Squamous cell carcinoma of the skin differential diagnosis: Difference between revisions

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{{Squamous cell carcinoma}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Squamous_cell_carcinoma_of_the_skin]]
{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Aditya Govindavarjhulla|Aditya Govindavarjhulla, M.B.B.S.]] [mailto:agovi@wikidoc.org], [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]] [mailto:ravitheja.g@gmail.com]
{{CMG}}; {{AE}} {{RAK}}{{Homa}}
 
== Overview ==
== Overview ==
Squamous cell carcinoma should be differentiated from [[melanoma]] and [[basal cell carcinoma]]. It accounts for 20% of all non-melanomatous tumors, and is fairly invasive contrary to its counterpart, [[basal cell carcinoma]]. [[Squamous cell carcinoma]] typically presents as a non-healing ulcer or growth on a sun exposed area of the skin.
Squamous cell carcinoma should be differentiated from [[melanoma]] and [[basal cell carcinoma]]. It accounts for 20% of all non-melanomatous tumors and is fairly invasive contrary to its counterpart, [[basal cell carcinoma]]. [[Squamous cell carcinoma]] typically presents as a non-healing ulcer or growth on a sun-exposed area of the skin.


== Differentiating Squamous cell carcinoma from other Diseases ==
== Differentiating Squamous cell carcinoma from other Diseases ==
A few conditions that mimic [[Squamous cell carcinoma]] include the following;
A few conditions that mimic Squamous cell carcinoma of the skin include the following:
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="5" |'''Skin examination'''
! colspan="2" |Diagnosis
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional 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;" |Texture
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Size
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Distribution
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dermoscopic Findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
| rowspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Cutaneous squamous cell carcinoma]]'''<ref name="pmid10848931">{{cite journal| author=Petter G, Haustein UF| title=Histologic subtyping and malignancy assessment of cutaneous squamous cell carcinoma. | journal=Dermatol Surg | year= 2000 | volume= 26 | issue= 6 | pages= 521-30 | pmid=10848931 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10848931  }}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Squamous cell carcinoma in situ of skin|'''SCC in situ (Bowen's disease''')]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Patched|Patch]]
*[[Plaque]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Erythematous]]
* Skin colored
| style="background: #F5F5F5; padding: 5px;" |
* Scaly
| style="background: #F5F5F5; padding: 5px;" |
* Variable
| style="background: #F5F5F5; padding: 5px;" |
* Fair-skinned individuals: sun-exposed areas
 
* In black individuals: [[Leg|legs]], [[anus]], and areas of [[chronic inflammation]]
| style="background: #F5F5F5; padding: 5px;" |
* Presence of dotted and/or [[glomerular]] [[vessels]]
* White to yellowish [[Surface area|surface]] scales
* Red-yellowish [[background]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Keratinocyte|Keratinocytic]] [[dysplasia]] of the [[epidermis]]
* No [[Infiltration (medical)|infiltration]] into [[dermis]]
*[[Pleomorphism|Pleomorphic]] [[Keratinocyte|keratinocytes]]
* Hyperchromatic [[nuclei]]
| style="background: #F5F5F5; padding: 5px;" |
* Slow [[growth]] over the years
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Invasive squamous cell carcinoma'''
| style="background: #F5F5F5; padding: 5px;" |
* [[Papules|Papule]]
* [[Plaques|Plaque]]
* [[Nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* Skin colored
| style="background: #F5F5F5; padding: 5px;" |
* [[Induration|Indurated]] + [[Hyperkeratosis|hyperkeratotic]]  (well [[Cellular differentiation|differentiated]])
* Soft + [[ulceration]] (poorly [[Cellular differentiation|differentiated]])
| style="background: #F5F5F5; padding: 5px;" |
* 0.5 to 1.5 cm
| style="background: #F5F5F5; padding: 5px;" |
* Fair-skinned individuals: sun-exposed areas


* [[Actinic keratosis]] (also called '''solar keratosis''', or '''AK''') is a [[premalignant condition]] consisting of one or multiple thick, scaly, or crusty patches on the skin. It is most common in fair-skinned people who are frequently exposed to the sun, due to lack of the protective pigment called melatonin. Actinic keratosis are pre-malignant lesions caused by solar damage that can progress to [[squamous cell carcinoma]], and should therefore be treated.It usually is accompanied by solar damage.
* In black individuals: legs, anus, and areas of chronic inflammation
* [[Atopic dermatitis]] (Atopic Eczema) is a hereditary, non-contagious skin disease characterized by chronic inflammation of the skin.
| style="background: #F5F5F5; padding: 5px;" |
* [[Atypical fibroxanthoma]] is a tumor that occurs primarily in older individuals when the skin of their head and neck area is exposed to sun and/or therapeutic radiation. Clinically, lesions usually are suggestive of malignancy because they arise rapidly in skin where other cancerous lesions have been found and treated. Clinical presentation is a red, beefy, sessile nodule. Solar telangiectasias can be found around the lesions.
* White circles
* [[Bowenoid papulosis]] presents as papules on the genitalia of both sexes and is induced by infection with [[HPV]]. Many of these lesions are benign, but there are case reports of malignant transformation (2.6%).
* White structureless areas
* [[Contact dermatitis]]
*[[Mass|Masses]] of [[keratin]]
* [[Erythroplasia of Queyrat]] is squamous cell carcinoma in situ of the penis.
*[[Hairpin]] and linear-irregular [[vessels]]
* [[Keratoacanthoma]] is a low-grade malignancy of the skin.  It originates in the [[sebaceous gland|pilo-sebaceous glands]], and is similar in its clinical presentation and microscopic analysis to squamous cell carcinoma, except that it contains a central [[keratin]] plug.  Statistically, it is less likely to become invasive than squamous cell carcinoma.
| style="background: #F5F5F5; padding: 5px;" |
* [[Bowen's disease]] is a sunlight-induced skin disease, and is considered to be an early form of squamous cell carcinoma.
* [[Keratinocyte|Keratinocytic]] [[dysplasia]] of the [[epidermis]]  
* [[Marjolin's ulcer]] is a type of squamous cell carcinoma that arises from a non-healing [[ulcer]] or burn wound.
* No [[Infiltration (medical)|infiltration]] into [[dermis]]
* [[Melanoma]]
* [[Basal cell carcinoma]] is the most common skin tumor accounting for 80% of all non-melanomatous tumors of skin. It is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts, and bleeds
* [[Pyoderma gangrenosum]] is an uncommon ulcerative condition associated with systemic disease in at least 50% of cases. This condition is a diagnosis of exclusion.


Squamous cell carcinoma of the mouth must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer
* [[Pleomorphism|Pleomorphic]] [[Keratinocyte|keratinocytes]]
* Hyperchromatic [[nuclei]]
| style="background: #F5F5F5; padding: 5px;" |
* May be [[painful]] or [[Itch|pruritic]]
|-
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Keratoacanthoma]]'''<ref name="pmid26853179">{{cite journal| author=Kwiek B, Schwartz RA| title=Keratoacanthoma (KA): An update and review. | journal=J Am Acad Dermatol | year= 2016 | volume= 74 | issue= 6 | pages= 1220-33 | pmid=26853179 | doi=10.1016/j.jaad.2015.11.033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26853179  }}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Macule]]
*[[Papule]]
* May have [[telangiectasias]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]-colored
* Mildly [[erythematous]]
| style="background: #F5F5F5; padding: 5px;" |
* Prominent [[keratinous]] [[Core (anatomy)|core]] in the center of the [[nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* 1 to 2.5 cm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas
*[[Face]], [[neck]], [[hands]], and [[Arm|arms]]
| style="background: #F5F5F5; padding: 5px;" |
* White circles
*[[Keratin]]
*[[Blood]] spots
* White structureless zones
| style="background: #F5F5F5; padding: 5px;" |
* Well-[[Cellular differentiation|differentiated]] [[squamous epithelium]]
* Central [[keratin]] core
*[[Epidermal]] [[hyperplasia]] + large [[eosinophilic]] [[Keratinocyte|keratinocytes]]


