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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="5" |'''Physical exam'''
! colspan="3" rowspan="2" |Para-clinical findings
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin Examination
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnosis
|-
! 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
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Unique features
|-
| 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;" |
* Scaly patch or plaque
| style="background: #F5F5F5; padding: 5px;" |
* Erythematous
* Skin colored
| style="background: #F5F5F5; padding: 5px;" |
* Scaly
| 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;" |
| 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.
| 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
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;" |
* Indurated or firm
 
* Hyperkeratotic
| style="background: #F5F5F5; padding: 5px;" |
* 0.5 to 1.5 cm
| 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
|-
| 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;" |
* 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;" |White circles, keratin, blood spots, and white structureless zones
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |a history of rapid growth within weeks favors this diagnosis
|-
| 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;" |
* 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;" |Milky red areas; linear, irregular vessels; and polymorphous vessels
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |Blue-red, dome-shaped nodule
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Basal cell carcinoma'''
| 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;" |Typically presents on the face
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Ulceration is frequent, and the term "rodent ulcer" refers to these ulcerated nodular BCCs
* May have a "rolled" border, where the periphery is more raised than the middle.
|-
| 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;" |
* 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;" |
| 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;" |
* Extensor surfaces of the arms and legs and on the trunk
 
* Upper back, abdomen, and sacrum
| style="background: #F5F5F5; padding: 5px;" |
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* Nodules range in number from few to hundreds
 
* upper midback area is usually spared
* Worsened by heat, sweating, or irritation from clothing
|-
| 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;" |
| 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;" |
|-
| 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;" |
* Head and neck,
* Dorsal aspect of the distal extremities
* Sacral area
| style="background: #F5F5F5; padding: 5px;" |
* Structureless blue pigmentation
* Structureless blue and white or blue and brown on some occasions
| 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;" |
* Nodules
| style="background: #F5F5F5; padding: 5px;" |
* Pink
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Cheek
| style="background: #F5F5F5; padding: 5px;" |
* Coiled vessels
* White network over a pink to reddish background
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* 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;" |
* Papule
| style="background: #F5F5F5; padding: 5px;" |
* Heavily pigmented
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Structureless black to gray center
* Hypopigmented follicular openings
* Peripheral streaks
* Pseudopods
* Globules
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* 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;" |
* Multiple spots
| style="background: #F5F5F5; padding: 5px;" |
* Brown
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Around 5mm
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Faint pigmented fingerprint structures
* Structureless pattern
* Light brown pseudonetwork with well-defined borders and a "moth-eaten" edge
| style="background: #F5F5F5; padding: 5px;" |
* '''↑''' melanin deposition in keratinocytes
* '''↑''' linear arrangement of melanocytes at the dermoepidermal junction.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Associated with UV exposure and skin aging
|-
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Melanoma'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Melanoma in situ''' (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;" |
|-
| 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;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Superficial spreading 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;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nodular 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;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Acral lentiginous 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;" |Cells proliferate downwards through the skin (vertical growth)
| style="background: #F5F5F5; padding: 5px;" |
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Do not make melanin, so lesions are not pigmented
*
|}
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.
 
<references />

Latest revision as of 15:09, 26 March 2021


Cardiac surgery[1]

  1. ↑ Aya HD, Cecconi M, Hamilton M, Rhodes A (2013). "Goal-directed therapy in cardiac surgery: a systematic review and meta-analysis". Br J Anaesth. 110 (4): 510–7. doi:10.1093/bja/aet020. PMID 23447502.
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