benign malignant

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erica4
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54003
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benign malignant
Updated:
2010-12-07 20:16:55
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benign malignant
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benign malignant
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  1. seborrheic keratosis
    • stuck-on, warty, crust
    • very variable appearance
    • benign
  2. why do people confuse SK with skin cancer
    • because it changes...it starts out skin color, then gets darker then crustier.
    • it is benign
  3. where does SK mostly happen
    • lower legs, feet
    • it is benign
  4. acrochordon
    • skin tags, skin folds, high friction, snip cryo dessication
    • it is benign
  5. dermatofibroma
    • dimple sign
    • circular
    • legs
    • from shaving
    • excision
    • benign
  6. chavus
    • corn.
    • specially shaped callus of dead skin
    • benign
  7. long name for pink-red papule on helical ear cartilage than can mimic SCC and BCC
    • chondrodermatitis nodularis helicis
    • (cartilage skin nodule helix)
    • benign
  8. treatment chondrodermatitis nodularis helicis
    • relieve pressure, inject kenalog, excision, C&D
    • benign
  9. epidermal cyst
    • subQ keratin filled cyst hair follicle
    • central punctum like open comedone
    • benign
  10. where epidermal cyst?
    • trunk, posterior neck, postauricular
    • benign
  11. what is the one thing about epidermal cysts that is easy to remember
    they are STINKY inside
  12. pilar cyst, patients will sometimes call it a
    • wen
    • benign
  13. where are pilar cysts?
    • scalp. develops from hair follicle
    • no punctum!
    • i think these are dad's
    • family inheritance, multiple, after puberty
    • benign
  14. sebaceous hyperplasia
    • enlargement of sebaceous gland on FACE
    • forehead nose cheeks
    • umbilicated
    • benign
  15. sebaceous hyperplasia treatment
    • shave or C&D
    • benign
  16. hemangiomas of infancy
    • red-blue-purple in year one
    • girls more than boys
    • head neck more than others
    • usually one
    • one in year one
    • benign
  17. treatment hemangiomas of infancy
    • laser, roids, excise, aldara (offlabel) propanolol (off label)
    • benign
  18. angiokeratoma 4 kinds--most common one is
    • angiokeratoma of Fordyce
    • scrotum, vulva
    • [they look like purple angiomas]
    • benign
  19. pyogenic granuloma also called
    lobular capillary hemangioma
  20. pyogenic granuloma what do they DO
    • grow rapidly and bleed easily
    • looks like the indian dot
    • benign
  21. pyogenic granuloma recurs especially in these people
    • pregnant women
    • benign
  22. lipoma and ages
    • soft movable
    • painless
    • 40-60 yrs
    • benign
  23. lipoma texture
    • very squishy
    • benign
  24. solar lentigo also called
    • senile lentigo
    • benign
  25. solar lentigo appearance and how/when
    • tan brown
    • associated with agina
    • 40+ yrs
    • increased number of melanocytes and melanin
    • benign
  26. junctional nevus
    flat mole, benign
  27. compound nevus
    • what people usually think of as moles
    • squishy brown or flesh
    • benign
  28. intradermal nevus
    • firmer, slightly elevated, can't wiggle it
    • benign
  29. nevus spilus
    • birthmark, grows with you
    • benign
  30. blue nevus
    • "tricky"
    • these can be flat or papule
    • bluish black symmetrical
    • benign
  31. spitz nevus
    • could be precursor, do clear margins
    • benign
  32. halo nevus
    • white ring around it that doesn't tan
    • you can leave the halo
    • if the mole looks normal, you can just watch it
    • benign
  33. recurrent nevus
    • if you've had one removed and it starts coming back
    • if benign? leave it
    • if you think precancerous, you need to go back and take more out
  34. actinic keratosis
    • pre-malignant
    • sun exposed areas
    • treat all as SCC
    • 40yrs+ (or younger if sun)
  35. actinic keratosis treatments
    • cryo
    • efudex
    • imiquimod
    • levulan/blue light (less irritating than efudex)
  36. Bowen's disease
    • squamous cell carcinoma (SCC) in situ
    • superficial variant of SCC
    • pre-malignant
  37. bowen's disease (SCC in situ) causes
    • sun
    • radiation/chemicals
    • hpv
  38. bowen's disease appearance
    faint inflammation, raised, red plaque, dry appearance
  39. bowen's disease looks like
    wart. crustier and wartier looking eczema
  40. erythroplasia of Queyrat (SCC in situ)
    Bowen's disease of the penis, under foreskin
  41. Bowen's disease of the penis (under the foreskin)
    Erythroplasia of Queyrat (SCC in situ)
  42. nevus sebaceous
    • premalignant
    • usually on head/scalp
    • linear-oval yellow-flesh colored plaque
    • 3 stages
    • tx: excision
  43. nevus sebaceous 3 stages
    • 1. childhood, barely noted, velvety, no sx
    • 2. puberty, more verrucous-like, sxs possible
    • 3. adulthood, 20% neoplastic changes--7% can turn into BCC