<div style="width: 70%;">
*[[Dermal]] [[inflammatory]] [[Infiltration (medical)|infiltrate]]
<small><small>
| style="background: #F5F5F5; padding: 5px;" |
{| class="wikitable"
* Rapid [[growth]] (within weeks)
!Disease
!Presentation
!Risk Factors
!Diagnosis
!Affected Organ Systems
!Important features
!Picture
|-
|-
! colspan="3" |Diseases predominantly affecting the oral cavity
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Dermatofibroma'''<ref name="LeeLee2015">{{cite journal|last1=Lee|first1=MiWoo|last2=Lee|first2=WooJin|last3=Jung|first3=JoonMin|last4=Won|first4=ChongHyun|last5=Chang|first5=SungEun|last6=Choi|first6=JeeHo|last7=Moon|first7=KeeChan|title=Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma|journal=Indian Journal of Dermatology, Venereology, and Leprology|volume=81|issue=3|year=2015|pages=263|issn=0378-6323|doi=10.4103/0378-6323.154795}}</ref><ref name="MentzelWiesner2012">{{cite journal|last1=Mentzel|first1=Thomas|last2=Wiesner|first2=Thomas|last3=Cerroni|first3=Lorenzo|last4=Hantschke|first4=Markus|last5=Kutzner|first5=Heinz|last6=Rütten|first6=Arno|last7=Häberle|first7=Michael|last8=Bisceglia|first8=Michele|last9=Chibon|first9=Frederic|last10=Coindre|first10=Jean-Michel|title=Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases|journal=Modern Pathology|volume=26|issue=2|year=2012|pages=256–267|issn=0893-3952|doi=10.1038/modpathol.2012.157}}</ref>
!
| style="background: #F5F5F5; padding: 5px;" |
!
*[[Nodule]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Hyperpigmentation|Hyperpigmented]]
| style="background: #F5F5F5; padding: 5px;" |
*Firm
| style="background: #F5F5F5; padding: 5px;" |
*0.3- 1 cm
| style="background: #F5F5F5; padding: 5px;" |
*Mostly seen in [[extremities]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
*Localized [[nodular]] [[proliferation]] of [[spindle]]-shaped [[fibrous]] [[Cells (biology)|cells]] in a [[mixture]] of [[Histiocyte|histocytoid]] [[Cells (biology)|cells]] inside the [[dermis]]
* Spiculated margin of cells
* “Storiform” [[pattern]]
*[[Collagen]] bundles
* "Grenz zone"
*[[Epidermal]] [[hyperplasia]]
| style="background: #F5F5F5; padding: 5px;" |
* Slow [[growth]] over the years
!
!
|-
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[dermatofibrosarcoma protuberans]]'''<ref name="BernardPoulalhon2013">{{cite journal|last1=Bernard|first1=J.|last2=Poulalhon|first2=N.|last3=Argenziano|first3=G.|last4=Debarbieux|first4=S.|last5=Dalle|first5=S.|last6=Thomas|first6=L.|title=Dermoscopy of dermatofibrosarcoma protuberans: a study of 15 cases|journal=British Journal of Dermatology|volume=169|issue=1|year=2013|pages=85–90|issn=00070963|doi=10.1111/bjd.12318}}</ref><ref name="AcostaVélez2017">{{cite journal|last1=Acosta|first1=Alvaro E.|last2=Vélez|first2=Catalina Santa|title=Dermatofibrosarcoma Protuberans|journal=Current Treatment Options in Oncology|volume=18|issue=9|year=2017|issn=1527-2729|doi=10.1007/s11864-017-0498-5}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Patched|Patch]]
*[[Plaque]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Skin]]-[[Color|colored]], [[Violet (plant)|violet]] or [[Red-Al|reddish]]-[[brown]]
| style="background: #F5F5F5; padding: 5px;" |
*Firm
| style="background: #F5F5F5; padding: 5px;" |
*1-5 cm
| style="background: #F5F5F5; padding: 5px;" |
*Mostly seen in [[trunk]]
| style="background: #F5F5F5; padding: 5px;" |
*Presence of [[vessels]]
*[[Pigmentation|pigmented]] network
*pinkish [[background]]
| style="background: #F5F5F5; padding: 5px;" |
*Highly [[cellular]] with [[Cells (biology)|cells]] having following [[Characteristic function (probability theory)|characteristics]]:
** Monomorphic
** Thin
** [[Spindle cells|Spindly]]
** Scant [[eosinophilic]] [[cytoplasm]]
** Hyperchromatic [[nuclei]] (resembling [[neurofibroma]])
| style="background: #F5F5F5; padding: 5px;" |
!
!
|-
|-
|[[Oral candidiasis|Oral Candidiasis]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Kaposi sarcoma]]'''<ref name="CesarmanDamania2019">{{cite journal|last1=Cesarman|first1=Ethel|last2=Damania|first2=Blossom|last3=Krown|first3=Susan E.|last4=Martin|first4=Jeffrey|last5=Bower|first5=Mark|last6=Whitby|first6=Denise|title=Kaposi sarcoma|journal=Nature Reviews Disease Primers|volume=5|issue=1|year=2019|issn=2056-676X|doi=10.1038/s41572-019-0060-9}}</ref><ref name="HuKe2009">{{cite journal|last1=Hu|first1=S C-S|last2=Ke|first2=C-L K|last3=Lee|first3=C-H|last4=Wu|first4=C-S|last5=Chen|first5=G-S|last6=Cheng|first6=S-T|title=Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured ‘rainbow pattern’|journal=Journal of the European Academy of Dermatology and Venereology|volume=23|issue=10|year=2009|pages=1128–1132|issn=09269959|doi=10.1111/j.1468-3083.2009.03239.x}}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
* [[Dysphagia]] or [[odynophagia]]
*[[Macule]]
* White patches on the mouth and tongue
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Newborn]] babies
* Red/violaceous
| style="background: #F5F5F5; padding: 5px;" |
*Smooth
| style="background: #F5F5F5; padding: 5px;" |
*[[Variable]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Mucus membrane]]
| style="background: #F5F5F5; padding: 5px;" |
* Rainbow pattern
* scaly [[Surface area|surface]]
* Small brown globules
| style="background: #F5F5F5; padding: 5px;" |
*[[Spindle cells]] with minimal [[nuclear]] [[atypia]]
* Excessive [[vascular]] [[proliferation]]
* Abundant [[Red blood cell|red blood cells]]
*[[RBC]] and [[hemosiderin]] [[extravasation]]
* Abundant [[Lymphocyte|lymphocytes]] and [[monocytes]]
* Premonitory sign
* Intracytoplasmic [[PAS stain|PAS]] +ve [[hyaline]] globules
| style="background: #F5F5F5; padding: 5px;" |
* Kaposi's sarcoma is commonly associated with [[AIDS|acquired immune deficiency syndrome]] ([[AIDS]])
|-


*Denture users
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Merkel cell carcinoma]]'''<ref name="pmid19638070">{{cite journal| author=Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE| title=Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. | journal=J Cutan Pathol | year= 2010 | volume= 37 | issue= 1 | pages= 20-7 | pmid=19638070 | doi=10.1111/j.1600-0560.2009.01370.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19638070  }}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* Intracutaneous [[nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* Shiny
* Flesh-colored or bluish-red
| style="background: #F5F5F5; padding: 5px;" |
* Firm
| style="background: #F5F5F5; padding: 5px;" |
* < 1 cm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas


*Poorly controlled [[diabetes]]
* [[Head]] and [[neck]]
 
* [[Upper limbs]] and [[shoulder]]
*As a side effect of medication, most commonly having taken [[antibiotic]]s. Inhaled [[corticosteroids]] for the treatment of lung conditions (e.g, [[asthma]] or [[COPD]]) may also result in oral candidiasis which may be reduced by regularly rinsing the mouth with water after taking the medication.
* [[Lower limbs]] and [[hip]]
 
