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Skin > Norton Part 3 > Flashcards

Norton Part 3 Flashcards

1
Q

what is the most common benign tumor in older individuals (40+ years)

A

seborrheic keratosis

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2
Q

seborrheic keratosis starts out how and becomes what

A

light brown, flat macule

later develop a velvety or waxy to finely verrucous (wart like) surface

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3
Q

what typically has an appearance of being stuck on the skin surface and crumbles with scraping

A

seborrheic keratosis

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4
Q

the color of seborrheic keratosis is what

A

varies from pale brown with pink tones to dark brown or black

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5
Q

what is the Leser-Trelat sign

A

multiple eruptive seborrheic keratoses with internal malignancy

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6
Q

what must one do if suspicious that seborrheic keratosis is melanoma

A

biopsy it

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7
Q

dermatosis papulosa nigra is a subtype of what

A

seborrheic keratosis

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8
Q

dermatosis papulosa nigra appears how and on who

A

brown to black, smooth, dome-shaped papule

mostly on African Americans

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9
Q

dermatosis papulosa nigra can be treated with liquid nitrogen but this can cause what

A

hypopigmentation

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10
Q

what are the histological features of seborrheic keratosis

A

exophytic
show sheets of small busload cells
frequently pigmented
exuberant keratin production at surface
small keratin-filled cysts known as horn cysts
loose lamellar “shredded-wheat” or “onion-skin” keratin

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11
Q

what is a horn-cyst and where is it found

A

small keratin-filled cysts

found in Seborrheic keratosis

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12
Q

loose lamellar “shredded-wheat” or “onion-skin” keratin is seen in what

A

seborrheic keratosis

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13
Q

where is acanthosis nigricans found

A

folds of the neck, axilla, and groin

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14
Q

what is seen in acanthosis nigricans

A

hyperpigmentation (first sign)

hyperplasia of stratum spinosum makes the skin thick and velvety

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15
Q

80% of acanthosis nigricans are what type and usually occur when

A

benign

usually occur in childhood or puberty

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16
Q

benign acanthosis nigricans may be associated with what

A

endocrine disorders (like DM)

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17
Q

the malignant type of acanthosis nigricans occurs when and is associated with what

A

middle-aged and older

associated with visceral malignancy

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18
Q

epidermal (inclusion) cyst is what type of lesion

A

benign

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19
Q

where and in who are epidermal (inclusion) cysts typically found

A

head and or neck in children

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20
Q

what are the histological features of an inclusion cyst

A

cyst wall resembles normal epidermis, filled with strands of keratin

21
Q

what two types of epidermal (inclusion) cysts are there

A

inflamed and “quiet”

inflamed may be surgically excised

22
Q

what benign epithelial tumors are there

A

seborrheic keratosis
acanthosis nigricans
epidermal (inclusion) cyst

23
Q

what is the earlier identifiable lesion that can develop into squamous cell carcinoma

A

actinic keratosis

24
Q

up to 60% of squamous cell carcinoma develop from what

A

actinic keratosis (if patient has 10 or more the risk is 10-15%)

25
Q

what are the risk factors for actinic keratosis

A

years of sun exposure, fair skin, immunosuppression

26
Q

what is the key to early diagnosis of actinic keratosis

A

palpation

27
Q

palpation of actinic keratosis has what findings

A

rough or “gritty”skin

discrete, scaly, feels like “broken glass”, surface legion

28
Q

actinic keratosis is commonly found where

A

sun exposed areas: face, scalp, ears, posterior neck, forearms and legs

29
Q

actinic keratosis develops into what kind of lesion

A

poorly-demarcated, slightly erythematous papule or plaque with adherent scale

30
Q

what is parakeratosis

A

retained nuclei

31
Q

parakeratosis in stratum corneum is seen in what

A

actinic keratosis

32
Q

what are the histological features of actinic keratosis

A

parakeratosis in stratum corneum
hyperplasia and cytologic atypic of basal layer cells
solar elastosis in superficial dermis

33
Q

how does one distinguish between actinic keratosis and squamous cell carcinoma

A

biopsy it

34
Q

how can actinic keratosis be treated

A

cryotherapy

topical 5-FU (intense inflammation as wise effect)

35
Q

what is the most common cancer in the US about equal to all other cancers combined

A

non melanoma skin cancer

36
Q

80% of non melanoma skin cancer is what

A

basal cell carcinoma

37
Q

after developing an initial BCC or SCC patients have what chance of developing another NMSC within 5 years

A

50%

38
Q

squamous cell carcinoma may present as what?

A

variety of primary morphologies with or without associated symptoms
can present with a scaly pink patch or a thin keratotic papule

39
Q

where does squamous cell carcinoma arise and what populations is it common in

A

in epithelium

common in middle-aged and elderly

40
Q

what is the most important cause of squamous cell carcinoma

A

DNA damage by UV light (UVB is #1 w/ UVA being 2nd)

41
Q

arsenic is a risk factor for what

A

squamous cell carcinoma

42
Q

what are some risk factors for squamous cell carcinoma

A 
male
elderly
UV and ionizing radiation
Fair skin
HPV
sites with chronic infection
thermal burn scars
43
Q

where is squamous cell carcinoma commonly found

A

scalp, dorsal upper extremities, ears

44
Q

what is bowen disease

A

a subtype of squamous cell carcinoma characterized by a sharply demarcated pink plaque and can arise on non-sun exposed skin

45
Q

what is Erythroplasia of Queyrat and how does it manifest

A

Bowen disease of the glans penis

manifests as one or more velvety red plaques

46
Q

squamous cell carcinoma in situ is characterized by what

A 
NO invasion through basement membrane of dermoepidermal junction
atypical nuclei (enlarged and hyper chromatic) involve ALL levels of the the epidermis
47
Q

squamous cell carcinoma (not in situ) is characterized by what

A

invasion of basement membrane
variable differentiation
orderly lobules of polygonal cells, areas of keratinization (well differentiated)
anaplastic cells, necrosis, no organized keratin production (poorly differentiated)

48
Q

a raised, firm, pink-to-flesh colored keratotic papule or plaque arising on sun-exposed skin is commonly seeing what

A

squamous cell carcinoma

49
Q

what surface changes can be seen in squamous cell carcinoma

A

scaling, ulceration, crusting, or the presence of a cutaneous horn

Skin (12 decks)

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