NCLEX Memory Hints: Skin Lesions

Dermatology is a challenging field because of all the different types of lesions and conditions which may develop. Often, a biopsy is needed for a definitive diagnosis. Repeated sun exposure is a risk factor for actinic keratosis and basal and squamous cell cancer.

Nevi

One of the most common growths which can be present at birth or develop over the lifetime. They can become dysplastic and have atypical features and growth pattern between the spectrum of a benign mole to melanoma but not be cancerous. Dysplastic moles can be removed with laser.

Seborrheic keratosis

Benign skin growth that originates in the keratinocytes. They tend to be darker in color and occur later in life and may be mistaken for cancerous lesions. Treatment is local incision.

Actinic keratosis

Precancerous lesions which present as a yellow or brown scale, primarily on sun exposed area and increase with aging. They are surgically removed or may be treated by freezing the area. 

Basal cell

Type of cancer that is confined to a particular area but can expand and cause ulcers and damage to the skin and tissues. It does not spread to other areas. Presents as a pearly lesion with a center crater and rolled waxy borders. They are surgically removed.

Squamous cell

Not as common as basal cell but more serious because it is likely to metastasize to the lymph nodes. It is usually not life-threatening, though it can be aggressive. Untreated, it can be lethal. Presents as a firm, nodular lesion that is topped with a crust and has an area of ulceration that often bleeds. 

Melanoma

Most dangerous type of skin cancer which readily spreads through invasion of the lymphatic system and blood vessels. It can spread to the brain, lung, bone, liver, and skin. It can occur at any age, including young people. Prognosis is related to the thickness of the tumor at the time of diagnosis. Presents as a red, white, or blue toned lesion. 

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