* [[Trunk]]
*People with poor [[nutrition]], specifically [[vitamin A]], [[Iron deficiency anemia|iron]] and [[Folate deficiency|folate deficiencies]].
| style="background: #F5F5F5; padding: 5px;" |
 
* Milky red areas
*People with an [[immune deficiency]] (e.g. as a result of [[AIDS]]/[[HIV]] or [[chemotherapy]] treatment).
* Linear
 
* Irregular [[vessels]]
*Women undergoing hormonal changes, like [[pregnancy]] or those on [[birth control pills]].
*[[Polymorphic|Polymorphous]] [[vessels]]
 
| style="background: #F5F5F5; padding: 5px;" |
*[[Organ transplantation]] patients
* Uniform [[cells]] with large [[basophilic]] [[nuclei]]
|
* Single-cell [[necrosis]]
* Clinical diagnosis
* Frequent [[mitoses]]
* Confirmatory tests rarely needed
* Lymphovascular [[Invasive (medical)|invasion]]
|'''Localized candidiasis'''
*[[Perineurium|Perineural]] [[invasion]]
* [[Oral candidiasis|Oral]] and [[Esophageal candidiasis|esophageal candidasis]]
* [[Epidermal]] involvement via [[pagetoid]] spread
* [[Candida vulvovaginitis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Chronic mucocutaneous candidiasis]]
* Older individuals with light [[skin]] tones
 
* Rapidly [[Growth|growing]]
'''Invasive candidasis'''
|-
* [[Candidiasis|Candidaemia]]
| rowspan="3" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Basal cell carcinoma]]'''<ref name="pmid22759209">{{cite journal| author=Wolberink EA, Pasch MC, Zeiler M, van Erp PE, Gerritsen MJ| title=High discordance between punch biopsy and excision in establishing basal cell carcinoma subtype: analysis of 500 cases. | journal=J Eur Acad Dermatol Venereol | year= 2013 | volume= 27 | issue= 8 | pages= 985-9 | pmid=22759209 | doi=10.1111/j.1468-3083.2012.04628.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22759209  }}</ref>
* [[Endocarditis|Candida endocarditis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Nodular basal cell carcinoma]]'''
* [[Osteoarthritis|Candida osteoarticular disease]]
| style="background: #F5F5F5; padding: 5px;" |
|
* [[Papule]]
* [[Osteoarthritis|Oral candidiaisis is]] a benign self limiting disease unless accompanied by [[immunosuppression]].
| style="background: #F5F5F5; padding: 5px;" |
|[[File:Human tongue infected with oral candidiasis--By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|thumb|Tongue infected with oral candidiasis - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|400x400px]]
* Flesh-colored
| style="background: #F5F5F5; padding: 5px;" |
* Small [[Bumps on skin|bump]]
| style="background: #F5F5F5; padding: 5px;" |
* Variable
| style="background: #F5F5F5; padding: 5px;" |
* [[Face]]
| style="background: #F5F5F5; padding: 5px;" |
* Focused, bright red, and branching arborizing [[vessels]]
* Loosely arranged blue-gray dots
| style="background: #F5F5F5; padding: 5px;" |
* Nest-like [[Infiltration (medical)|infiltration]] with [[Basal cell|basaloid]] [[cells]]
| style="background: #F5F5F5; padding: 5px;" |
* May have a "rolled" [[Borderline|border]]
|-
|-
|[[Herpes simplex|Herpes simplex oral lesions]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Superficial basal cell carcinoma '''
|
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]]
*[[Patched|Patch]]
* [[Sore throat]]
| style="background: #F5F5F5; padding: 5px;" |
* Painful [[ulcer]]s
* [[Erythematous]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Stress
* Scaly
* Recent [[URTI]]
| style="background: #F5F5F5; padding: 5px;" |
* Female sex
* 1 to > 10 cm
|
| style="background: #F5F5F5; padding: 5px;" |
* Physical examination
* Sun-exposed areas
* [[Viral culture]]
* [[Head]] (cheek and nose)
* [[Tzanck smear]]
* [[Trunk]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Orofacial Infection
*[[Superficial]] fine [[Telangiectasias|telangiectasia]]
* [[Herpes simplex anogenital infection|Anogenital Infection]]
* Shiny white to red, [[translucent]] or opaque structureless areas
* [[Herpes simplex ocular infection|Ocular Infection]]
* Multiple small erosions
* [[Herpes simplex encephalitis|Herpes Encephalitis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Herpes simplex neonatorum|Neonatal Herpes]]
* Large, hyperchromatic, oval [[nuclei]]
* [[Herpetic whitlow|Herpetic Whitlow]]
* Minimal [[cytoplasm]]
* [[Herpes gladiatorum|Herpes Gladiatorum]]
* Small basaloid nodules
|
| style="background: #F5F5F5; padding: 5px;" |
* The symptoms of primary [[HSV]] infection generally resolve within two weeks
* Higher [[incidence]] in men
|[[File:Herpesinfection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|thumb|Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|400x400px]]
|-
|-
|[[Aphthous ulcer|Aphthous ulcers]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Sclerosing basal cell carcinoma (morpheaform)'''<ref name="pmid8959949">{{cite journal| author=Wrone DA, Swetter SM, Egbert BM, Smoller BR, Khavari PA| title=Increased proportion of aggressive-growth basal cell carcinoma in the Veterans Affairs population of Palo Alto, California. | journal=J Am Acad Dermatol | year= 1996 | volume= 35 | issue= 6 | pages= 907-10 | pmid=8959949 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8959949  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
* Painful, red spot or bump that develops into an open [[ulcer]]
*[[Papule]]
|
 
* Being a female
*[[Plaque]]
* Between the ages of 10-40
| style="background: #F5F5F5; padding: 5px;" |
* Family history of [[Aphthous ulcer|aphthous ulcers]]
* Flesh-colored
|
* [[Erythematous|Slightly erythematous]]
* Physical examination
| style="background: #F5F5F5; padding: 5px;" |
* Diagnosis of exclusion
* Firm
|
* [[Induration|Indurated]]
* Oral cavity
* Indistinct [[Borderline|borders]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Self-limiting , [[Pain]] decreases in 7 to 10 days, with complete healing in 1 to 3 weeks
* Variable
|[[File:Afta foto - By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358.jpg|thumb|Apthous ulcer on the under surface of the tongue|By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358|400x400px]]
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas
| style="background: #F5F5F5; padding: 5px;" |
* Whitish [[background]]
* Few fine arborizing [[vessels]]
* Multiple brown dots
* [[Ulceration]]
| style="background: #F5F5F5; padding: 5px;" |
* Thin columns + small nodules
* Highly [[Collagen|collagenized]] stroma
| style="background: #F5F5F5; padding: 5px;" |
* Expression of [[Alpha-actin|smooth muscle protein alpha-actin]] in tumor [[stroma]]
|-
|-
|[[Squamous cell carcinoma]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Prurigo nodules'''<ref name="pmid25808786">{{cite journal| author=Errichetti E, Piccirillo A, Stinco G| title=Dermoscopy of prurigo nodularis. | journal=J Dermatol | year= 2015 | volume= 42 | issue= 6 | pages= 632-4 | pmid=25808786 | doi=10.1111/1346-8138.12844 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25808786  }}</ref><ref name="pmid20002240">{{cite journal| author=Weigelt N, Metze D, Ständer S| title=Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients. | journal=J Cutan Pathol | year= 2010 | volume= 37 | issue= 5 | pages= 578-86 | pmid=20002240 | doi=10.1111/j.1600-0560.2009.01484.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20002240  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Non healing [[ulcer]], [[nodule]], indurated plaque or mass
* Dome-shaped [[nodule]]
*May involve [[skin]], [[lips]], inside the [[mouth]], [[throat]] or [[esophagus]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Flesh-colored
* Chronic sun or [[Ultraviolet|UV exposure]]
* [[Erythematous]]
* Fair [[skin]]
* Brown/black
* [[Elderly]] age (>45 yrs)
| style="background: #F5F5F5; padding: 5px;" |
* [[Male sex]]
* Firm
* [[Smoking]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
*[[Extensor]] [[Surface area|surfaces]] of the [[Arm|arms]] and [[Leg|legs]] and on the [[trunk]]
|
 
