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| {|
| | __NOTOC__ |
| |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
| |
| ! colspan="2" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| |
| | colspan="4" |'''Clinical manifestations'''
| |
| ! colspan="4" rowspan="2" |Para-clinical findings
| |
| ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
| |
| |-
| |
| ! colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin Examination
| |
| |-
| |
| ! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;"|Lab Findings
| |
| |-
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type
| |
| ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Color
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Risk factors
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin exam 3
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dermoscopic Findings
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Areas affected
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Unique features
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
| |
| |-
| |
| | rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Cutaneous squamous cell carcinoma'''
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''SCC in situ (Bowen's disease''')
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Well-demarcated, scaly patch or plaque
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Erythematous
| |
| * Skin colored
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Hyperkeratotic, or ulcerative lesions
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Any cutaneous surface, including the head, neck, trunk, extremities, oral mucosa, shoulders, chest and back
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * In fair-skinned individuals, SCCs most commonly arise in sites frequently exposed to the sun
| |
|
| |
|
| * In black individuals, common sites for SCC include the legs, anus, and areas of chronic inflammation or scarring
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Keratinocytic dysplasia involving the full thickness of the epidermis without infiltration of atypical cells into the dermis
| |
|
| |
|
| * The keratinocytes are pleomorphic with hyperchromatic nuclei, and numerous mitoses are present.
| | Cardiac surgery<ref name="pmid23447502">{{cite journal| author=Aya HD, Cecconi M, Hamilton M, Rhodes A| title=Goal-directed therapy in cardiac surgery: a systematic review and meta-analysis. | journal=Br J Anaesth | year= 2013 | volume= 110 | issue= 4 | pages= 510-7 | pmid=23447502 | doi=10.1093/bja/aet020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23447502 }} </ref> |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * SCC in situ lesions tend to grow slowly, enlarging over the course of years
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Invasive squamous cell carcinoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Papules
| |
| * Plaques
| |
| * Nodules
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Poorly differentiated lesions are usually fleshy, soft, granulomatous papules or nodules that lack the hyperkeratosis that is often seen in well-differentiated lesions
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * none
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Poorly differentiated tumors may have ulceration, hemorrhage, or areas of necrosis.
| |
| * Well-differentiated lesions usually appear as indurated or firm, hyperkeratotic
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * White circles, keratin, blood spots, and white structureless zones
| |
| | style="background: #F5F5F5; padding: 5px;" | | |
| * same as above
| |
| | style="background: #F5F5F5; padding: 5px;" |same as above
| |
| | style="background: #F5F5F5; padding: 5px;" |same as above
| |
| | style="background: #F5F5F5; padding: 5px;" |same as above
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Keratoacanthoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |Initial lesion: small pink macule
| |
| | |
| Later: papular quality and eventually forms a circumscribed nodule.
| |
| | style="background: #F5F5F5; padding: 5px;" |The periphery of the nodule tends to be skin-colored or mildly erythematous and may have accompanying telangiectasias
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Skin color
| |
| * Ultraviolet radiation
| |
| * Genetics
| |
| * Drug exposure (BRAF inhibitors)
| |
| * Trauma (surgery, laser therapy, cryotherapy or accidental trauma)
| |
| * Chemical carcinogens (tar, pitch, polyaromatic hydrocarbons)
| |
| * Human papillomavirus infection
| |
| | style="background: #F5F5F5; padding: 5px;" |The center of the nodule typically demonstrates a prominent keratinous core.
| |
| | style="background: #F5F5F5; padding: 5px;" |White circles, keratin, blood spots, and white structureless zones
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Develops on sun-exposed areas of the skin.
| |
| * The face (especially the eyelids, nose, cheek, and lower lip), neck, hands, and arms are common sites for involvement
| |
| | style="background: #F5F5F5; padding: 5px;" |a history of rapid growth within weeks favors this diagnosis | |
| | style="background: #F5F5F5; padding: 5px;" | | |
| * Epidermal hyperplasia with large eosinophilic keratinocytes
| |
| | |
| * Central invagination with a keratotic core (in later stages)
| |
| | |
| * "Lipping" or "buttressing" of the epidermis over the peripheral rim of the central keratotic plug
| |
| | |
| * Sharp demarcation between the tumor and the surrounding stroma
| |
| | |
| * Mixed inflammatory infiltrate in the dermis
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * It is controversial whether keratoacanthomas represent a subtype of well-differentiated SCC or a separate entity
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Merkel cell carcinoma''' | |
| | style="background: #F5F5F5; padding: 5px;" |rapidly growing, painless, firm, nontender, shiny, flesh-colored or bluish-red, intracutaneous nodule
| |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings | |
| | style="background: #F5F5F5; padding: 5px;" |Older patients with light skin tones | |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings
| |
| | style="background: #F5F5F5; padding: 5px;" |Milky red areas; linear, irregular vessels; and polymorphous vessels | |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Starts on areas of skin exposed to the sun
| |
| | |
| * Most frequent locations for the primary tumor are head and neck, upper limbs and shoulder, lower limbs and hip, and trunk
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Strands or nests of monotonously uniform, round, blue cells, containing large basophilic nuclei with powdery dispersed chromatin and inconspicuous nucleoli, and minimal cytoplasm
| |
| * Single-cell necrosis, frequent mitoses, lymphovascular invasion, perineural invasion, and epidermal involvement via pagetoid spread.
