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BCC
nodular
- well circumscribed, nodule, surface telangiectasia, pearly white/pink color |
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macule |
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BCC
ulceronodular
-ulcerated nodule with rolled edges |
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BCC nodular histology
a-nests of basaloid cells
b-linear arrangement of nuclei
c-loose fibrous stroma |
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Gorlin's syndrome
AD young people, on the back
also have bifid ribs, palmer pitting and increased risk of other tumors |
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SCC in situ / bowen's disease
red, scaly, plaque, well demarcated |
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SCC invasive (invades dermis)
skin colored nodule, ulcerated, indurated |
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seborrheic keratosis
multiple brown papules/plaques
scaly
'stuck on'
well circumscribed
soft
trunk |
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seborrheic keratosis
brown scaly papule/nodule
stuck on |
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Skin Tags - benign
skin colored, pedunculated, soft, papule/nodule
neck/face |
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Corn - benign
keratosis on pressure points
clear core, central depression
papule |
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Wart
HPV virus
SCALY (hyperkeratosis), papule/nodule (acanthosis), skin colored, red spots (BV close to surface)
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mollusca contagiosum
pox virus - contact or sexual transmission
grouped, skin colored, umbilicated papules |
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actinic keratosis
premalignant lesion on sun-exposed skin
red/brown plauqes/papules
not well demarcated, rough, scaly |
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keratocanthoma
benign?
skin colored nodule with central keratin crater, appear and disappear quickly |
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keratocanthoma |
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SCC (invasive) |
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Cutaneous Horn
biopsy the BASE
can be b/c of seborrheic keratosis, actinic keratosis, SCC (bowens), SCC (invasive)... |
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epidermal cyst (fluid filled capsule with epidermal lining)
papule/nodule, skin colored
fluctuant |
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infected epidermal cyst
purulant material in it |
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pilar cyst (scalp)
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dermatofibroma |
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dermatofibroma
-papule/nodule (esp on legs)
-well circumscribed
-dimple sign/ fitzpatricks sign
- pigmented (red or brown) |
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dermatofibroma |
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dimple/fitzpatricks sign |
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hemangioma - benign tumor of BVs
cherry red color
can be flat/raised, large/small, inherited/acquired |
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hemangioma |
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pyogenic granuloma - benign tumor of BV
pedunculated nodular red
can be ulcerated
bleeds |
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pyogenic granuloma |
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melanoma
a-asymmetry
b-border irregularity
c-color differences (white/red/blue)
d-diameter >6mm
e-elevated/expanding |
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compound nevus
(nevus progression: lentigo simplex --> junctional nevus --> compound nevus --> intradermal nevus) |
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blue nevus |
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halo nevus (regressing) |
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dysplatic nevus
- dysplatic nevus syndrome: many atypical looking nevi. brown papules/plaques, not scaly, induration, not 'stuck on'
- higher incidence of melanoma |
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dysplastic nevus
flat and papular component |
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melanoma
(prognostic factors: 1-breslows thickness in mm, 2-clarks level, 3-mitoses, 4-ulceration, 5-sentinel node status, 6-satellite nodules) |
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melanoma
(prognostic factors: 1-breslows thickness in mm, 2-clarks level, 3-mitoses, 4-ulceration, 5-sentinel node status, 6-satellite nodules) |
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lentigo melanoma (on face) - in situ |
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lentigo maligna melanoma (on face) - invasive |
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acral lentiginous melanoma (fingers/nails) can be invasive or in situ |
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small nodular melanoma (anywhere on body)
always invasive |
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acute allergic contact dermatitis
ill defined |
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acute allergic contact dermatitis
poison ivy
linear arrangment
microvesicles secondary to spongiosis |
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acute infantile atopic dermatitis
-erythema, some scales |
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subacute infantile atopic dermatitis
-scales, erythema, excroriations, pruritic |
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chronic atopic dermatitis
-LICHENIFICATION |
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lichenification
a-parakeratosis
b-acanthosis
c-dermal fibrosis |
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SPONGIOSIS
a-intercellular edema
b-microvesicles
c-dermal inflammation |
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psoriasis vulgaris
-red, plaque, silvery scales, well demarcated |
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guttate psoriasis
-dropper like
-usually after strep infection/in kids |
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psoriasis vulgaris
auspitz sign - pin point bleeding when scale removed |
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linear psoriasis
koebner phenomenon (also seen in lichen planus) |
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Pityriasis Rosea
herald patch - salmon color
xmas tree distribution
not on palms/soles (if it is think 2 syphillis)
herpes 6 + 7 |
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Lichen Planus
planar, polygonal, purple, papules, pruritic
wickhams striae (lacy)
often on wrist |
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vasculitis - inflammation of or around BVs. doesnt blanche
palpable purpura (small vessels)
livedo reticularis (medium sized vessels).
can be henoch schonlein purpura --> associated with arthritis, abdominal pain and hematuria. post strep infection. children. IgA disorder. |
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Bullous pemphigoid
immunobullous disorder
hemidesmisome = antigen
tense blisters
sub-epidermal blister |
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pemphigus vulgaris
immunobullous disorder
desmosome = antigen. get acantolysis --> keratinocytes separate and round up
flaccid blisters
intra-epidermal blister |
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pemphigus vulgaris
nikolsky's sign - oral lesions |
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bullous pemphigous
firm topped/tense bullae |
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dermatitis herpatiformis
immunobullous disorder
associated with gluten intolerance
grouped, skin colored pruritic/burning vesicles
elbows/knees/butt |
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dermatitis hepatiformis |
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Erythema multiforme = morbiliform = maculopapular
target lesions
sign of drug reaction, virus, idiopathic |
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Erythema nodosum
red/blue nodules in the subcutaneous fat in legs (panniculitis)
causes: IBD, malignancy, infections, drugs |
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cutaneous horn |
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