*[[Oral Cavity]]
* Upper [[back]], [[abdomen]], and [[sacrum]]
**Floor of [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
**Lateral [[tongue]]
* White "starburst pattern" surrounding red/brown/yellow crusts
*[[Throat]]
*[[Erosion (dental)|Erosions]]
*[[Esophagus]]
*[[Hyperkeratosis]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Malignant]]
* Thick and compact orthohyperkeratosis
*Can spread to [[TMJ]]
* Irregular [[epidermal]] [[hyperplasia]]
*Some times associated with [[leukoplakia]]
* Focal parakeratosis with irregular [[Acanthosis nigricans|acanthosis]]
|[[File:Squamous cell carcinomaa.jpg|Squamous cell carcinoma|400x400px]]  
* Nonspecific [[dermal]] [[Infiltration (medical)|infiltrate]] containing [[WBC|WBCs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Nodule (medicine)|Nodules]] range in number from few to hundreds
* Worsened by [[heat]], [[sweating]], or [[irritation]] from clothing
|-
|-
|[[Leukoplakia]]
| rowspan="6" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Melanoma]]'''<ref name="pmid201377432">{{cite journal| author=Witt C, Krengel S| title=Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi). | journal=Dermatol Online J | year= 2010 | volume= 16 | issue= 1 | pages= 1 | pmid=20137743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20137743  }}</ref>
|
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Melanoma in situ''' (Lentigo Maligna)<ref name="pmid30266559">{{cite journal| author=Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K| title=Follicular involvement is frequent in lentigo maligna: Implications for treatment. | journal=J Am Acad Dermatol | year= 2019 | volume= 80 | issue= 2 | pages= 532-537 | pmid=30266559 | doi=10.1016/j.jaad.2018.07.071 | pmc=6333487 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30266559  }}</ref>
*White leathery spots on the [[mucous membranes]] of the [[tongue]] and inside of the [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
*Lateral borders of [[tongue]]
* [[Macule]]
|
| style="background: #F5F5F5; padding: 5px;" |
*Atypical [[Tobacco]] use
* Variable (from light to dark brown, black, pink, red, or white)
*Chronic [[irritation]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Immunodeficiency]]
* Smooth
*[[Bloodroot]] ([[Sanguinarine|sanguinaria]])
| style="background: #F5F5F5; padding: 5px;" |
|
* Around 1 cm
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
*Diagnosis of exclusion
* Sun-damaged [[skin]] of the [[head]] or [[neck]]
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Asymmetric, [[Pigmented lesions|pigmented]] follicular openings
*[[Vulva|Vulvar]] lesions occur independent of oral lesions
* Gray angulated lines
|
* Gray areas, dots, and globules
*Associated with [[HIV]]
* Circle within a circle
*Persistant white spots
| style="background: #F5F5F5; padding: 5px;" |
*[[Benign]] but can progress to [[carcinoma]] after almost 10 years
* '''↑''' atypical [[spindle]] shaped [[melanocytes]]  
*Oral proliferative [[Leukoplakia|verrucous leukoplakia]] is an aggressive sub type with multiple lesions and higher conversion to [[warts]] or [[carcinoma]]<ref>{{Cite journal
* Arranged in single [[Cells (biology)|cells]] or in small nests along the [[Epidermal junctions|dermal-epidermal junction]]
| author = [[Ann M. Gillenwater]], [[Nadarajah Vigneswaran]], [[Hanadi Fatani]], [[Pierre Saintigny]] & [[Adel K. El-Naggar]]
| style="background: #F5F5F5; padding: 5px;" |
| title = Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity!
* Darkening of [[pigmentation]], sharpening of borders, or emergence of [[nodular]] areas are [[signs]] of progression to [[lentigo maligna melanoma]]
| journal = [[Advances in anatomic pathology]]
| volume = 20
| issue = 6
| pages = 416–423
| year = 2013
| month = November
| doi = 10.1097/PAP.0b013e3182a92df1
| pmid = 24113312
}}</ref>
|[[File:Oral hairy leukoplakia (EBV, in HIV)a.jpg|Leukoplakia|400x300px]]
|-
|-
|[[Melanoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Lentigo maligna melanoma]]'''<ref name="pmid302665592">{{cite journal| author=Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K| title=Follicular involvement is frequent in lentigo maligna: Implications for treatment. | journal=J Am Acad Dermatol | year= 2019 | volume= 80 | issue= 2 | pages= 532-537 | pmid=30266559 | doi=10.1016/j.jaad.2018.07.071 | pmc=6333487 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30266559  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*A lesion with [[ABCD]]
* [[Macule]]
**[[Asymmetry]]
| style="background: #F5F5F5; padding: 5px;" |
**Border irregularity
* Brown/tan
**Color variation
| style="background: #F5F5F5; padding: 5px;" |
**[[Diamete]]r changes
*[[Freckle]]-like
*[[Bleeding]] from the lesion
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*[[Ultraviolet|UV radiations]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Genetic predisposition]]
*[[Chronic|Chronically]] sun-damaged [[Area|areas]]
*[[Old age]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Male gender]]
* Asymmetric, [[Pigmented lesions|pigmented]] follicular openings
*Family or personal history of [[melanoma]]
* Gray angulated lines
*Multiple benign or atypical [[Nevus|nevi]]
* Gray areas, dots, and globules
|
* Circle within a circle
*[[ABCD]] characteristics
| style="background: #F5F5F5; padding: 5px;" |
*[[Bleeding]] or [[ulceration]] may show [[malignancy]]
* "Star-burst giant cells" in [[epidermis]]
*Serum [[LDH]] may be elevated in case of [[malignancy]]
* "Swallow's nest" sign along the [[Epidermal junctions|dermal-epidermal junction]]
*[[Biopsy]]
* Minimal [[cytoplasm]]
|
* Pale nucleus with small nucleoli
*Can [[metastasize]]
| style="background: #F5F5F5; padding: 5px;" |
*All [[UV radiation]] or sun exposed areas can be effected independently
* Usually in older individuals
*1-2 to hundreds of [[granules]]
|
*[[Neural crest cell]] derivative
*Development begins with disruption of [[nevus]] growth control
*Progression involves [[MAPK/ERK pathway]]
*[[RAS|N-RAS]] or [[BRAF]] [[oncogene]] also involved
|[[File:Melanoma oral 001a.jpg|Oral melanoma|400x400px]]
|-
|-
|[[Fordyce spots]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Superficial spreading melanoma]]'''<ref name="pmid19782937">{{cite journal| author=Argenziano G, Ferrara G, Francione S, Di Nola K, Martino A, Zalaudek I| title=Dermoscopy--the ultimate tool for melanoma diagnosis. | journal=Semin Cutan Med Surg | year= 2009 | volume= 28 | issue= 3 | pages= 142-8 | pmid=19782937 | doi=10.1016/j.sder.2009.06.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19782937  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Rice-like [[granules]] or [[spots]]
* [[Macule]]
*Small, [[painless]], [[raised]], [[pale]], red or white
*[[Plaque]] with irregular [[Borderline|borders]]
*1 to 3 mm in [[diameter]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Variably [[Pigmented lesions|pigmented]] (red, blue, black, gray, and white)
*Greasy skin types
| style="background: #F5F5F5; padding: 5px;" |
*Some [[Rheumatic|rheumatic disorders]]
* Thin
*[[Hereditary nonpolyposis colorectal cancer]]
| style="background: #F5F5F5; padding: 5px;" |
**Lower [[gingiva]] (gums)
* 1 mm to > 1 cm
**[[Vestibular system|Vestibular mucosa]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Anywhere but usually:
*[[Physical exam]]
**[[Back]] ([[men]] and [[women]])
*Small [[keratin]]-filled [[pseudocysts]]
** Lower [[extremities]] ([[women]])
*May be seen on [[incidental]] [[mucosal]] [[biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
**[[Biopsy]] not done for them primarily
* Asymmetry of shape
|
* > 2 colors
*[[Oral cavity]]
* Asymmetry of structures
**[[Vermillion border|Vermilion border]] of the lips
| style="background: #F5F5F5; padding: 5px;" |
**[[Oral mucosa]] of the upper lip
* Asymmetric
*[[Buccal mucosa]] in the commissural region often bilaterally
* Poorly circumscribed
*[[Genitals]]
* Lack [[cellular]] [[maturation]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Benign neoplasms]] with [[sebaceous]] features
*[[Lateral]] (radial) [[growth]] before [[Vertical direction|vertical]] ([[invasive]]) [[growth]]
*Visible [[sebaceous glands]]
*No surrounding [[mucosal]] change
*Several adjacent [[glands]] may coalesce into a larger cauliflower-like cluster
|[[File:Fordyce spots 02a.jpg|Fordyce spots|400x400px]]
|-
|-
|[[Burning mouth syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Nodular melanoma]]'''<ref name="pmid12734496">{{cite journal| author=Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, Sera F et al.| title=Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. | journal=J Am Acad Dermatol | year= 2003 | volume= 48 | issue= 5 | pages= 679-93 | pmid=12734496 | doi=10.1067/mjd.2003.281 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12734496  }}</ref><ref name="MenziesMoloney2013">{{cite journal|last1=Menzies|first1=Scott W.|last2=Moloney|first2=Fergal J.|last3=Byth|first3=Karen|last4=Avramidis|first4=Michelle|last5=Argenziano|first5=Giuseppe|last6=Zalaudek|first6=Iris|last7=Braun|first7=Ralph P.|last8=Malvehy|first8=Josep|last9=Puig|first9=Susana|last10=Rabinovitz|first10=Harold S.|last11=Oliviero|first11=Margaret|last12=Cabo|first12=Horacio|last13=Bono|first13=Riccardo|last14=Pizzichetta|first14=Maria A.|last15=Claeson|first15=Magdalena|last16=Gaffney|first16=Daniel C.|last17=Soyer|first17=H. Peter|last18=Stanganelli|first18=Ignazio|last19=Scolyer|first19=Richard A.|last20=Guitera|first20=Pascale|last21=Kelly|first21=John|last22=McCurdy|first22=Olivia|last23=Llambrich|first23=Alex|last24=Marghoob|first24=Ashfaq A.|last25=Zaballos|first25=Pedro|last26=Kirchesch|first26=Herbert M.|last27=Piccolo|first27=Domenico|last28=Bowling|first28=Jonathan|last29=Thomas|first29=Luc|last30=Terstappen|first30=Karin|last31=Tanaka|first31=Masaru|last32=Pellacani|first32=Giovanni|last33=Pagnanelli|first33=Gianluca|last34=Ghigliotti|first34=Giovanni|last35=Ortega|first35=Blanca Carlos|last36=Crafter|first36=Greg|last37=Ortiz|first37=Ana María Perusquía|last38=Tromme|first38=Isabelle|last39=Karaarslan|first39=Isil Kilinc|last40=Ozdemir|first40=Fezal|last41=Tam|first41=Anthony|last42=Landi|first42=Christian|last43=Norton|first43=Peter|last44=Kaçar|first44=Nida|last45=Rudnicka|first45=Lidia|last46=Slowinska|first46=Monika|last47=Simionescu|first47=Olga|last48=Di Stefani|first48=Alessandro|last49=Coates|first49=Elliot|last50=Kreusch|first50=Juergen|title=Dermoscopic Evaluation of Nodular Melanoma|journal=JAMA Dermatology|volume=149|issue=6|year=2013|pages=699|issn=2168-6068|doi=10.1001/jamadermatol.2013.2466}}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Burning or [[tingling]] on the [[lips]], [[tongue]], or entire [[mouth]]
*[[Polyploidy|Polypoid]] [[nodule]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Nutritional deficiencies]]
* Dark color
*Chronic [[anxiety]] or [[depression]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Diabetes type 2]]
*[[Lump]]
*[[Menopause]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Oral thrush]] or [[dry mouth]], or damaged [[nerves]] transmitting taste
* 6mm to > 1 cm
*[[Female gender ]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Menopause]]
*[[Trunk]]
|
*[[Head]]
*[[Presentation]]
*[[Neck]]
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Pigment]] network or pseudonetwork
*[[Oral cavity]]
* Aggregated brown or black globules
|
* Blue [[pigmentation]] within [[lesion]]
*Pain typically is low in the morning and builds up over the day
* Small dotted or comma [[vessels]]
*Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Cells (biology)|Cells]] [[proliferate]] downwards through the [[skin]]
 
