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Dermatology for MCCQE1 (class #1) > ACQUIRED Pigmented Lesions > Flashcards

ACQUIRED Pigmented Lesions Flashcards

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Dermatology Board Prep flashcards
1
Q 
Which is this lesion? 
Small (<5 mm) welldemarcated
light brown
macules
Sites: sun-exposed skin
A

Ephelides

Freckles

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2
Q 
Which is this lesion?
Hairy, light brown
macule/patch with
a papular verrucous
surface
Sites: trunk and
shoulders, onset in
teen yr
A

Becker’s Nevus

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3
Q 
Which is this lesion?
Symmetrical
hyperpigmentation on
sun-exposed areas of
face (forehead, upper
lip, cheeks, chin)
A

Melasma

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4
Q 
Which is this lesion?
Variegated macule/
papule with irregular
distinct melanocytes in
the basal layer
Risk factors: family
history
A

Atypical Nevus

Dysplastic Nevus

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5
Q

Which is this lesion? well circumscribed, round, uniformly pigmented macules/papules <1.5 cm. commin mole.

A

ACQUIRED NEVOMELANOCYTIC NEVI

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6
Q

Which is this lesion? Well-demarcated
brown/black macules
Sites: sun-exposed skin

A

Solar Lentigo

Liver Spot

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7
Q

ACQUIRED NEVOMELANOCYTIC NEVI

Clinical Feature. Average number. and stages

A
  • average number of moles per person: 18-40

* 3 stages of evolution: junctional NMN, compound NMN, and dermal NMN

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8
Q

Junctional NMN. Age of Onset

A

Childhood
Majority progress to
compound nevus

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9
Q

Junctional NMN. Clinical Feature

A

Flat, regularly bordered, uniformly tan-dark

brown, sharply demarcated macule

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10
Q

Junctional NMN. Histology

A

Melanocytes at dermal-epidermal

junction above basement membrane

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11
Q

Compound NMN. Age of Onset

A

Any age

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12
Q

Compound NMN. Clinical Feature

A

Domed, regularly bordered, smooth, round,
tan-dark brown papule
Face, trunk, extremities, scalp
NOT found on palms or soles

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13
Q

Compound NMN. Histology

A

Melanocytes at dermal-epidermal

junction; migration into dermis

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14
Q

Dermal NMN.Age of Onset

A

Adults

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15
Q

Dermal NMN. Clinical Feature

A

Soft, dome-shaped, skin-coloured to tan/
brown papules or nodules
Sites: face, neck

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16
Q

Dermal NMN. Histology

A

Melanocytes exclusively in dermis

17
Q

ANMN Management

A

new or changing pigmented lesions should be evaluated for atypical features which could indicate a
melanoma
• excisional biopsy should be considered if the lesion demonstrates rapid change, asymmetry, varied
colours, irregular borders and persistent pruritus or bleeding

18
Q

Atypical Nevus

(Dysplastic Nevus) Pathophysiology

A 
Hyperplasia and proliferation
of melanocytes extending
beyond dermal compartment
of the nevus
Often with region of adjacent
nests
19
Q

Atypical Nevus

(Dysplastic Nevus) Epidemiology

A 
>5 atypical nevi increase risk for
melanoma
Numerous dysplastic nevi may
be part of familial atypical mole
and melanoma syndrome
20
Q

Atypical Nevus

(Dysplastic Nevus) Clinical Course and Management

A 
Follow with baseline photographs
for changes
Excisional biopsy if lesion changing
or highly atypical
Close surveillance with whole body
skin examination
21
Q

Ephelides

(Freckles) Pathophysiology

A

Increased melanin within
basal layer keratinocytes
secondary to sun exposure

22
Q

Ephelides

(Freckles) Epidemiology

A

Skin phototypes I-II most

commonly

23
Q

Ephelides

(Freckles) Clinical Course and Management

A 
Multiply and darken with sun
exposure, fade in winter
No treatment required
Sunscreen and sun avoidance may
prevent the appearance of new
freckles
24
Q

Solar Lentigo

(Liver Spot) Pathophysiology

A

Benign melanocytic
proliferation in dermalepidermal
junction due to
chronic sun exposure

25
Q

Solar Lentigo

(Liver Spot) Epidemiology

A

Most common in Caucasians
>40 yr
Skin phototypes I-III most
commonly

26
Q

Solar Lentigo

(Liver Spot) Clinical Course and Management

A

Laser therapy, shave excisions,

cryotherapy

27
Q

Becker’s Nevus Pathophysiology

A

Pigmented hamartoma with
increased melanin in basal
cells

28
Q

Becker’s Nevus Epidemiology

A

M>F
Often becomes noticeable at
puberty

29
Q

Becker’s Nevus Clinical Course and Management

A

Hair growth follows onset of
pigmentation
Cosmetic management (usually too
large to remove)

30
Q

Melasma Pathophysiology

A

Increase in number and
activity of melanocytes
Associated with estrogen
and progesterone

31
Q

Melasma Epidemiology

A 
F>M
Common in pregnancy and
women taking OCP or HRT
Risk factors: sun exposure, dark
skin tone
Can occur with mild endocrine
disturbances, antiepileptic
medications and other
photosensitizing drugs
32
Q

Melasma Clinical Course and Management

A 
Often fades over several mo after
stopping hormone treatment or
delivering baby
Treatment: hydroquinone, azelaic
acid, retinoic acid, topical steroid,
combination creams, destructive
modalities (chemical peels, laser
treatment), camouflage make-up,
sunscreen, sun avoidance

Dermatology for MCCQE1 (class #1) (35 decks)

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