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Actinic keratosis
25%
1/4
Basal cell carcinoma
Melanoma
50%
2/4
Squamous cell carcinoma
0%
0/4
Xerosis
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This patient is presenting with an expanding crusting/ulcerated skin lesion which is concerning for squamous cell carcinoma Squamous cell carcinoma (SCC) is common in the elderly and arises from epidermal cells undergoing keratinization. Sunlight exposure is the most important risk factor, along with chronic skin damage, and immunosuppressive therapy. Actinic keratosis is a pre-malignant skin lesion that results from sun exposure and may progress to SCC. SCC has an excellent prognosis in lesions without lymph node involvement that is completely surgically excised. Any patient with a suspected SCC should undergo a biopsy followed by surgical excision. Figure A is the physical exam finding of squamous cell carcinoma with an irregular, ulcerated/crusting skin lesion on the patient's head (a sun exposed area). Incorrect Answers: Answer 1: Actinic keratosis is a pre-malignant skin lesion that presents with skin crusting/flaking. It is not associated with an enlarging/ulcerated lesion. Answer 2: Basal cell carcinoma presents with a pearly/shiny, telangiectatic papule. Answer 3: Melanoma presents with a hyperpigmented skin lesion with irregular borders and irregular pigmentation. Answer 5: Xerosis or dry skin presents with crusting/scaling and dry skin that is usually diffuse and can be treated with emollients. Bullet Summary: Squamous cell carcinoma presents with an irregular, ulcerated, crusted skin lesion.
2.9
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