*[[Dermal]] [[growth]] in isolation or in association with an [[epidermal]] component
| style="background: #F5F5F5; padding: 5px;" |
* Two-thirds arise in normal [[skin]], the rest in existing [[moles]]
* Rapidly enlarging
|-
|-
|[[Torus palatinus]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Acral lentiginous melanoma]]'''<ref name="pmid19922528">{{cite journal| author=Phan A, Dalle S, Touzet S, Ronger-Savlé S, Balme B, Thomas L| title=Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population. | journal=Br J Dermatol | year= 2010 | volume= 162 | issue= 4 | pages= 765-71 | pmid=19922528 | doi=10.1111/j.1365-2133.2009.09594.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19922528  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Bony growth on midline of the [[hard palate]]
* [[Macule]]
*[[Nodular]] mass covered with normal [[mucosa]]
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Genetic predisposition]]
* Dark brown to black
**[[Autosomal dominant]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Raised [[Area|areas]]
*[[Physical exam]]
* [[Ulceration]]
*Types
* [[Bleeding]]
**[[Torus palatinus|Flat tori]]
| style="background: #F5F5F5; padding: 5px;" |
**[[Torus palatinus|Spindle tori]]
* Variable
**[[Torus palatinus|Nodular tori]]  
| style="background: #F5F5F5; padding: 5px;" |
**[[Torus palatinus|Lobular tori]]  
*[[Palmar]]
|
*[[Plantar]]
*[[Hard palate]]
* Subungual
|
*[[Mucosal]] surfaces
*More common in [[Asian]] and Inuit populations
| style="background: #F5F5F5; padding: 5px;" |
*Twice more common in [[females]]
* Parallel-ridge [[pattern]]
*Repeated [[trauma]] can cause [[bleeding]]
* Irregular [[diffuse]] [[pigmentation]]
*[[Surgery]] may be required in symptomatic
| style="background: #F5F5F5; padding: 5px;" |
|[[File:06-06-06palataltoria.jpg|Torus palatinus|400x400px]]
* Asymmetric [[proliferation]] of single [[melanocytes]] at dermoepidermal junction
| style="background: #F5F5F5; padding: 5px;" |
* Most common among dark [[Skin|skinned]] individuals
|-
|-
| colspan="4" |'''Diseases involving oral cavity and other organ systems'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Amelanotic melanoma]]'''<ref name="pmid23197217">{{cite journal| author=Steglich RB, Meotti CD, Ferreira MS, Lovatto L, de Carvalho AV, de Castro CG| title=Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma. | journal=An Bras Dermatol | year= 2012 | volume= 87 | issue= 6 | pages= 920-3 | pmid=23197217 | doi= | pmc=3699915 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23197217  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]] color
| style="background: #F5F5F5; padding: 5px;" |
* Slightly elevated [[Borderline|borders]]
| style="background: #F5F5F5; padding: 5px;" |
* Around 6 mm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed [[Area|areas]]
| style="background: #F5F5F5; padding: 5px;" |
* No [[melanin]] [[pigmentation]]
 
