malignant skin tumers

1. some times u may notice activating BRAF or RAS
2. STABLE in size and shape
3. microscopic : nests or cords of uniform nevus cells WITH or WITHOUT PIGMENT

1. AD familial or sporadic
2. consider as a marker for future melanoma

1. AD familial or sporadic
2. activated BRAF and RAS
3. ON NON EXPOSED SKIN
4. large and multiple
5. compound and dermal fibrosis around proliferating cells

1. DEPTH OF INVASION
2. METASTASIZE to any part by LYMPH and BLOOD
3. MICRO
   1. LOSS OF MATURATION
   2. LOS OF NESTING PATTERN

Anmerkungen:

• grossly : ulcer , papule or pigmented  basosquamous and sclerosing types associated with worse prognosisMAY BE PIGMENTED SO ENTER THE DIFFRENTIAL DIAGNOSIS OF MELANOMA SUPER FACIAL OR NUDULAR I COUD BE ULCER (rodent ulcer)commenst  type ( group)infiltrative and may destroy the whole face paralysis of facial nerve  

1. over 40s
   1. never affect mucosal

      Anmerkungen:

      • their is no basal layer 
      1. metastasis is more in gorlin which is multiple
2. IMMUNOSUPPRESION
   1. PTCH حقير
   2. P53
3. microscopicaly

   Anmerkungen:

   • CLEFT : is very important feature  nest of epidermal cells that resemble basal cells  some times we will have squamous like cells which is basosquamous : more aggresive and tend to recurrence and rearly metastasize   

Anmerkungen:

• squamous may be affected (oral especially in people with pad teeth )  

1. may develop from actinic keratosis
2. also develop from marjolin ulcer
3. HPV 16 , 18
4. xeroderma pigmentosum
5. sites : dorsum of hand, ears , face and mucosal surfaces
6. grossly : small scaly lesion which ulcerate later
7. microscopic : CA in situ ( full thickness of epidermis)

   Anmerkungen:

   • invasive carcinoma  variable degrees of keratenization ( the more kra. the more it is well diffrentiated )
   1. more tend to infiltrate and metastasize locally to regional lymph nodes