week 7

BCC growth

Slow growth

Locally destructive

most BBC on

90% on head/neck

BCC

nodular BCC desc

Pearly papule 

Ulcerative center 

Bleeds easily

nodular BCC location

Head/neck

nodular bcc

Superficial BCC desc

Rash like 

Flat, maybe pearly 

Thread-like slightly raised border

Superficial BCC location

Trunk (esp back) 

Extremities

Superficial BCC assoc w what disease

HIV

Superficial BCC

Morpheaform (infiltrative) BBC desc

Scar 

Depressed, white, firm 

No bleeding or pearliness 

Morpheaform (infiltrative) BBC high risk for

recurrence

Morpheaform (infiltrative) BBC

Pigmented BCC desc

Pearly (like nodular) 

Pigmentation 

Resemble melanoma

Pigmented BCC

Squamous Cell Carcinoma is hyperkeratotic and

erosive

SCC inc chance for metastasis if

Inc chance for metastasis if: poorly diff histo, size, depth, recurrent lesion/location

SCC

SCC in situ desc

Superficial SCC involving full thickness of epidermis, no dermal invasion

SCC in situ locaiton

Non sun-exposed areas

Bowens disease aka ____ can progress to

SCC in situ

may progress to SCC

Bowens

SCC in situ

Keratoacanthoma SCC desc

Well-diff histo 

Dome shaped w/ central hyperkeratotic center usually on sun-exposed areas 

Fast-growing, can spont resolve

Keratoacanthoma SCC growth

Fast-growing, can spont resolve

Sunungual and Giant KAs

Sunbungal KAs- do not resolve

Giant KAs- aggressive

Keratoacanthoma SCC

Superficial spreading melanoma desc

Radial growth before diving down

Flat, scalloped, notched borders, regression

Superficial spreading melanoma location

Trunk (men) 

Legs (women)

Superficial spreading melanoma mutation

BRAF(V600E) mutations

Superficial spreading melanoma

Nodular Melanoma desc

Dark and raised 

Rapid growth/invasion

Nodular Melanoma growth

Rapid growth/invasion

Nodular Melanoma location

Head/neck 

Males slightly higher risk

Nodular Melanoma

Lentigo Maligna Melanoma growth

slow

Lentigo Maligna Melanoma are ___ that slowly enlarge

Sun spots that slowly enlarge and get more irregular

Lentigo Maligna Melanoma location/age

Sun-exposed areas in elderly

Lentigo Maligna Melanoma

Acral Lentiginous Melanoma location

Palms/soles and nails

Acral Lentiginous Melanoma

Desmoplastic Melanoma location age

Head/neck in elderly

Desmoplastic Melanoma desc

Fibrosis and perineural involvement 

Subclinical spread 

Desmoplastic Melanoma

Telogen Effluvium desc

Hair falling out at roots

Diffuse 2-4 mths after event

Telogen Effluvium causes

Severe illness 

Childbirth 

High fever 

Iron def, thyroid disease, medications, surgery, emotional stress

Telogen Effluvium tx

Self-limited, hair grows back

Telogen Effluvium

Male Androgenetic Alopecia (male pattern baldness) causes

Genes and hormones 

AD (incomplete penetrance) or polygenic from either or both parents 

Testosterone → dihydrotestosterone (5a-reductase)

Female Androgenetic Alopecia desc

Less well-defined

Progressive loss of hair density and widening of part on top of head w/ preservation of frontal hairline

Female Androgenetic Alopecia causes

Genetic

Hyperandrogenemia 

Iron def

Thyroid disease

Alopecia Areata desc

Non-scarring hair loss 

Round or oval patches of hair loss 

Exclamation pt hairs- distal end broader than proximal end

Alopecia Areata common sx

Pitting of nails 

Alopecia Areata cause

autoimmune

Alopecia Areata

alopecia universalis

Alopecia universalis

(all scalp and body hair)

Alopecia totalis

(all scalp hair)

Tinea capitis

Dry, scaly patches w/ or w/o alopecia

Kerion- severe pustular form w/ alopecia (scarring) 

Alopecia w/ or w/o scale in discrete patches or over entire scalp

Kerion-

severe pustular form of tinea capitis w/ alopecia (scarring) 

Tinea capitis other sx

Posterior cervical or posterior auricular lymphadenopathy

tinea capitis cause

Dermatophyte infection of scalp in children

tinea capitis hair/scarring

Hair usually grows back unless infection persists for long period of time

kerion

tinea capitis

Scarring alopecia (cicatricial alopecia) desc

Permanent injury to hair follicle → perm baldness 

Replacement of hair follicle and surrounding tissue w/ scar tissue

Lichen planopilaris desc

Scarring alopecia 

Patchy hair loss w/ perifollicular erythema, follicular spines, scarring 

Signs of lichen planus skin

Lichen planopilaris. mainly affects

women

Lichen planopilaris tx

Some resolve spontaneously, others persist for years

Lichen planopilaris

lichen planopilaris

Discoid lupus (chronic cutaneous lupus erythematosus) desc

Active lesions inflamm, indurated plaques 

Lesions → scarring 

Follicular plugging and scarring alopecia 
Dyspigmentation 

Discoid lupus (chronic cutaneous lupus erythematosus) location

Face, scalp, ears

Discoid lupus (chronic cutaneous lupus erythematosus)

Hirsutism in males vs females

In women: terminal hairs 

In male: pattern baldness

Hirsutism cause

Excess of androgens or increased end-organ sensitivity to androgens

Hirsutism

Paronychia desc

Acute or chronic 

Inflamm of skin surrounding nail 

Swollen, red, painful digit 

Compression → pus

Paronychia cause

Bacteria, esp in children (staph aureus, strep pyogenes, HSV)

Chronic paronychia affects who

Fingernails 

Adult women 

Food handlers 

Chronic paronychia course

Prolonged course w/ recurrent flares

Chronic paronychia cause

Contact rxn to irritants or allergens

Chronic paronychia secondary

Contact rxn to irritants or allergens 

Secondary bacterial and candida infections

Chronic paronychia

clubbing desc

Enlargement of soft tissue of distal digit 

Nail enlarged and excessively curved

clubbing cause

Congenital or acquired 

Pulmonary disease

digital clubbing

Onycholysis desc

Distal nail plate detachment 

Yellow white due to the presence of air in subungual space

Onycholysis location

Fingernails or toenails

Onycholysis cause

Trauma, psoriasis, onychomycosis

Photo-oncolysis, tetracycline 

Onycholysis

Onychomycosis desc

Fungal inf of nail 

Invasion of nail bed by organism → hyperkeratosis, yellowing, thickening of nail plate, onycholysis

Onychomycosis location/who

Men 

Toenails > fingernails

Onychomycosis cause

Tinea pedis

Onychomycosis

psoriasis nails desc

Irregular pitting, salmon (oil drop) patches, onycholysis

Toenails look like onychomycosis

Several nails affected (fingernails or toenails)

psoriasis pitting assoc w

psoriatic arthropathy

psoriasis

psoriasis salmon patches

psoriasis

Melanonychia desc

Longitudinal black-brown band on nail 

Hutchinson’s sign → melanoma (pigmentation in prox nail fold in assoc w/ longitudinal melanonychia)