* Dotted [[vessels]]
* Linear irregular [[vessels]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Lesion|Lesions]] not [[Pigmented lesions|pigmented]] since they don't produce [[melanin]]
*
|-
|-
|[[Behçet's disease|Behcet's disease]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Nevus|Common nevus]]<ref name="pmid20137743">{{cite journal| author=Witt C, Krengel S| title=Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi). | journal=Dermatol Online J | year= 2010 | volume= 16 | issue= 1 | pages= 1 | pmid=20137743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20137743  }}</ref><ref name="pmid12753404">{{cite journal| author=Bauer J, Garbe C| title=Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. | journal=Pigment Cell Res | year= 2003 | volume= 16 | issue= 3 | pages= 297-306 | pmid=12753404 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12753404  }}</ref>'''
|
| style="background: #F5F5F5; padding: 5px;" |
*Painful [[mouth sores]]
* Dome-shaped  [[nodules]]
*[[Acne]] like skin lesions
| style="background: #F5F5F5; padding: 5px;" |
*Headache, [[fever]], poor [[balance]], [[disorientation]]
* [[Hypopigmentation|Hypopigmented]]
*[[Abdominal pain]], [[diarrhea]] or [[bleeding]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Uveitis]]
* Smooth [[Surface area|surface]]
*Joint [[swelling]] and joint [[pain]]
* Terminal [[hairs]] often present
*Genital [[sores]] wit [[pain]] and [[scaring]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Aneurysms]]
* 1 cm to > 20 cm
|
| style="background: #F5F5F5; padding: 5px;" |
*Over active [[immune system]]
* Sun-exposed [[Area|areas]] above the [[waist]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Physical examination]]
* Comma-shaped or curved [[vessels]]
|
* Structureless light brown [[background]]
*[[Mouth]]
* Residual brown thick circles around the [[hair follicles]]
*[[Genitals]]
| style="background: #F5F5F5; padding: 5px;" |
*[[GIT]]
*[[Multinucleated]] [[melanocytes]]
*[[Eye]]
* [[Melanocyte|Melanocytes]] diffusely [[Infiltration (medical)|infiltrate]] [[dermis]]
*[[Joints]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* Also called Miescher [[nevus]]
*[[Vascular system]]
*[[Brain]]
|
*[[Outbreaks]] of exaggerated [[inflammation]]
*Affects smaller [[blood vessels]]
|[[File:Behcet's syndrome 11a.jpg|Behcet's disease|400x400px]]
|-
|-
|[[Crohn's disease]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Blue nevus]]'''<ref name="pmid11224601">{{cite journal| author=Granter SR, McKee PH, Calonje E, Mihm  MC, Busam K| title=Melanoma associated with blue nevus and melanoma mimicking cellular blue nevus: a clinicopathologic study of 10 cases on the spectrum of so-called 'malignant blue nevus'. | journal=Am J Surg Pathol | year= 2001 | volume= 25 | issue= 3 | pages= 316-23 | pmid=11224601 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11224601  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Chronic, episodic [[diarrhea]] or [[constipation]]
* [[Macules|Macule]]
*[[Abdominal pain]]
* [[Papule]]
*[[Vomiting]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Weight loss]] or [[weight gain]]
* Blue
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Smoking]]
* Smooth
*[[Whites]] and [[European]] [[Jews]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Hormonal contraception]]
* Variable
*Diets high in microparticles, sweet, fatty or refined foods
| style="background: #F5F5F5; padding: 5px;" |
*Industrialized country
*[[Head]] and [[neck]],
|
*[[Dorsal]] aspect of the [[distal]] [[extremities]]
*Typical [[history]] and [[symptoms]]
*[[Sacral]] [[area]]
*[[Skip lesions]] on [[biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Anti saccharomyces cerevisiae antibodies|Anti-Saccharomyces cerevisiae antibodies (ASCA)]]
* Structureless blue [[pigmentation]]
*[[Anti-neutrophil cytoplasmic antibodies]] ([[ANCA]])
* Structureless blue and white or blue and brown on some occasions
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Eyes]]
*[[Proliferation]] of [[Dendritic cell|dendritic]], [[dermal]], [[melanin]]-producing [[melanocytes]]
*[[Joints]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* Also called [[Mongolian spot|Mongolian spots]]
|
*May lead to
**[[Obstruction]]s
**[[Abscess]]es
**Free [[perforation]]
**[[Hemorrhage]]
|
|-
|-
|[[Agranulocytosis]]
| rowspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Spitz nevus'''<ref name="pmid22082838">{{cite journal| author=Luo S, Sepehr A, Tsao H| title=Spitz nevi and other Spitzoid lesions part I. Background and diagnoses. | journal=J Am Acad Dermatol | year= 2011 | volume= 65 | issue= 6 | pages= 1073-84 | pmid=22082838 | doi=10.1016/j.jaad.2011.04.040 | pmc=3217183 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22082838  }}</ref><ref name="pmid21494025">{{cite journal| author=Argenziano G, Agozzino M, Bonifazi E, Broganelli P, Brunetti B, Ferrara G et al.| title=Natural evolution of Spitz nevi. | journal=Dermatology | year= 2011 | volume= 222 | issue= 3 | pages= 256-60 | pmid=21494025 | doi=10.1159/000326109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21494025  }}</ref>
|
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nonpigmented Spitz nevus'''
*[[Fever]] or [[chills]]
| style="background: #F5F5F5; padding: 5px;" |
*Frequent [[infections]]
* [[Nodule]]
*Unusual [[redness]], [[pain]], or [[swelling]] around a wound
| style="background: #F5F5F5; padding: 5px;" |
*Mouth [[ulcers]]
* Pink
*[[Abdominal pain]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Burning sensation when urinating]]
* Smooth
*[[Sore throat]]
| style="background: #F5F5F5; padding: 5px;" |
|
* < 1 cm
*[[Medications]]<ref name="PMID17142169">{{cite journal |author=Andrès E, Zimmer J, Affenberger S, Federici L, Alt M, Maloisel F. |title=Idiosyncratic drug-induced agranulocytosis: Update of an old disorder. |journal=Eur J Intern Med. |volume=17|issue=8 |pages=529-35 |year=2006|pmid 17142169|doi=|url=https://www.ncbi.nlm.nih.gov/pubmed/17142169}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[List of chemotherapeutic agents#Cytotoxic Chemotherapy|Cytotoxic chemotherapy]]
*[[Cheek]]
*[[Hematological malignancy|Hematologic malignancies]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Autoimmune disorders]]
* Coiled [[vessels]]
|
* White network over a pink to reddish [[background]]
*[[Neutropenia]] <100 cells per micro litre
| style="background: #F5F5F5; padding: 5px;" |
*[[Eosinopenia]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Basopenia]]
* In [[children]] and [[Adolescent|adolescents]]
|
*[[Oral cavity]]
*[[Skin]]
*[[GIT]]
*[[Urinary system]]
*[[Conjunctiva]]
|
*[[Immunocompromised|Immunocompromization]]
*Types
**[[Drug-induced]]
**[[Malignant]]
**[[Autoimmune]]
|
|-
|-
|[[Syphilis]]<ref> title="By Internet Archive Book Images [No restrictions], via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File:A_manual_of_syphilis_and_the_venereal_diseases%2C_(1900)_(14595882378).jpg"</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Reed-like Spitz'''<ref name="pmid27222770">{{cite journal| author=Pedrosa AF, Lopes JM, Azevedo F, Mota A| title=Spitz/Reed nevi: a review of clinical-dermatoscopic and histological correlation. | journal=Dermatol Pract Concept | year= 2016 | volume= 6 | issue= 2 | pages= 37-41 | pmid=27222770 | doi=10.5826/dpc.0602a07 | pmc=4866625 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27222770  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Chancre]]
*[[Papule]]
*Regional [[lymphadenopathy]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Heavily [[Pigmented lesions|pigmented]]
*[[Multiple sexual partners]]
| style="background: #F5F5F5; padding: 5px;" |
*Illicit [[drug use]]
* Smooth
