Chapter·PathologyDermatopathology

Premalignant skin lesionsDownloads

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1

A 60-year-old white man with a past medical history significant for hypertension and hyperlipidemia presents to his family medicine physician with concerns about a 'spot' on his ear. He has been a construction worker for 35 years and spends most of his time outside. His family history is insignificant. On physical examination, there is a dark lesion on his left ear. The patient states that he has always had a mole in this location but that it has recently become much larger. A review of systems is otherwise negative. Which of the following lesion characteristics would be MOST reassuring among the given options?

ASingle, dark color

BChanging over time

CLesion asymmetry

DIrregular, indistinct borders

2

A 57-year-old post-menopausal woman comes to the physician because of intermittent, bloody post-coital vaginal discharge for the past month. She does not have pain with intercourse. Eleven years ago, she had LSIL on a routine Pap smear and testing for high-risk HPV strains was positive. Colposcopy showed CIN 1. She has not returned for follow-up Pap smears since then. She is sexually active with her husband only, and they do not use condoms. She has smoked half a pack of cigarettes per day for the past 25 years and does not drink alcohol. On speculum exam, a 1.4 cm, erythematous exophytic mass with ulceration is noted on the posterior wall of the upper third of the vagina. Which of the following is the most probable histopathology of this mass?

ABasal cell carcinoma

BMelanoma

CAdenocarcinoma

DSarcoma botryoides

ESquamous cell carcinoma

3

A 52-year-old Caucasian man presents to the clinic for evaluation of a mole on his back that he finds concerning. He states that his wife noticed the lesion and believes that it has been getting larger. On inspection, the lesion is 10 mm in diameter with irregular borders. A biopsy is performed. Pathology reveals abnormal melanocytes forming nests at the dermo-epidermal junction and discohesive cell growth into the epidermis. What is the most likely diagnosis?

ADesmoplastic melanoma

BLentigo maligna melanoma

CSuperficial spreading melanoma

DNodular melanoma

EAcral lentiginous melanoma

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