    • TREATMENT EXCISION
    • pre-malignant
  44. nevus sebaceous appearance
    • orangey yellowish irregular plaque
    • scalp
  45. atypical nevi syndrome (ANS)
    • multiple clinically atypical moles, increased risk melanoma
    • moles continue to form into adulthood
  46. most with atypical nevi syndrome (ANS) have more than this many moles
    more than 50
  47. atypical nevi:
    • larger
    • border irregular
    • color variation
    • surface irregular
  48. ABCDE skin lesions
    • A asymmetry, fold in half
    • B borders notching or irregular
    • C more than one color
    • D diameter bigger than pencil eraser
  49. BCC
    basal cell carcinoma
  50. BCC most common type of malignancy
    • over 40 yrs
    • only sun exposed areas
    • mets rare
    • fair skin and sun exposure before 14 yrs

    (mom)
  51. BCC appearance
    • pink/red shiny pearly papule with superficial telangiectasias
    • rolled translucent borders
    • ulcerated center
    • firm to palpation
    • non healing
  52. BCC treatments
    • complete excision with primary closure
    • MOHS
    • C&D
  53. SCC
    squamous cell carcinoma
  54. SCC mets?
    rare
  55. SCC risk
    outdoor occupations, industrial, HPV, arsenic ingestion
  56. keratocanthoma
    • variant of SCC
    • volcano/crater-like
  57. SCC treatments
    • complete excision with primary closure
    • MOHS
    • C&D
  58. MM
    malignant melanoma
  59. malignant melanoma
    • 4% of all skin CA
    • #1 25-29yrs, #2 30-35yrs
  60. who's at risk for MM: MMRISK
    • MMRISK
    • M atypical nevi more than 5-10
    • M moles more than 50 on the body
    • R red hair and freckling
    • I inability to tan
    • S severe sunburns before 14 yrs
    • K kindred (any 1st degree relative with melanoma)
  61. ABCDE
    • Asymmetry
    • Borders
    • Color
    • Diameter
    • *Evolution
  62. how to bx MM
    take punches in different places, one from lighter, one from darker, for example
  63. MM: superficial spreading MM, most common
    • laterally before vertical growth
    • trunk/extremities
    • whites, females
  64. 2. nodular MM
    • grows vertically
    • extremities
    • raised
  65. 3. lentigo maligna
    laterally in epidermis but if left untreated can grow into dermis and becomes LMM lentigo maligna melanoma
  66. 4. acral lentiginous melanoma
    • dark skinned people
    • palms, soles, subungual
  67. Amelanotic MM
    • non pigmented melanoma
    • bx and tx often delayed because it appears innocent
  68. treatments for MM
    • wide excition with 1cm margin
    • 2cm margin for bigger

    Stage 1B and II: sentinel node bx

    upper stages--high dose interferon-2a (chemo)
  69. CTCL cutaneous T cell lymphoma aka MF mycosis fungoides
    helper T cell lymphoma
  70. stages of CTCL
    • pre-MF
    • patch
    • plaque
    • tumor

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