00:02
With that,
let's do a quick review.
00:04
Again, I'll ask some questions.
00:06
I'll pause after each question
to allow you to reflect on the answer
and then we'll go
and give the answers.
00:13
First one, a 52-year-old,
fair-skinned woman
presents with a skin lesion
on her forehead.
00:19
She has multiple rough,
sandpapery patches
on the forehead
and dorsum of the hands.
00:25
One of those scaly patches
on the forehead
is associated with
a firm hyperkeratotic papule.
00:32
What's the diagnosis?
Great.
The answer is there are
multiple actinic keratoses
shown here.
00:45
Again, those rough,
sandpapery patches on the forehead
and the dorsum of the hands,
classic location for those
with a single squamous cell
carcinoma in situ lesion
and that's that lesion that has
that firm hyperkeratotic papule.
00:59
This is something which
has a 3% chance
of progressing to
squamous cell carcinoma
if we don't treat it
potentially with 5-FU
or imiquimod cream
or cryotherapy.
01:12
Next question.
01:13
All of the following is true
of a keratoacanthoma except:
Number one,
grows rapidly and may resolve spontaneously.
01:29
Well, we know
that's true.
01:30
That's one of the classic features
of a keratoacanthoma.
01:33
Number two,
it is considered a pseudocancer
or a low-grade malignancy.
01:39
That's also true.
01:39
The nomenclature has changed
and gone back and forth
but ultimately,
it's clearly not an aggressive cancer.
01:46
Number three,
it is nodular or dome-shaped.
01:49
That's also true.
01:50
Oftentimes, it will have that
central hyperkeratotic plug that I described.
01:55
Number four,
most commonly appears on the face.
01:58
That's also true.
01:59
Ninety percent of the time,
you'll see them there.
02:02
Five, most important
risk factor is HIV.
02:06
That's not true.
02:07
HIV is not really linked
with keratoacanthomas at all.
02:10
The answer in this case
is number five.
02:12
Okay, next question.
02:14
A 61-year-old Caucasian man
presents with a flesh-colored papular lesion
with multiple telangiectasias
and rolled borders on his left cheek.
02:25
What's the diagnosis?
Great.
I want to make sure you come up with
the right subtype
here as well
and it's a
basal cell carcinoma
specifically, the nodular subtype,
similar to what our prior patient had.
02:46
One last question.
02:48
All of the following is true
of a seborrheic keratosis except:
Great. Number one,
they're often hereditary and increase with age.
03:04
That's true.
03:06
Number two,
they occur mainly in sun-exposed areas.
03:10
I don't think that's true.
03:12
They're oftentimes in areas
like the chest, the upper back
even on the axilla,
all over the place
but they don't tend to go with
a predilection for sun-exposed areas.
03:23
Just to round things
out though,
number three,
described as waxy and stuck-on.
03:28
That's a classic
sort of descriptive terminology
used to describe
seborrheic keratosis
so that part is true.
03:33
Lastly and importantly,
the lesions are almost universally benign
and that's true as well.
03:39
The answer to this question
is number two.
03:41
They don't really occur
in sun-exposed areas
or at least they don't have
a predilection for those areas.
03:47
With that,
I think we've come to the end.