Vascular Lesions and Skin Cancer – Flashcards
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spider angioma
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- red central body with spider legs - blanchable - can be from liver dz, vit B deficiency or idiopathic
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venous star
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- bluish spider with linear or irregular shapes - non blanchable - caused by an increased pressure in superficial veins - common with aging
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capillary hemangioma
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- also called nevus flammeus - red irregular macular patched - caused by dilation of dermal capillaries
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cherry angioma
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- red to purple small papules up to several cm - dilated capillaries - found on trunk/face - >30 yo, both genders, asx, increases with age - txt is cosmetic (cauterize to reduce bleeding)
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hemangioma
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- red to blue/purple plaques, single or multiple - blanchable - found anywhere on bound - usually at birth and spontaneously regresses, asx - txt is cosmetic laser therapy - angels kisses and storks bite
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strawberry hemangioma
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- more papular - txt is cosmetic - may cause secondary compression sx - bleeds a lot when removing
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pyogenic granuloma
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- bright red, big papule - erodes and develops hemorrhagic crust, spontaneously bleeds - single lesion - associated with minor trauma - can be found anywhere - any age but more common in kids
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telangiectasia
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- permanently dilated blood vessels - flat with linear or netlike pattern - blanchable - more in aging and increased estrogen (cirrhosis) - txt is cosmetic (laser) - found anywhere
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venous lake
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- blue papules due to dilated venule - blanchable - distributed on face, lips and ears - >50 yo, both m/w, asx - txt is cosmetic (laser)
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benign neoplasms
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- seborrheic keratosis - actinic keratosis
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seborrheic keratoses
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-no malignant potential - very common - pigmented, raised, warty lesions - look like they are stuck on (stickers!!) - acquire with aging
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actinic keratoses
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- malignant potential! - slightly raised red lesion due to chronic sun damage - irregular rough surface - may have a cutaneous horn (biopsy that)
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basal cell carcinoma
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- from chronic sun exposure (head, face) - most common type of skin cancer - locally invasive, aggressive, destructive - limited metastasis - >40 yo, males, rare in AA - risk fx: white skinned, sun, lots of xray - look at central part of face, behind ears
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nodular BBC
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-solitary, shiny, smooth, pearly - rolled edges ( looks like a donut) - may ulcerate - most common BBC
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dx and txt of BBC
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- biopsy - cryosurgery (freezing) - moh's procedure: precise microscopic margin control, done with freezing
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squamous cell carcinoma
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- in epidermis, skin appendages, and stratified squamous - invasive - arises in pre- cancerous lesions (actinic keratosis) - aggressive and limited metastasis - malignant keratin cells - from UV radiation or HPV - >55 yo, males, white skin, excessive sun exposure - can also be from immunosuppression, chronic inflammation, industrial carcinogens - slowly evolves
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appearance of SCC
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- highly differentiated - indurated plaque, papule, nodule - erosion or ulceration - may have crust or horn - red/ yellow color - on sun exposed areas
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dx and txt of SCC
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- biopsy - excision and possible node dissection if it's aggressive
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risk fx of metastases
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- ionizing radiation - inorganic arsenic - old burn scar site - located on lip or genitalia
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malignant melanoma
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- 80% from NEW lesions and 20 from old (superficial spreading melanoma) - arise in melanocytes - rising mortality rate ( the earlier the better)
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risk fx of melanoma
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M: moles. atypical more than 5 M: moles, typical more than 50 R: red hair and freckling I: inability to tan S: sunburn, severe before 14 K: kindred, + FHx
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characteristics of melanoma
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A: asymmetry B: irregular borders C: variation in color D: diameter >6mm E: elevation and may be enlarged
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dx and txt of melanoma
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- biopsy - wide excision (req'd)
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treatment of melanoma
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avoid sun and look over skin