*[[Unprotected sex]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Homosexual men|Men who have sex with men]]
* < 1 cm
*Residence in highly prevalent areas
| style="background: #F5F5F5; padding: 5px;" |
*[[Human Immunodeficiency Virus (HIV)|HIV]] infection
*[[Head]] and [[neck]]
*Presence of other [[STI]]s
* Upper and lower [[extremities]]
*Previous history of [[Sexually transmitted disease|STIs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Intravenous drug use]]
* Structureless black to gray center
|
* [[Hypopigmented area|Hypopigmented]] follicular openings
*[[Darkfield microscope|Darkfield microscopy]]
* Peripheral streaks
*Non [[Treponema|treponemal]] tests like [[VDRL]] and [[RPR test]])
* [[Pseudopods]]
*[[Treponema|Treponemal]] tests[[FTA-ABS|FTA-ABS tests]], (TP-PA) assay, [[Enzyme linked immunosorbent assay (ELISA)|enzyme immunoassays]], and [[Chemiluminescence|chemiluminescence immunoassays]])
* Globules
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Oral cavity]]
* Enlarged [[spindle]] [[melanocytes]] with polyangular form
*[[Penis]]
* "Ground glass" [[cytoplasm]]
*[[Cervix]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Labia]]
* Most commonly develops in [[children]], [[Adolescent|adolescents]], and young [[Adult|adults]].
*[[Anal canal]]
*[[Rectum ]]
*[[CNS]]
*[[Cardiovascular|CVS]]
|
*[[Primary syphilis]]
**[[Chancre]]
*[[Secondary syphilis]]
**[[Condyloma latum|Condylomata lata]]
*[[Latent syphilis]]
**[[Asymptomatic]]
*[[Tertiary syphilis]]
**[[Gumma|Gummas]]
**[[Neurosyphilis]]
|[[File:Syphilis orala.jpg|oral syphilis|400x400px]]
|-
|-
|[[Coxsackie virus]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Solar lentigo]]'''<ref name="pmid21175756">{{cite journal| author=Tanaka M, Sawada M, Kobayashi K| title=Key points in dermoscopic differentiation between lentigo maligna and solar lentigo. | journal=J Dermatol | year= 2011 | volume= 38 | issue= 1 | pages= 53-8 | pmid=21175756 | doi=10.1111/j.1346-8138.2010.01132.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21175756  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Fever]]
* Multiple spots
*[[Sores]] in the [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Rash]] with [[blisters]]
* Brown
*[[Aches]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Smooth
*[[Pregnancy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[immunodeficiency]]
* Around 5mm
|
| style="background: #F5F5F5; padding: 5px;" |
*[[History]] and [[Physical exam]]
* Sun-exposed [[Area|areas]]
*[[Swabbing|Throat swabs]]
| style="background: #F5F5F5; padding: 5px;" |
*Swabs from the lesion
* Faint [[Pigment|pigmented]] [[fingerprint]] structures
*[[Tzanck test]]
* Structureless [[pattern]]
|
* Light brown pseudonetwork with well-defined [[Borderline|borders]] and a "moth-eaten" edge
*[[Oral cavity]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* '''↑''' [[melanin]] deposition in [[Keratinocyte|keratinocytes]]  
|
* '''↑''' linear arrangement of [[melanocytes]] at the [[Epidermal junctions|dermal-epidermal junction]]
*Symptomatic treatment
| style="background: #F5F5F5; padding: 5px;" |
|[[File:Hand foot mouth disease 07a.jpg|Hand-foot-and-mouth disease|400x400px]]
* Associated with UV exposure and skin aging
|-
|-
|[[Chickenpox|Chicken pox]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Sebaceous hyperplasia]]'''<ref name="pmid24520522">{{cite journal| author=Sato T, Tanaka M| title=Linear sebaceous hyperplasia on the chest. | journal=Dermatol Pract Concept | year= 2014 | volume= 4 | issue= 1 | pages= 93-5 | pmid=24520522 | doi=10.5826/dpc.0401a16 | pmc=3919849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24520522  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Conjunctival]] symptoms
* [[Papule]]
*[[Catarrhal]] symptoms
| style="background: #F5F5F5; padding: 5px;" |
*Characteristic [[spots]] on the trunk appearing in two or three waves
*[[Skin]]-colored to brownish
*[[Itching]]
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Umbilicated lesions|Umbilicated]]
*[[Pregnancy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Premature infants]] born to susceptible mothers
* 2 - 6 mm
*All [[infants]] born at less than 28 weeks [[gestation]] or who weigh ≤1000 grams
| style="background: #F5F5F5; padding: 5px;" |
*[[Immunocompromised]]
* [[Forehead]]
|
* [[Nose]]
*[[History]] and [[physical exam]]
* [[Cheeks]]  
*[[PCR]] to detect [[VZV]] in [[skin lesions]] ([[vesicles]], [[scabs]], [[Maculopapular|maculopapular lesions]])
| style="background: #F5F5F5; padding: 5px;" |
|
* Structureless yellow to whitish center surrounded by short linear "crown [[vessels]]"
*[[Oral cavity]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Usually in middle-aged or older [[patients]]
*[[Sodium bicarbonate]] in baths or [[antihistamines]] for [[itching]]
*[[Paracetamol]] ([[acetaminophen]]) for [[fever]]
*[[Prednisolone]] is [[contraindicated]]
|[[File:Chickenpox18a.jpg|Chickenpox|400x400px]]
|-
|-
|[[Measles]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Lichen planus-like keratosis'''<ref name="pmid16148406">{{cite journal| author=Morgan MB, Stevens GL, Switlyk S| title=Benign lichenoid keratosis: a clinical and pathologic reappraisal of 1040 cases. | journal=Am J Dermatopathol | year= 2005 | volume= 27 | issue= 5 | pages= 387-92 | pmid=16148406 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16148406 }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Fever]]
* [[Papule]]
*[[Rash]]
* [[Plaques|Plaque]]
*[[Cough]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Coryza]] (runny nose)
* Gray to brown
*[[Conjunctivitis]] (pink eye)
| style="background: #F5F5F5; padding: 5px;" |
*[[Malaise]]
* Prominent
*[[Koplick spots]] in mouth
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*Unvaccinated individuals<ref name="pmid11135778">{{cite journal| author=Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE| title=Individual and community risks of measles and pertussis associated with personal exemptions to immunization. | journal=JAMA | year= 2000 | volume= 284 | issue= 24 | pages= 3145-50 | pmid=11135778 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11135778  }} </ref><ref name="pmid9009400">{{cite journal| author=Ratnam S, West R, Gadag V, Williams B, Oates E| title=Immunity against measles in school-aged children: implications for measles revaccination strategies. | journal=Can J Public Health | year= 1996 | volume= 87 | issue= 6 | pages= 407-10 | pmid=9009400 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9009400 }} </ref>
| style="background: #F5F5F5; padding: 5px;" |
*Crowded and/or unsanitary conditions
* [[Upper trunk]]
*Traveling to less developed and developing countries
| style="background: #F5F5F5; padding: 5px;" |
*Immunocompromized
* Shows a coarse or fine, gray to blue, granular [[pigmentation]]
*Winter and [[spring]] seasons
*[[Diffuse]] brownish gray [[granules]]
*Born after 1956 and never fully vaccinated
| style="background: #F5F5F5; padding: 5px;" |
*Health care workers
* [[Hypergranulosis]]
|
* [[Epidermal]] [[hyperplasia]]
*[[History]] and [[examination]]
*[[Superficial]] bandlike  [[Infiltration (medical)|infiltrate]]
*[[PCR]] for [[Measles]]-specific [[IgM|IgM antibody]]
* Melanophages
*[[PCR]] for [[Measles]] [[RNA]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Appearance depends on stage of evolution
*[[Oral cavity]]
|}
*[[Skin]]
*[[Respiratory tract]]
*[[Eyes]]
*[[Throat]]
|
*Caused by [[Morbillivirus]]
*Primary site of infection is the [[respiratory epithelium]] of the [[nasopharynx]]
*Transmitted in [[respiratory secretions]], via [[aerosol droplets]] containing [[Virus|virus particles]]
|[[File:Koplikspot1a.jpg|Koplick spots (Measles)|400x400px]]
|}</small></small>
</div>


