Skin lesions question pool ANATOMY

What factors are used to determine if a person has FAMM syndrome?

A significant number of nevi and two close family members with malignant melanoma.

Which statement is true regarding basal cell carcinomas?

They can bleed, become irritated, are disfiguring if untreated, grow slowly, and rarely metastasize.

What is the most likely diagnosis of a smooth, bluish-black papule on a 60-year-old woman's neck?

Common blue nevus.

What is the most likely diagnosis for several pinkish brown lesions on a 72-year-old man's lower back?

Seborrheic keratoses.

pigmented lesion on a 73 year old man's ear. The lesion is round (2cm), light brown and located on chronically sun-exposed skin and remained stable. What featured strongly support a diagnosis of solar lentigo rather than melanoma?

Uniform light brown coloration and stability over time

A pathology report for a patient with melanoma states that malignant cells have penetrated into the dermis and that is lesion is 3.2mm thick. Which statement best explains why Breslow thickness is considered a stronger prognostic factor than Clark level?

Breslow thickness more accurately correlates with patient survival outcomes

Several benign conditions can easily be mistaken for melanoma. Which of the following from the answer choices below is an example of this?

solar lentigo

What diagnostic test differentiates basal cell carcinoma from seborrheic keratosis?

Shave biopsy.

What cells produce pigment in the skin?

Melanocytes.

Which characteristic is not typical of melanoma?

Symmetric appearance.

Which of the following is not a feature of melanoma?

Monochromatic pigmentation

Having a singular, uniform color to the lesion is not typical of melanoma, but having multiple shades of pigmentation would be.

Atypical Nevi

A patient presents herself at a dermatology appointment due to growing concern over a mole located on her upper lip. The patient states that the mole has grown and occasionally bleeds as well. When assessing the patient she also mentioned that her mother was diagnosed with melanoma. There are also many atypical nevus on her neck and face and the mole presented is larger than .8cm, has a textured surface, has irregular borders, and is varied in color in the same shade of brown. After assessing the patient what factors would contribute to malignant transformation?

Familial history and the nevi is larger than 6cm, presence of multiple nevi

pathologist is reading the slides of a submitted biopsy that confirms melanoma. The pathologist notes that the lesion possibly extends into the papillary dermis (they are having difficulty interpreting the slide) and also measures a Breslow thickness of 2.1. Why is Breslow thickness more clinically useful than Clark's level in prognosing?

breslow measures how thick the beginning of the mole is to the epidermis

All of the following are warning signs of a melanoma except:

hair growth

A patient comes to the doctor asking for a mole on his back to be looked at. On physical examination the lesion appears identical to an ordinary acquired nevus. A biopsy was taken, and lymphocytic infiltration surrounding the nevus cells are observed. Which type of nevus has most likely been found?

halo nevus

If a pediatrician notices that a 12-year-old has a congenital nevus measuring 6.2 cm in diameter, what would be the appropriate classification size?

Medium

A 50-year-old construction worker visits their primary care physician for an annual checkup. Upon examination they discover multiple small, round light-yellow macules covering the patient's hands. The patient states that they have not worn gloves or used sunscreen for the thirty years they have been building houses. What could this possibly be identified as?

Solar lentigo

What type of lesion has a 'fried egg' appearance?

Atypical Nevi

What are warning signs of melanoma?

Asymmetry, Irregular Borders, Increasing Diameter

What is the most evident finding of invasive melanoma?

Cancer cells have descended through the basement membrane into the dermis

With the different melanoma staging criteria in mind, which lesion would be considered the most severe?

Tumor greater than 4 mm with ulceration

Given the following information about this patient, how would you classify his skin lesions?

65-year-old white male

Vocation: fisherman, retired

Pt has many small brown 1-3cm macules on the dorsal side of his forearms and hands. They are non-ulcerated and some of them are coalescing.

solar lentigo

All of the following are features of malignant melanoma except which?

regular even borders

What lesion can grow larger, become irritated and crusty, itch and bleed, and may appear waxy, soft, and greasy?

Seborrheic keratosis

What are the two classification schemes and what is the difference between them?

