • Various clinical presentations with considerable variability

    Melanoma - Clinical & Histologic Types

    • Superficial spreading (70%)
    • Nodular (15%)
    • Lentigo malignant (5%)
    • Acral lentiginous (5-10%)
    • Tumor thickness is a key prognostic factor, impacting 10-year survival rates

    "ABCDE" Criteria

    • Asymmetry
    • Border irregularities
    • Color variation
    • Diameter > 6 mm
    • Evolution

    Kaposi Sarcoma

    • Systemic endothelial cell tumor linked to HSV-8 infection
    • Presents in clinical manifestations with purple, brown, or black patches, plaques, or nodules
    • Primarily seen in populations with immunodeficiencies, such as HIV/AIDS
    • Treatment often involves radiation, chemotherapy, or antivirals and generally responds to treatment

    Congenital Nevus

    • Nevus (single) or nevi (plural)
    • Small congenital nevi can be dome-shaped, especially on the face
    • May be mamillated or hypertrichotic
    • Benign moles
    • Distinction is necessary between benign moles and large or giant congenital nevi, where the risk of developing melanoma is 5-10%
    • Yearly monitoring with photographs is advised for larger nevi

    Atypical Nevi

    • Aka dysplastic nevi
    • Benign acquired melanocytic nevi share characteristics of melanoma, including asymmetry, irregular borders, color variegation, and a diameter greater than 5 mm.
    • Increased risk of melanoma with 50 or more nevi
    • 5% of Caucasian population, comparatively rare in Japanese people, common in familial cases of cutaneous melanoma

    Biopsy of Suspicious Lesions

    • Never perform superficial shave biopsy on pigmented lesions suspected of being melanoma
    • Accurate determination of Breslow depth (tumor thickness) is essential for survival assessment

    Biopsy vs. Excision

    • Biopsy is initially performed for histologic confirmation before surgical removal
    • Benign growth is identified, avoiding unnecessary excision
    • Malignant tumor may require different management approach to suspected lesion
    • Melanomas necessitate wide margins

    Skin Biopsy - Indications and Contraindications

    • Indications: rashes, blisters, drug reactions, skin abnormalities, suspected lesions.
    • Contraindications: infection, patient on blood thinners

    Bacterial Infections

    • Abscess
    • Folliculitis
    • Furuncle/carbuncle
    • Cellulitis
    • Erysipelas
    • Impetigo

    Pressure Ulcers (aka Pressure Sores)

    • Body weight over bony promontories can cause friction, increased pressure, and injuries.
    • Elderly patients, bedridden patients, poor nursing care, lack of sensation, and hypotension are risk factors.
    • Staging includes non-blanching erythema (Stage 1), epidermis/dermis loss (Stage II), full-thickness loss (Stage III), and full-thickness loss with exposed tissue/bone (Stage IV).
    • Treatment involves repositioning, decreasing pressure, and antibiotics and/or surgery as needed.

    Other Disorders

    • Burns
    • Lipomas
    • Epidermal Inclusion Cysts
    • Sebaceous Cysts
    • Pressure Ulcers
    • Vitiligo
    • Melasma
    • Photosensitivity Reactions
    • Syphilis

    Topical Treatments -Amount per Dosage

    Dermatology Steroids

    Steroid Side Effects

    Examination Procedures

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    Related Documents

    Dermatology 3 CAM I Notes PDF

    Description

    Test your knowledge on basal cell carcinoma (BCC), melanoma, and related skin cancers. This quiz covers subtypes, risk factors, treatment options, and important criteria for diagnosis. Perfect for students and professionals in the medical field.

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