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Disease]]
[[Category:Dermatology]]
[[Category:Types of cancer]]
[[Category:Otolaryngology]]
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Latest revision as of 16:52, 27 August 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2] Homa Najafi, M.D.[3]

Overview

Squamous cell carcinoma should be differentiated from melanoma and basal cell carcinoma. It accounts for 20% of all non-melanomatous tumors and is fairly invasive contrary to its counterpart, basal cell carcinoma. Squamous cell carcinoma typically presents as a non-healing ulcer or growth on a sun-exposed area of the skin.

Differentiating Squamous cell carcinoma from other Diseases

A few conditions that mimic Squamous cell carcinoma of the skin include the following:

Diseases Skin examination Diagnosis Additional findings
Type Color Texture Size Distribution Dermoscopic Findings Histopathology
Cutaneous squamous cell carcinoma[1] SCC in situ (Bowen's disease)
  • Scaly
  • Variable
  • Fair-skinned individuals: sun-exposed areas
Invasive squamous cell carcinoma
  • Skin colored
  • 0.5 to 1.5 cm
  • Fair-skinned individuals: sun-exposed areas
  • In black individuals: legs, anus, and areas of chronic inflammation
Keratoacanthoma[2]
  • 1 to 2.5 cm
Dermatofibroma[3][4]
  • Firm
  • 0.3- 1 cm
dermatofibrosarcoma protuberans[5][6]
  • Firm
  • 1-5 cm
Kaposi sarcoma[7][8]
  • Red/violaceous
  • Smooth
  • Rainbow pattern
  • scaly surface
  • Small brown globules
Merkel cell carcinoma[9]
  • Shiny
  • Flesh-colored or bluish-red
  • Firm
  • < 1 cm
  • Sun-exposed areas
  • Older individuals with light skin tones
  • Rapidly growing
Basal cell carcinoma[10] Nodular basal cell carcinoma
  • Flesh-colored
  • Variable
  • Focused, bright red, and branching arborizing vessels
  • Loosely arranged blue-gray dots
Superficial basal cell carcinoma
  • Scaly
  • 1 to > 10 cm
  • Sun-exposed areas
  • Head (cheek and nose)
  • Trunk
  • Large, hyperchromatic, oval nuclei
  • Minimal cytoplasm
  • Small basaloid nodules
Sclerosing basal cell carcinoma (morpheaform)[11]
  • Variable
  • Sun-exposed areas
Prurigo nodules[12][13]
  • Firm
  • Variable
Melanoma[14] Melanoma in situ (Lentigo Maligna)[15]
  • Variable (from light to dark brown, black, pink, red, or white)
  • Smooth
  • Around 1 cm
  • Asymmetric, pigmented follicular openings
  • Gray angulated lines
  • Gray areas, dots, and globules
  • Circle within a circle
Lentigo maligna melanoma[16]
  • Brown/tan
  • Variable
  • Asymmetric, pigmented follicular openings
  • Gray angulated lines
  • Gray areas, dots, and globules
  • Circle within a circle
  • Usually in older individuals
Superficial spreading melanoma[17]
  • Variably pigmented (red, blue, black, gray, and white)
  • Thin
  • 1 mm to > 1 cm
  • Asymmetry of shape
  • > 2 colors
  • Asymmetry of structures
Nodular melanoma[18][19]
  • Dark color
  • 6mm to > 1 cm
  • Two-thirds arise in normal skin, the rest in existing moles
  • Rapidly enlarging
Acral lentiginous melanoma[20]
  • Dark brown to black
  • Variable
  • Most common among dark skinned individuals
Amelanotic melanoma[21]
  • Around 6 mm
Common nevus[22][23]
  • 1 cm to > 20 cm
  • Also called Miescher nevus
Blue nevus[24]
  • Blue
  • Smooth
  • Variable
  • Structureless blue pigmentation
  • Structureless blue and white or blue and brown on some occasions
Spitz nevus[25][26] Nonpigmented Spitz nevus
  • Pink
  • Smooth
  • < 1 cm
Reed-like Spitz[27]
  • Smooth
  • < 1 cm
Solar lentigo[28]
  • Multiple spots
  • Brown
  • Smooth
  • Around 5mm
  • Associated with UV exposure and skin aging
Sebaceous hyperplasia[29]
  • Skin-colored to brownish
  • 2 - 6 mm
  • Structureless yellow to whitish center surrounded by short linear "crown vessels"
  • Usually in middle-aged or older patients
Lichen planus-like keratosis[30]
  • Gray to brown
  • Prominent
  • Variable
  • Appearance depends on stage of evolution

References

  1. Petter G, Haustein UF (2000). "Histologic subtyping and malignancy assessment of cutaneous squamous cell carcinoma". Dermatol Surg. 26 (6): 521–30. PMID 10848931.
  2. Kwiek B, Schwartz RA (2016). "Keratoacanthoma (KA): An update and review". J Am Acad Dermatol. 74 (6): 1220–33. doi:10.1016/j.jaad.2015.11.033. PMID 26853179.
  3. Lee, MiWoo; Lee, WooJin; Jung, JoonMin; Won, ChongHyun; Chang, SungEun; Choi, JeeHo; Moon, KeeChan (2015). "Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma". Indian Journal of Dermatology, Venereology, and Leprology. 81 (3): 263. doi:10.4103/0378-6323.154795. ISSN 0378-6323.
  4. Mentzel, Thomas; Wiesner, Thomas; Cerroni, Lorenzo; Hantschke, Markus; Kutzner, Heinz; Rütten, Arno; Häberle, Michael; Bisceglia, Michele; Chibon, Frederic; Coindre, Jean-Michel (2012). "Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases". Modern Pathology. 26 (2): 256–267. doi:10.1038/modpathol.2012.157. ISSN 0893-3952.
  5. Bernard, J.; Poulalhon, N.; Argenziano, G.; Debarbieux, S.; Dalle, S.; Thomas, L. (2013). "Dermoscopy of dermatofibrosarcoma protuberans: a study of 15 cases". British Journal of Dermatology. 169 (1): 85–90. doi:10.1111/bjd.12318. ISSN 0007-0963.
  6. Acosta, Alvaro E.; Vélez, Catalina Santa (2017). "Dermatofibrosarcoma Protuberans". Current Treatment Options in Oncology. 18 (9). doi:10.1007/s11864-017-0498-5. ISSN 1527-2729.
  7. Cesarman, Ethel; Damania, Blossom; Krown, Susan E.; Martin, Jeffrey; Bower, Mark; Whitby, Denise (2019). "Kaposi sarcoma". Nature Reviews Disease Primers. 5 (1). doi:10.1038/s41572-019-0060-9. ISSN 2056-676X.
  8. Hu, S C-S; Ke, C-L K; Lee, C-H; Wu, C-S; Chen, G-S; Cheng, S-T (2009). "Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured 'rainbow pattern'". Journal of the European Academy of Dermatology and Venereology. 23 (10): 1128–1132. doi:10.1111/j.1468-3083.2009.03239.x. ISSN 0926-9959.
  9. Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE (2010). "Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study". J Cutan Pathol. 37 (1): 20–7. doi:10.1111/j.1600-0560.2009.01370.x. PMID 19638070.
  10. Wolberink EA, Pasch MC, Zeiler M, van Erp PE, Gerritsen MJ (2013). "High discordance between punch biopsy and excision in establishing basal cell carcinoma subtype: analysis of 500 cases". J Eur Acad Dermatol Venereol. 27 (8): 985–9. doi:10.1111/j.1468-3083.2012.04628.x. PMID 22759209.
  11. Wrone DA, Swetter SM, Egbert BM, Smoller BR, Khavari PA (1996). "Increased proportion of aggressive-growth basal cell carcinoma in the Veterans Affairs population of Palo Alto, California". J Am Acad Dermatol. 35 (6): 907–10. PMID 8959949.
  12. Errichetti E, Piccirillo A, Stinco G (2015). "Dermoscopy of prurigo nodularis". J Dermatol. 42 (6): 632–4. doi:10.1111/1346-8138.12844. PMID 25808786.
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