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27 terms

PATH #21—Skin Cancer

STUDY
PLAY
List 3 known etiologic factors for the development of skin cancers - carcinogens that alter cellular DNA
- UV light (also alters immune system)
- ionizing radiation (x-rays)
- chronic inflammation (leg ulcers, osteomyelitis sinus tracts
- thermal burns (Marjolin ulcer)
- HPV
- arsenic
- carcinogenic hydrocarbons
Actinic cheilitis
- what
- where
-cause
- describe
- lower lip

- Solar (actinic) keratosis clinically and microscopically

o Premalignant neoplasm of epidermis, can develop into invasive SCC

o Cause: UV light

o Scaly erythematous papules; perakeratosis, disordered maturation of keratinocytes (dyskeratosis) and solar elastosis in the dermis
Actinic cheilitis
- what
- location
-cause
- describe
- Solar (actinic) keratosis clinically and microscopically
Actinic cheilitis
-cause
UV light
Actinic cheilitis
- location
- lower lip
Actinic cheilitis
- describe
Scaly erythematous papules; perakeratosis, disordered maturation of keratinocytes (dyskeratosis) and solar elastosis in the dermis
Basal cell carcinoma - relationship of epith component to stroma
dependent upon their stroma for growth and development
stroma
(fibrovascular CT)
• Most common type of human epith malignancy, 2x more frequent, develops de novo
Basal cell carcinoma
Basal cell carcinoma —describe clinically
Papule →ulcerates centrally, rolled border, translucent, telangiectasias
May invade widely and deeply but rarely metastasizes—BCC or SCC
BCC
Basal cell carcinoma —describe microscopically
Nests of basaloid cells (palisading) surrounded by fibrovascular stroma
Basal cell carcinoma —cause
Chronic solar damage and/or genetic predisposition
Malignant melanoma
- malignant neoplasm of melanocytes, begins in epidermis

• >6mm, Asymmetrical, irregular borders, variation in color, ulceration (late)
"great mimicker", aypical melanocytes in epidermis
Malignant melanoma
Malignant melanoma—who?
- Sun exposure
- fair complexion
- heredity
Malignant melanoma- describe clinically
>6mm, Asymmetrical, irregular borders, variation in color, ulceration (late)
the difference (biologically) btw actinic keratosis arising on the lower lip and actinic keratosis arising elsewhere on the skin
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SCC that arise from Solar keratosis else where on the body rarely metastasize (2%) (locally aggressive)
SCC from actinic keratoses on the lip >20 % develop metastatic disease !!!!!!!!!!!!!!!!!!!!!!!!
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Most common type of human epith malignancy
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BCC
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Skin cancer:
Locally aggressive
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BCC
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Skin cancer:
seldom metastasize
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BCC
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Who get Malignant melanoma and risk factors?
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- Sun exposure (lots of sun)BLISTERING SUN BURN @EARLY AGE
- fair complexion (very fair skinned—so less likely blacks, hispanics and asians)
- heredity (family history)
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>6mm
- Asymmetrical
- irregular borders
- variation in color
- ulceration (late)
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Malignant melanoma
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Skin cancer:
No uniform color
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Malignant melanoma
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Skin cancer:
No uniform outline
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Malignant melanoma
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Skin cancer:
asymmetrical
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Malignant melanoma
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Lentigo maligna?
melanoma in situ on chronically sun damaged skin of the face