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81 Cards in this Set
- Front
- Back
Which intraepidermal cells take up and process antigens presenting them to immunocompetent T-cells?
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Langerhans Cells
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Which dermal cell is associated with the assembly of macromolecular complexes involved in early stages of healing in deep wounds?
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Dermal dendrocyte
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Which epithelial structures harbor epithelial stem cells capable of regenerating superficial epithelial skin structures?
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Hair follicles (manufacture hair shafts)
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Which integumentary glands are responsible for thermoregulation?
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Eccrine glands
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What type of modified glands comprise the breast?
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Apocrine
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What histological finding will be observed in the lumen of an apocrine gland?
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Cytoplasmic blebbing
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What slow adapting mechanoreceptors located in the papillary dermis, are associated with pain, itch, and detecting temperature?
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Free-Nerve endings
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What rapidly adapting mechanoreceptor for touch is prominent in the papillary dermis of hands and feet?
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Meissner's corpuscles
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What integumentary structure detects deep pressure and vibration?
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Pacinian corpuscle (onion skinning appearance histologically)
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What term describes a small flat primary lesion of the skin?
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Macule (<.5cm)
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What term describes a large flat primary lesion of the skin?
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Patch (>.5cm)
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What term describes a small, elevated solid primary skin lesion?
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Papule (<.5cm)
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What term describes a large, solid, well-circumscribed primary skin lesion?
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Plaque (>.5cm) - Psoriasis
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What term describes a palpable solid lesion found in the dermis or subcutaneous tissue?
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Nodule (>.5cm but < 2cm) - Dermatofibroma
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What term describes a solid, firm lesion typically > 2 cm?
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Tumor
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What term describes a small, superficial circumscribed elevation that contains serous fluid?
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Vesicle - Herpes Zoster
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What term describes a large raised circumscribed lesion that contains serous fluid?
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Bulla (blister) - Bullous pemphigoid
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What term describes an itchy, transient, circumscribed, elevated papule or plaque that is the result of dermal edema?
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Wheel - Urticaria
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What term describes a small circumscribed superficial elevation of the skin that contains purulent material?
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Pustule (<1cm)
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What term describes a secondary skin lesion with visible fragments of the stratum corneum as it is shed from the skin?
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Scale
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What term describes varying colors liquid debris that dried on the surface of the skin?
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Crust (Impetigo)
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What term describes the loss of superficial layer of upper epidermis by wearing away as from friction or pressure?
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Erosion (Pemphigus vulgaris)
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What term describes a sharply-defined, linear or wedge-shaped tears in the epidermis with abrupt wall?
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Fissure
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What term describes a secondary skin lesion with loss of epidermis and dermis?
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Ulceration (Stasis ulcer or pyoderma gangrenosum)
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What term describes superficial skin abrasions, that are usually due to scratching of the skin?
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Excoriation
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What term describes diffuse thickening of the epidermis as a result of chronic rubbing (Hint: Looks like it grows on a tree)?
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Lichenification (Lichen simplex chronicus)
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What microscopic finding is the result of autoimmune loss of intercellular cohesion between keratinocytes?
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Acantholysis
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What microscopic term refers to diffuse epidermal hyperplasia which is often due to chronic irritation?
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Acanthosis
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What microscopic term refers to abnormal, premature keratinization below the stratum granulosum?
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Dyskeratosis
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What microscopic term refers to the infiltration of the epidermis with inflammatory cells?
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Exocytosis
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What microscopic term refers to intracellular edema of keratinocytes, which is often seen in viral infections?
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Hydropic swelling (ballooning) - seen in HSV infections
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What microscopic term refers to thickening of the stratum granulosum which is often due to intense rubbing?
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Hypergranulosis (Lichen Simplex Chronicus)
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What microscopic term refers to thickening of stratum corneum?
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Hyperkeratosis (Ichthyosis)
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What microscopic term refers to linear pattern of melanocyte proliferation within the epidermal basal cell layer?
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Lentiginous
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What microscopic term refer to surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae?
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Papillomatosis
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Where is parakeratosis normal?
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Mucous membranes
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What microscopic term refers to keratinization with retained nuclei in the stratum corneum?
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Parakeratosis (Actinic Keratosis)
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Which microscopic term refers to intercellular edema of the epidermis?
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Spongiosis
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What microscopic term refers to discontinuity of the skin showing complete loss of the epidermis?
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Erosion
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What microscopic term refers to discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutis?
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Ulceration
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What autoimmune disease is associated with basal vacuolization?
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GVHD
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What disease is characterized by autoimmune depigmentation; with partial or complete loss of pigment?
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Vitiligo (autoimmune destruction of melanocytes)
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What disease is characterized by melanocytes that do not produce melanin due to a lack or defect in tyrosinase?
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Albinism
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What skin lesion associated with NF is histologically indistinguishable from freckles?
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Cafe-au-lait spots
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What pigmented lesions common in childhood are due to increased pigmentation not an increase number of melanocytes?
