Card Set Information

2011-01-15 16:53:41
skin lesions skin cancer basal cell carcinoma squamous cell carcinoma melanoma

Skin lesions/cancer
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  1. Hutchinson's sign
    the presence of pigmentation on the nail along with pigmentation on the proximal nail fold
  2. blister
    lesions that affect or destroy adhesion molecules between keratinocytes or keratinocytes & basement membrane
  3. epidermolysis bullosa
    an inherited defect in structural proteins that are either in the epidermis or anchoring the epidermis to the dermis; results in extremely blister-prone skin that reacts to even very mild trauma; affects primarily hands and feet
  4. bullous pemphigoid
    involves an antibody-mediated response against adherent molecules of the basement membrane of the skin; entire epidermis separates from the basement membrane; results in sub-epidermal fluid-filled blister; generally occurs in older patients
  5. pemphigus vulgaris
    involves an antibody-mediate response against desmoglein 3 (component of desmosomes) in the skin; more serious than bullous pemphigous - similar to burn patients; results in intra-epidermal blisters
  6. albinism
    disorder involving abnormal production of melanin; results from defect in tyrisonase; number of melanocytes is normal but function is impaired
  7. vitiligo
    disorder involving destruction of melanocytes; results in patches of non-pigmented skin; melanocytes that are present function normally
  8. alopecia
    hair loss
  9. onchomycosis
    fungal infection of the nails - especially tonails
  10. epidermolysis bullosa simplex
    subtype of EB in which blistering occurs within the epidermis; does not result in scarring; blistering generally occurs on hands/feet/extremities; generally spares mucosa; patients generally have normal lifespan; defect in keratin 5 & 14 (intermediate filaments)
  11. epidermolysis bullosa junctional
    subtype of EB in which blistering occurs mostly at the epidermal-dermal junction; generally fatal before 1 year (due to sepsis/respiratory defect); involves defects in laminin 5; large denuded areas & mucosal involvement; granulation tissue around mouth
  12. epidermolysis bullosa dystrophic
    subtype of EB in which blistering occurs in the superficial part of the dermis; often display milia (superficial cysts - characteristic of dystrophic EB); scarring typical & may lead to mitten deformities; absent or dystrophic nails often present; GI involvement often leads to malnutrition & anemia & growth retardation; results from collagen VII defect; patients often die of squamous cell carcinoma in 2nd-4th decade
  13. acantholytic
    involves loss of adhesion between cells (as opposed to cytolytic - involves cell lysis/death)
  14. incisional biopsy
    partial removal of a suspect lesion for biopsy; should only be done if excisional is not possible; should ideally be done at thickest spot; data do not indicate that incisional biopsy facilitates spread of melanoma
  15. excisional biopsy
    complete removal of a suspect lesion for biopsy; preferred over incisional & shave biopsies
  16. Breslow depth
    measurement in mm from the stratum granulosum to the deepest point at which the tumor invades
  17. superficial spreading melanoma
    most frequently seen melanoma; can occur at any site in the body but usually on trunk (men) & legs (women); has a radial growth phase; generally diagnosed in middle life (30-50); generally starts as a flat black-brown macule; 1/3 develop from existing nevi; regression common
  18. nodular melanoma
    2nd most common melanoma type; no significant horizontal growth phase; most commonly diagnosed in 6th decade; 2x as common in men; more often on trunk than head/neck and head/neck than other sites; frequently ulcurated; usually presents as blue/black/red nodule
  19. lentigo maligna melanoma
    generally slow-growing & occurs later in life; tends to occur in sun-exposed areas; frequently occur around the eye in women; longest radial growth phase; most often diagnosed in 7th decade; generally presents as a brown/black irregular macule that develops into a nodule
  20. acral lentiginous melanoma
    most frequently diagnosed in 6th-7th decade; less common in Caucasians but most common type in Asians & blacks; occurs most often in feet then hands then mucous membranes; sunubgual melanomas are usually ALM; most often presents as an irregular macule -> patch -> nodule
  21. excisional margins for melanoma <1mm
    1 cm
  22. excisional margins for melanoma >1mm
    2 cm for 1-4 mm lesion; 2-3 cm for 4+ mm lesion
  23. sentinal lymph node biopsy
    staging tool (NOT treatment tool); allows for early detection of lymph node metastases (before LNs are palpable); involves injection of radioactive material near site of melanoma to track the pathway the melanoma most likely took - look at which lymph node radiation ends up with & biopsy that lymph node
  24. dysplastic nevus
    irregular nevus based on clinical & histological features; at higher risk than other nevi of developing into melanoma but most do not develop into melanoma; require monitoring
  25. regression
    partial loss of pigmentation in a melanoma; negative prognostic sign
  26. melanonychia striata
    stripe of subungual pigmentation; when melanoma - generally begins at the matrix
  27. excisional margins for melanoma in situ
    0.5 cm
  28. congenital nevi
    higher diameter -> greater likelihood of developing into cancer
  29. dysplastic nevus syndrome
    risk factor for melanoma - clinically atyical nevi with 2+ family members with malignant melanoma are at a greater than 50% risk for developing melanoma in their lifetime
  30. actinic keratoses
    precancerous lesions; characterized by thick scaly erythematous patches; occur in sun-exposed areas - 80% on upper limbs & head & neck; identify people at higher risk of developing basal cell or squamous cell carcinoma; represent a progression along a spectrum from benign to malignant; can be treated with cryosurgery or curettage or topical medications
  31. basal cell carcinoma
    most common skin cancer; arise from epidermis or follicular epithelium; common in sun-exposed areas such as the face; most common site on face = nose; <1% metastatic potential; related to chronic UVB exposure; more common in males
  32. squamous cell carcinoma
    2nd most common skin cancer; generally occurs btwn 55-70 - slightly older than BCC (rare < 30); higher metastatic potential than BCC but lower than MM; some forms of HPV can predispose to SCC; most common on upper face & hands & ears; primary tumors typically = enlarging nodule that ultimately ulcerates; may be verrucous; tend to grow faster than BCC; may masquerade as nail fungus (typically HPV forms); location on lip or genitalia = poor prognostic factors
  33. treatment for non-melanoma skin cancer
    standard surgical excision; Mohs micrographic surgery; electrodessication & curettage; cryosurgery; photodynamic therapy (mostly for precancerous lesions); radiation therapy (typically adjunctive); topical therapy