Apr10 M1-Bumps_Nevi_Melanoma Flashcards
benign acquired melanocytic nevi (BAMN) def
- any hamartoma (normal tissue in abnormal location)
- spinal fold tissue in embryo migrates to skin
- at birth = congenital nevus (CMN: congenital melanocytic nevus)
- later = acquired nevus (BAMN)
risk factors for BAMN
- genetics
- sun exposure
nevus charact
- uniform color and shape
- <6 mm (<0.6 cm)
3 types of BAMN and charact
- junctional (between epidermis and dermis) = DARK MACULE.
- intradermal (within the dermis) = papule, light colored
- compound (both junctional and intradermal components) = papule or tumor, light colored
BAMN treatment
- remove if bothers
- punch biopsy or compress and shave or laser
congenital melanocytic nevus (CMN) melanoma risk depends on what
- size
- location
- how many melanocytes (color)
dysplastic nevus charact and risk factors for having that
- peculiar mole, fuzzy shaped, slightly raised patch (>0.5 cm)
- can vary a lot in shape, colour, border, etc.
- risk factors = genetics + sun exposure
dysplastic nevus tx
- biopsy if think melanoma
- sun protection
- regular exams
melanoma some risk factors
- sun exposure
- having more moles (means you got more UV)
- skin phototype 1 to 3
- freckles
- sunburns
- FHx, PMHx, immunosuppression
5 subtypes
- superficial spreading (flat or papule)
- nodular (papule)
- acral lentiginous (palms, soles, nails)
- lentigo maligna melanoma (in situ called lentigo maligna)
- amelanotic, hypomelanotic melanoma
(IMPORTANT) main determinant of how malignant a melanoma is at a certain point in time
depth of invasion*
two different melanomas with same depth of invasion = same malignant potential
how to detect a melanoma
ABCDE rule -asymmetry -border -colour -diameter -evolution EGF rule for nodular and amelanotic -elevated -firm -growing
specific signs to detect a melanoma (superficial spreading kind)
-whitish area in the black lesion
nodular melanoma charact
- elevated
- diff levels of involvement (from epidermis to subcutaneous = lvl 1 to 4)
- black or blue
acral lentiginous melanoma charact
- heel or sole or nails
- black lesion that seems to be under the skin
- nail black on two thirds
lentigo maligna melanoma charact
-polycyclic, RED, orange, yellow, brown
amelanotic, hypomelanotic subtype of melanoma charact
- pinky (bright) red
- bx
- ddx = merkel cell CA or undiff squamous cell CA
prognosis factors in melanoma
- depth (2-4 mm = 60% survival)
- subtype
- mitotic index
- ulceration (means deepness)
- negative SLNB (sentinel lymph node bx)
melanoma tx
- bx surgical or excisional + SLNB
- follow up (monthly self exam, TBSE once a year, sun protection
2 main non melanoma skin cancers (NMSC)
- basal cell CA = 3-4 times more common than SCC
- small cell CA (SCC): correlates with lifetime UV exposure
most common site of NMSC
head and neck
main risk factor for NMSC
sun exposure (+ skin type, previous CA, immunosupression)
how many skin phototypes
6
- black hair very pale
- redhead with freckles
- usual
- Mediterranean, Asian, etc.
- African American (brown)
- African (black)
most common site of MELANOMA in the body
eyes (get cataracts)
BCC charact
-most common, least dangerous (doesn’t metastasize)
4 types of BCC
- nodular (exophytic, grows out)
- pigmented (brown mimicks melanoma)
- superficial (back or scalp where have thick dermis)
- sclerosing or morpheaform
BCC nodular type charact
rolled, pearly border, ulcerated center, telangiectasia (dilated veins)
BCC pigmented type charact
- nodular but pigmented
- rolled border, pearly, telangiectatic, ulcerated
- ddx = melanoma
BCC superficial subtype charact
- microulcerations
- bleeding
- fragile skin
BCC sclerosing type (morpheaform)
- sclerosing = shiny, white, infiltrating
- morphea (whitish colour, perly)
- telangiectasias, irregular
- rolled borders
BCC tx
- currettage and electrodessication x3
- radiotherapy
- topical chemo
- excision
why tx BCC
don’t want the tumor to infiltrate the brain
BCC metastasis prevalence and drug for the tx
- 1 in 10 000 cases
- vismodebig (Erivedge, hedgehog pathway inhibitor)
(imp?) how to make the difference between SCC and BCC
- SCC = hurts when you squeeze (SCC - Squeeze, s-s)
- BCC = doesn’t hurt when you squeeze
actinic keratosis def and tx
- PRECANCEROUS SCC lesion
- tx = cryotherapy or imiquimod or 5-FU, etc.
tx of SCC in general
- bx + check nodes
- ED&C x3
- surgical excision