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Freckles
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What causes the permanent growth arrest that is observed in normal nevi?
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Accumulation of p16/INK4a (inhibitor of cyclin-dependent kinases)
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What mutations are associated with normal nevi (which are neoplasms)?
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Mutations in BRAF or NRAS (RAS/BRAF)
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What type of nevus is very large and associated with an increased risk of developing melanoma?
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Congenital nevus
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What type of nevus is often clinically confused with melanoma?
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Blue nevus
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What type of nevus is often clinically confused with hemangioma but histologically confused with melanoma?
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Spitz nevus (spindle and epitheliod cell nevus)
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What type of nevus is clinically and histologically confused with melanoma due to its characteristic halo?
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Halo nevus
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What type of nevus is considered to be a precursor to melanoma?
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Dysplastic nevus
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What type of nevus is characterized by minimal pagetoid spread, lentiginous hyperplasia, sideway nesting and briding, and fibrosis
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Dysplastic/Atypical nevus
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What are the most important autosomal dominant mutations associated with dysplastic nevus syndrome?
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CDNK2A and CDK4 mutations
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What are the ABCDEs associated with melanoma?
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- Asymmetry
- Border (Irregularity) - Color (Regression) - Diameter (>6 cm) - Elevation |
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Which phase of malignant melanoma is usually without metastasis?
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Radial Growth Phase ONLY (Lentigo maligna, superficial spreading melanoma)
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Which phase of malignant melanoma is metastasis most likely?
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Vertical Growth Phase ONLY (Nodular melanoma)
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The risk of metastasis depends on Breslow and Clark's level in which phases of malignant melanoma?
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Radial + Vertical Growth Phase
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What prognostic factors are associated with a favorable outcome?
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- Ulceration absent
- Depth <1.7mm - Mitosis absent or low - Regression absent - TIL brisk - Female - Extremity |
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What prognostic factors are associated with poor outcome?
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- Ulceration present
- Depth > 1.7mm - High number of mitoses - Regression present - TIL non-brisk - Male - Head |
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What are the most important predisposing factors for malignant melanoma?
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- Inherited genes
- Sun exposure (severe sunburns early in life) |
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What should you consider if you patient begins acquiring lots of seborrheic keratoses?
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GI tract malignancy (Paraneoplastic syndrome, Leser-Trelat sing)
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What histological finding is associated with a seborrheic keratosis?
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Horn cysts (Keratin horn cysts)
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What skin conditions presents as thickend, hyperpigmented skin with a "velvet-like texture?"
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Acanthosis nigricans (typically found in flexural areas, axillae, & skin folds)
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What skin lesion is a well-circumscribed, firm and movable and is filled with keratin and lipid- containing debris?
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Epithelial cyst
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What type of cysts are commonly found around the eye?
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Dermoid cyst
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What adnexal tumor present on the forehead and scalp sometimes being referred to as Turban tumor (coalescence of nodules)?
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Cylindroma (associated with AD mutations in CYLD)
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Multiple trichilemmomas are asociated with?
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- Cowden syndrome (PTEN mutations)
- Breast carcinomas |
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What tumor is associated with internal malignancy (Muir-Torre syndrome)?
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Sebaceous adenomas
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What is the most common site of sebaceous carcinoma?
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Meibomian glands of the eyelid (must differentiate from BCC)
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What hyperkeratotic and parakeratotic skin lesion is considered to be a precursor lesion?
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Actinic keratosis (sun-damaged skin on the face, arms, dorsum of hands)
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What type of skin cancer present as a sharply defined lesion with red, scaling plaques?
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Squamous cell carcinoma (2nd most common tumor arising on sun-exposed skin)
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What is the most common mutation associated with squamous cell carcinoma?
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p53 mutations
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What skin cancer rarely metastasizes but is associated with extensive local invasion?
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Basal cell carcinoma
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What type of skin cancer presents as pearly papules with telangiectasias grossly and with basaloid cells and peripheral pallisading histologically?
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Basal cell carcinoma
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What autosomal dominant mutation is associated with nevoid basal cell carcinoma syndrome (Gorlin syndrome)?
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Mutations of PTCH gene (aka "PATCH" gene)
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What syndrome presents with multiple basal cell carcinomas and jaw cysts?
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Nevoid basal cell carcinoma (AD PTCH mutation)
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What syndrome presents with trichilemmomas and breast carcinomas?
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Cowden syndrome (AD mutation in PTEN)
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What autosomal recessive disease is the results of deficient nucelotide excision repair?
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Xeroderma pigmentosum (prevents repair of thymidine dimers)
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What tumor contains neurosecretory granules positive for chromogranin and synaptophysisn?
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Merkel Cell carcinoma (small round blue cell tumor like neuroblastoma and pheochromocytoma)
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What is the result of a defect in the PTCH gene?
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Uninhibited activation of SMO leading to Basal Cell Carcinoma associated with Gorlin syndrome.
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