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*Dermal patologicdr. Muhartono, M.kes, Sp.PA
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*Benign epithelial tumorsSeborrheic keratosesFibroepithelial
tumor (skin tag acrochordon, soft fibroma, fibroma
molle)KeratoacanthomaAppendage tumor
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*1. Seborrheic keratosesIns: common, benign, pigmented, basal
keratinocytic proliferation,
single/multipleAge:middle/older/adultPredileksi;trunkIns: male >
femaleMac: round, flat, coin plaqmm to cm dark brown,
colortan-black pigmented SK confused melanomaMic:the number of
epidermal basal cells is greately; acantotic; pseudohorny cysts
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*2. Fibroepithelial tumorIns: most common of thew cutaneus
tumorAge:midle/olderPredileksi: neck, trunk, face, Intertrigo
areasMac:soft flesh color, small stalkMic: fibrovascular cores
covered by squamous epithelBiologically : associated: DM,
intestinal polyposispregnancy
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*3. KeratoacanthomaAge: >50y of age caucasiansPredilecti: sun
exposed skin cheeks nose, ears, handsMac: flesh colored, dome
shaped with central keratinplugcrater, 1cm to sev cmMic central
keratin filled crater surounded with proliferating epithelial
cellsBerpotensi menjadi ganasepidermoid karsinoma
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*Dome shaped lesion with central crater filled with
keratinlaki:perempuan=4:1
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*4. Appendage tumorCylindromas: lesi:nodules on forehead and
scalp.appear early in lifeMic:appocrine differentiationSyringoma:
lesion of eccrine differentiationLesi occur as multiple on the
lower eye lidsTrichoepithelioam: hair follikel differentiationLesi
occur on the face,scalp,neck and upper trunk
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*Premalignant epidermal tumorActinic keratosis (solar
keratosis)prior developt malignancy!epidermisAc keratosis
progresive dysplasia sun exposureKeratin , other causes: radiation,
hydrocarbon, arsens*Mutasi p53
- *Actinic keratosisMac: diameter lesi
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*Bowens diseaseIndolent, scaly, erytematous plaquesCarcinoma
insituMic: atypical changes
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*Malignant tumor1. Squamous cell carcinoma Most common typeSun
exposed sites, older peopleMale. femalePredisposisi fact: sun
light, chronic ulcers, old burns scar, industrial carcinogens (tars
& oils), arsen, radiationMucosa (oral cav); tobacco
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*1. Squamous cell carcinoma Mac: well demarcated, red scalling
plaqs, or nodular, hyperkeratotic ulcerationMucosal leukoplakiaMic:
epidermal atypia,Well diufferentiated (with prominent
keratinisasition ) to highly anaplastic with necrosis and abortive
keratinisation
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*2. Basal cell carcinomaCommon, slow growing, very rare
metastaseChronic sun exposure lightly pigmented peopleAge: middle
>40yPredileksi; face,head not occur in mucosal surfacePattern
growth: multifoka l(extended)Nodular (down ward)Mic: like normal
basal layer of the epidermis(palisading)basal cell
proliferating
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*Disorder of pigmentationLentigo dont involve proliferation of
melanocyt celIns: all ages (also infancy & childhood)All sexNo
racial predilectionCause; unknownMac: can involve skin &mucosa
membrane
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*LentigoMac: 5-10 mm,oval,brown maculesMic : hyperplasia
melanocytichyperpigmented basal cell layer in the epidewrmis
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*Pigmented naevusMac: congg/acquired1cm, uniform
pigmentedPapules & well defined, rounded bordersDark brownMic:
junctional naevus:naevus cell along the dermoepidermal
junctionIntradermal naevusCompound naevus: when the melanocyt nest
within both dermis & junctional
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*Dysplastic naevusHave characteristic featuresMic : compound
naevus with architecture and cytologic evidence of abnormal growth
(atypia)This type is precursor of malignant melanoma.
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*Malignant melanomaCommon (relative)deadlySun light important
role; hereditery?Lightly pigmented individuhigher risk, than darkly
pigmented (tanning fad?)Predisp: sunlight pre existing naevus: eg
dysplastic naevusMic: melanoma cells (individual) (>naevus
cell)Large nuclei, irregular chromatin, prominent nuclear
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*Pemeriksaan klinis A=asimetri; B=border; C=color; D=diameter;
E=levationJenis: superficial spreading melanoma; nodular melanoma;
acral lentigo melanoma
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*Clark levellary dermisI: intraepidermalII: in the papil100%III:
papilary-reticularis88%IV: reticularis66%V: subcutaneus fat15%
