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Bloc F - Defense > Apr10 M1-Bumps_Nevi_Melanoma > Flashcards

Apr10 M1-Bumps_Nevi_Melanoma Flashcards

1
Q

benign acquired melanocytic nevi (BAMN) def

A
  • 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)
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2
Q

risk factors for BAMN

A
  • genetics

- sun exposure

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3
Q

nevus charact

A
  • uniform color and shape

- <6 mm (<0.6 cm)

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4
Q

3 types of BAMN and charact

A
  1. junctional (between epidermis and dermis) = DARK MACULE.
  2. intradermal (within the dermis) = papule, light colored
  3. compound (both junctional and intradermal components) = papule or tumor, light colored
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5
Q

BAMN treatment

A
  • remove if bothers

- punch biopsy or compress and shave or laser

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6
Q

congenital melanocytic nevus (CMN) melanoma risk depends on what

A
  • size
  • location
  • how many melanocytes (color)
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7
Q

dysplastic nevus charact and risk factors for having that

A
  • peculiar mole, fuzzy shaped, slightly raised patch (>0.5 cm)
  • can vary a lot in shape, colour, border, etc.
  • risk factors = genetics + sun exposure
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8
Q

dysplastic nevus tx

A
  • biopsy if think melanoma
  • sun protection
  • regular exams
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9
Q

melanoma some risk factors

A
  • sun exposure
  • having more moles (means you got more UV)
  • skin phototype 1 to 3
  • freckles
  • sunburns
  • FHx, PMHx, immunosuppression
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10
Q

5 subtypes

A
  • superficial spreading (flat or papule)
  • nodular (papule)
  • acral lentiginous (palms, soles, nails)
  • lentigo maligna melanoma (in situ called lentigo maligna)
  • amelanotic, hypomelanotic melanoma
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11
Q

(IMPORTANT) main determinant of how malignant a melanoma is at a certain point in time

A

depth of invasion*

two different melanomas with same depth of invasion = same malignant potential

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12
Q

how to detect a melanoma

A 
ABCDE rule
-asymmetry
-border
-colour
-diameter
-evolution
EGF rule for nodular and amelanotic
-elevated
-firm
-growing
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13
Q

specific signs to detect a melanoma (superficial spreading kind)

A

-whitish area in the black lesion

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14
Q

nodular melanoma charact

A
  • elevated
  • diff levels of involvement (from epidermis to subcutaneous = lvl 1 to 4)
  • black or blue
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15
Q

acral lentiginous melanoma charact

A
  • heel or sole or nails
  • black lesion that seems to be under the skin
  • nail black on two thirds
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16
Q

lentigo maligna melanoma charact

A

-polycyclic, RED, orange, yellow, brown

17
Q

amelanotic, hypomelanotic subtype of melanoma charact

A
  • pinky (bright) red
  • bx
  • ddx = merkel cell CA or undiff squamous cell CA
18
Q

prognosis factors in melanoma

A
  • depth (2-4 mm = 60% survival)
  • subtype
  • mitotic index
  • ulceration (means deepness)
  • negative SLNB (sentinel lymph node bx)
19
Q

melanoma tx

A
  • bx surgical or excisional + SLNB

- follow up (monthly self exam, TBSE once a year, sun protection

20
Q

2 main non melanoma skin cancers (NMSC)

A
  • basal cell CA = 3-4 times more common than SCC

- small cell CA (SCC): correlates with lifetime UV exposure

21
Q

most common site of NMSC

A

head and neck

22
Q

main risk factor for NMSC

A

sun exposure (+ skin type, previous CA, immunosupression)

23
Q

how many skin phototypes

A

6

  1. black hair very pale
  2. redhead with freckles
  3. usual
  4. Mediterranean, Asian, etc.
  5. African American (brown)
  6. African (black)
24
Q

most common site of MELANOMA in the body

A

eyes (get cataracts)

25
Q

BCC charact

A

-most common, least dangerous (doesn’t metastasize)

26
Q

4 types of BCC

A
  1. nodular (exophytic, grows out)
  2. pigmented (brown mimicks melanoma)
  3. superficial (back or scalp where have thick dermis)
  4. sclerosing or morpheaform
27
Q

BCC nodular type charact

A

rolled, pearly border, ulcerated center, telangiectasia (dilated veins)

28
Q

BCC pigmented type charact

A
  • nodular but pigmented
  • rolled border, pearly, telangiectatic, ulcerated
  • ddx = melanoma
29
Q

BCC superficial subtype charact

A
  • microulcerations
  • bleeding
  • fragile skin
30
Q

BCC sclerosing type (morpheaform)

A
  • sclerosing = shiny, white, infiltrating
  • morphea (whitish colour, perly)
  • telangiectasias, irregular
  • rolled borders
31
Q

BCC tx

A
  • currettage and electrodessication x3
  • radiotherapy
  • topical chemo
  • excision
32
Q

why tx BCC

A

don’t want the tumor to infiltrate the brain

33
Q

BCC metastasis prevalence and drug for the tx

A
  • 1 in 10 000 cases

- vismodebig (Erivedge, hedgehog pathway inhibitor)

34
Q

(imp?) how to make the difference between SCC and BCC

A
  • SCC = hurts when you squeeze (SCC - Squeeze, s-s)

- BCC = doesn’t hurt when you squeeze

35
Q

actinic keratosis def and tx

A
  • PRECANCEROUS SCC lesion

- tx = cryotherapy or imiquimod or 5-FU, etc.

36
Q

tx of SCC in general

A
  • bx + check nodes
  • ED&C x3
  • surgical excision

Bloc F - Defense (57 decks)

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