| |
| | style="background: #F5F5F5; padding: 5px;" |Blue-red, dome-shaped nodule
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nodular basal cell carcinoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |Pearly papule with telangiectasias
| |
| | style="background: #F5F5F5; padding: 5px;" |Pink or flesh-colored papule
| |
| | style="background: #F5F5F5; padding: 5px;" |none
| |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |Typically presents on the face
| |
| | style="background: #F5F5F5; padding: 5px;" |May have a "rolled" border, where the periphery is more raised than the middle.
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |Ulceration is frequent, and the term "rodent ulcer" refers to these ulcerated nodular BCCs
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Superficial basal cell carcinoma '''
| |
| | style="background: #F5F5F5; padding: 5px;" |Scaly patch
| |
| | style="background: #F5F5F5; padding: 5px;" |Erythematous lesion
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * large, hyperchromatic, oval nuclei and little cytoplasm
| |
| * well differentiated and cells appear histologically similar to basal cells of the epidermis
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Prurigo nodules'''
| |
| | style="background: #F5F5F5; padding: 5px;" |Firm, dome-shaped and itchy
| |
| | style="background: #F5F5F5; padding: 5px;" |ranging in size from a few millimeters to several centimeters and often symmetrically distributed
| |
| | style="background: #F5F5F5; padding: 5px;" |none
| |
| | style="background: #F5F5F5; padding: 5px;" |Nodules can be flesh-colored, erythematous, or brown/black
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Extensor surfaces of the arms and legs and on the trunk
| |
| | |
| * Upper back, abdomen, and sacrum
| |
| | style="background: #F5F5F5; padding: 5px;" |Worsened by heat, sweating, or irritation from clothing
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Thick, compact orthohyperkeratosis
| |
| * Irregular epidermal hyperplasia or pseudoepitheliomatous hyperplasia
| |
| * Focal parakeratosis with irregular acanthosis
| |
| * Diminished nerve fiber density
| |
| * A nonspecific dermal infiltrate containing lymphocytes, macrophages, eosinophils, and neutrophils
| |
| | style="background: #F5F5F5; padding: 5px;" |Nodules range in number from few to hundreds
| |
| | |
| upper midback area is usually spared
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Common nevus'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Dome-shaped, usually nonpigmented or hypopigmented nodules with a smooth surface
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Terminal hairs are often present
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Comma-shaped or curved vessels
| |
| * Structureless skin-colored to light brown background pigmentation
| |
| * Residual brown globules (clods) or brown thick circles, mainly located around the hair follicles can sometimes be seen
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Blue nevus'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Bluish macules or papules
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Structureless blue pigmentation
| |
| * Structureless blue and white or blue and brown on some occasions
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Head and neck,
| |
| * Dorsal aspect of the distal extremities
| |
| * Sacral area
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Spitz nevus'''
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nonpigmented Spitz nevus'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |coiled vessels and a white network (also called reticular depigmentation or negative network) over a pink to reddish background
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |benign, indolent melanocyte proliferation that most commonly develops in children, adolescents, and young adults.
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Reed-like Spitz'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |coiled vessels and a white network (also called reticular depigmentation or negative network) over a pink to reddish background
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |benign, indolent melanocyte proliferation that most commonly develops in children, adolescents, and young adults.
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Solar lentigo'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Lentigo Maligna'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Lentigo Maligna Melanoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Sebaceous hyperplasia'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Lichen planus-like keratosis'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Seborrheic keratosis'''
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Actinic keratosis'''
| |
| | style="background: #F5F5F5; padding: 5px;" |less pigmentation, and tend to be somewhat smaller in size.
| |
| | style="background: #F5F5F5; padding: 5px;" |Erythema
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |Hyperkeratosis
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |painful
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nodular malignant melanoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |Lump that has been rapidly growing over the past weeks
| |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings
| |
| | style="background: #F5F5F5; padding: 5px;" |none
| |
| | style="background: #F5F5F5; padding: 5px;" |No more additional findings
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |Cells proliferate downwards through the skin (vertical growth)
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Two-thirds arise in normal skin, the rest in existing moles
| |
| * Genetic component in some cases with a positive family history
| |
| |-
| |
| | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Amelanotic melanoma'''
| |
| | style="background: #F5F5F5; padding: 5px;" |Color usually pink, purple or normal skin color
| |
| | style="background: #F5F5F5; padding: 5px;" |Usually have an asymmetrical shape with an irregular border
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |Red, nonspecific lesion with slightly elevated borders
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
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| * Do not make melanin, so lesions are not pigmented
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| *
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| SCC in situ: Frequently, there is associated thickening of the epidermis (acanthosis), as well as hyperkeratosis and parakeratosis of the stratum corneum. In contrast to SCC in situ, actinic keratoses demonstrate only partial-thickness epidermal dysplasia.
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| <references /> | |