gwt-lesi ganas kulit kulkel.ppt
TRANSCRIPT
![Page 1: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/1.jpg)
LESI GANAS KULIT
FAKULTAS KEDOKTERANUNIVERSITAS METHODIST INDONESIA
![Page 2: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/2.jpg)
MELANOMA RADIAL GROWTH PHASE MELANOMA
(SUPERFISIAL SPREADING) the very beginning of malignant melanoma.
VERTICAL GROWTH PHASE MELANOMA
![Page 3: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/3.jpg)
RADIAL GROWTH PHASE MELANOMA (SUPERFISIAL SPREADING)
![Page 4: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/4.jpg)
PATHOGENESIS
Arise from neoplastic transformation of normally epidermis melanocytes proliferation superficial spreading invasive metast to lymphatic/hematogen
![Page 5: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/5.jpg)
CLINICAL FEATURE
Change in a mole developed Itching Increase size Lesion darkening
![Page 6: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/6.jpg)
MACROSCOPICALLY Early melanoma radial growth phase Slightly elevated & palpable border Variably colored some parts unusually
black / dark brown Lighter brown shade mingled with pink &
light blue tints Entire lesion purely dark brown occasionaly
![Page 7: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/7.jpg)
MICROSCOPICALLY Large epitheloid melanocytes dispersed in
nests / as individual cells entire thickness of epidermis
Brisk lymphocytis response May be only in epidermis (in situ) Focal extension papillary dermis is rule Grow in all directions Dermal mitoses (-)
![Page 8: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/8.jpg)
VERTICAL GROWTH PHASE MELANOMA
1-2 years of radial growth character of growth change focally
Focal mitotic activity (+) Grow as spheroidal nodules Expand rapidly in surrounding papillary
dermis Net direction growth perpendicular
![Page 9: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/9.jpg)
CHARACTERISTIC VERTICAL GROWTH PHASE
Cells differ in appearance little / no pigment ; radial : melanotic
Cellular aggregate characteristic vertical Larger cluster cells extend into lower half
reticular dermis Host cellular immune response (-)
![Page 10: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/10.jpg)
TYPES :
1. Metastatic Melanoma
2. Nodular Melanoma
- Rarest form
- Radial growth phase (-)
- Malignant character expressed in initial
lesion
![Page 11: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/11.jpg)
3. Lentigo Malignant Melanoma
- Usually in fair, elderly & whites
= Hutchinson’s freckle
4. Acral Lentiginous Melanoma
- Most common form dark-skinned
- Limited to palm, sole & subungual region
![Page 12: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/12.jpg)
PROGNOSIS
1. Type of melanoma Lentigo better
2. Depth of invasion Breslow’s thickness
3. Level of invasion Clark
4. Number of inflammatory cells
5. Clinical Stage
6. Sex : female better
7. Regression (+) poorer prognosis
![Page 13: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/13.jpg)
Lentigo maligna melanoma
![Page 14: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/14.jpg)
Lentigo maligna
![Page 15: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/15.jpg)
Lentigo maligna melanoma
![Page 16: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/16.jpg)
Superficial spreading melanoma
![Page 17: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/17.jpg)
Superficial spreading melanoma
![Page 18: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/18.jpg)
Superficial spreading melanoma
![Page 19: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/19.jpg)
Acral lentigo melanoma
![Page 20: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/20.jpg)
Acral lentigo melanoma
![Page 21: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/21.jpg)
Acral lentigo melanoma
![Page 22: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/22.jpg)
Acral lentigo melanoma
![Page 23: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/23.jpg)
Nodular melanoma
![Page 24: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/24.jpg)
Nodular melanoma
![Page 25: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/25.jpg)
Nodular melanoma
![Page 26: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/26.jpg)
SKIN CARCINOMA
1. BASAL CELL CARCINOMA
2. SQUAMOUS CELL CARCINOMA
![Page 27: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/27.jpg)
BASAL CELL CARCINOMA
Most common pale skin Locally aggressive Rare metastases
![Page 28: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/28.jpg)
PATHOGENESIS Develop on sun damaged skin fair skin &
freckles Fingers & dorsum of hand Derived from pluripoten cells of basal layer Differentiated along skin appendage lines
![Page 29: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/29.jpg)
CLINICAL FEATURE Pearly papule prototypic lesion Rodent ulcer small crater in center of pearl Superficial BCC scaly, red, sharply
demarcated plaque Morphea-like BCC ill defined, pale, firm, scar-
like tumor Pigmented BCC grossly resembles malignant
melanoma
![Page 30: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/30.jpg)
PATHOLOGY Multiple nests of deeply basophilic epithelial cells
attached to epidermis protude into papillary dermis
Central part compose of closely packed keratinocytes
Nuclei deeply basophilic surround by small rim cytoplasm
Periphery nests composed of an organized layer of polarized, columnar keratinocytes
![Page 31: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/31.jpg)
![Page 32: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/32.jpg)
![Page 33: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/33.jpg)
![Page 34: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/34.jpg)
![Page 35: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/35.jpg)
![Page 36: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/36.jpg)
![Page 37: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/37.jpg)
![Page 38: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/38.jpg)
![Page 39: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/39.jpg)
![Page 40: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/40.jpg)
![Page 41: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/41.jpg)
![Page 42: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/42.jpg)
![Page 43: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/43.jpg)
![Page 44: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/44.jpg)
SQUAMOUS CELL CARCINOMA
Cancer of epidermis whose cells resemble differentiated keratinocytes
Incidence : second only to BCC Caused by UV, radiation, chemical
carcinogens, HPV Often originates in actinic keratoses
![Page 45: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/45.jpg)
PATHOGENESIS
Related to UV light Chronic scarring process > metastase
than solar-related SCC
![Page 46: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/46.jpg)
CLINICAL FEATURE
Arise on hand, face, lip / ear Small lesion, scaly / ulcerated
![Page 47: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/47.jpg)
PATHOLOGY Composed of tumor cells mimic
epidermal stratum spinosum extend into subjacent dermis
Variably thickened & parakeratotic Atypia basal keratinocyte (+)
![Page 48: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/48.jpg)
![Page 49: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/49.jpg)
Squamous cell carcinoma in situ, medium power. The normal maturation pattern of keratinocytic apithelium is disturbed, imparting a “windblown” look to the neoplastic epithelium. There is a parakeratotic scale
![Page 50: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/50.jpg)
Squamous cell carcinoma in situ, high power. The lesional cells exhibit nuclear attributes of malignancy-enlargement, hyperchromatism, pleomorphism, and dyskeratosis
![Page 51: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/51.jpg)
![Page 52: GWT-LESI GANAS KULIT KULKEL.ppt](https://reader036.vdocuments.net/reader036/viewer/2022062300/55cf9c3f550346d033a92d76/html5/thumbnails/52.jpg)