Clark levels and Breslow depth invasion, clark is based on layer or tissue involved while breslow is based on thickness

The physician biopsied an asymmetric irregular melanoma on the back of the patient. The biopsy came back Clark Level IV with a Breslow Invasion of 2 mm. What is the next procedure that should be done?

Sentinel Lymph node biopsy

A 25 year old patient walked into a clinic for yearly examination. The physician noticed a dark irregular spot with a light brown rim of erythema located near their collarbone, it resembles a "fried-egg". The patient explains that it has always been there. What should the physician do?

take a shave biopsy, ask the patient to continue monitoring any changes in the dark spot

This type of growth is defined by a focal pigmentation, arises from pluripotential cells in the basal layer of the epidermis, and often has telangiectases (spider-like veins/ broken blood vessels). What growth is being described?

Nodular basal cell carcinoma

This nevus, measuring 0.8 cm with a textured surface and indistinct borders, runs in families and represents what was previously referred to as 'dysplastic nevus syndrome'.

atypical nevus

Which of the following factors does NOT frequently raise flags of suspicion that a skin lesion may be melanoma?

appearance of being stick on skin

A patient is diagnosed with melanoma in a skin lesion that is penetrating into the reticular dermis. What Clark level is categorized with this level of penetration?

clark level IV

A 53 year-old woman presents a 0.3 cm flat, gray spot on her neck. She says it has been there since her early 20s and has not changed since it first appeared. The patient says it does not itch or bleed. After a thorough overview of the rest of her body, no other spots in similar appearance are found. What is the most likely diagnosis for this patient?

common blue nevus

A 20 year-old patient comes into the dermatology office concerned about a mole he has had since childhood. It appears raised, dark brown with irregular borders, and is located just above where his swim trunks sit on his hips. He states it is not itchy nor does it bleed, but he would like it biopsied to rule out any malignancy. The biopsy showed this spot was a compound nevus. What layer of the skin would this growth be found in?

epidermis and dermis

If a patient presents with a congenital nevi that is 3 cm in diameter, what size would it be classified as?

medium

It can be difficult to clinically diagnose a skin lesion as a seborrheic keratoses or a melanoma due to them both being black in color. What is a way that you CAN determine the difference between the two?

height

What is the name of the lesion that can be called a barnacle and is the most common benign type of lesion in older individuals? These lesions can become irritated, crusty, itch/bleed, and can even be waxy.

seborrheic keratosis

wo Classification Schemes, Breslow and Clark, are used for which skin lesion? Breslow is used for thickness, while Clark is based on the layer of skin involved.

melanoma

Which of the following descriptions best characterizes seborrheic keratosis? 

A "stuck on" growth that could appear greasy or waxy and has variable pigmentation

For assessing a patient's prognosis, why is the Breslow measurement typically seen as more important than Clark Levels?

Breslow measurement is more accurate due to the measurement of thickness rather than skin penetrated

hese lesions or "barnacles" are the most common benign skin lesions in older individuals and can clinically resemble melanoma.

seborrheic keratosis

In the case of melanoma in situ, neoplastic cells have not penetrated the

Dermoepidermal junction

Which melanoma features are important when determining treatment?

ulceration, Breslow measurement, lymph node involvement

Which melanoma subtype has early vertical growth as opposed to radial growth?

nodular melanoma

A 22 year old male presents to the clinic with a small growth extending up from the skin of his forearm by about 3 mm. It is firm, all dark blue in color and has a rounded appearance. The patient states it appeared within the past month and has been steadily increasing in size. There is some redness on the skin surface surrounding the growth. Which of the following names most likely matches the description of the lesion?

Nodular pigmented malignant melanoma

Based on general prognostic factors and your knowledge of different lesions, which of the following scenarios would have the lowest survival rate?

An ulcerated lesion with >4mm invasion and there is a positive sentinel lymph node

What is NOT a potential feature of a melanoma?

presence of hair

Which one of the following lesions has the potential to develop into a malignancy?

Dysplastic nevus

what does the clark level test for

depth of infiltration

what does "in situ" mean

in the original place

What are common characteristics of melanoma? (Select all that apply)

irregular border, blotchy appearance

What are the two classification schemes used for melanoma?

Breslow and clark