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Dermatology > Benign and malignant melanocytic naevi > Flashcards

Benign and malignant melanocytic naevi Flashcards

1
Q

What are the 3 layers of the skin?

A

epidermis

dermis

fat

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2
Q

Where do melanocytes normally reside?

A

the base layer of the epidermis

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3
Q

What are moles/naevi?

A

nests of melanocytes

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4
Q

What are the types of benign melanocytic naevi?

A

FRECKLES

MOLES:

Acquired:

1) Junctional naevus
2) Compound naevus
3) Intradermal naevus
4) Atypical naevus

Congential

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5
Q

What are the types of atypical naevus?

A

Blue naevus

Halo naevus

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6
Q

What is the difference between moles and freckles?

A

Freckles - melanocytes line the basal layer of epidermis

Moles - melanocytes have formed nests

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7
Q

When do acquired moles generally appear?

A

late childhood to early adolescence

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8
Q

How do junctional, compound and intradermal naevus’ link?

A

The are essentially the ageing process of a mole

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9
Q

In what layer are junctional naevi?

A

Most internal portion of epidermis

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10
Q

What shape + colour are junctional naevi?

A

Flat and dark

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11
Q

What is more common acquired or congential moles?

A

acquired

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12
Q

What is the management of atypical naevi?

A

Excised as clinically difficult to say its 100% benign

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13
Q

What is the risk with atypical naevi?

A

The pt is at greater risk of developing melanoma

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14
Q

What are the risk factors for developing malignant melanoma?

A

Increased UV exposure (most common)

Family history (can be familial)

Previous melanoma

Multiple dysplastic naevi
Large congenital naevi

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15
Q

Is genetic testing available for familial milignant melanoma?

A

Yes

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16
Q

What are the referral criteria for melanoma? (scoring only NOT the actual features)

A

7 point checklist (refer if score ≥3)

split into minor (1 point each) and major features (2 points each)

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17
Q

What features are included in the referral criteria for melanoma?

A

Major: (2 points)
Changing colour
Changing shape
Changing size

Minor: (1 point)
Bleeding
Inflammation
Itching
Diameter >7mm
18
Q

Explain the ABCDE rule for describing a potential melanoma?

A 
A symmetry
B order is irregular
C olour (multiple)
D iameter >6mm
E nlarging/E volving
19
Q

What are the different subtypes of melanoma?

A

in-situ melanoma
(Lentigo maligna - a subtype of insitu)

INVASIVE types:

Superficial spreading melanoma

Nodular melanoma

Lentigo maligna melanoma

Acral melanoma

20
Q

Where do lentigo maligna most commonly occur?

A

On the face of elderly people

21
Q

What precedes lentigo maligna’s?

A

Solar lentigo’s

22
Q

Describe how solar lentigo’s develop into lentigo maligna’s.

A

Over several years

They change in size, shape and colour

23
Q

What is the most common type of invasive melanoma? (what %)

A

superficial spreading melanoma (70%)

24
Q

What are the characteristics of superficial spreading melanoma?

A

Thin and

expand radially

25
Q

What is the prognosis of lentigo maligna melanoma?

A

It has a good prognosis

26
Q

What does lentigo maligna melanoma arise from?

A

lentigo maligna

27
Q

What is acral melanoma?

A

melanoma characterised by its site of origin:

palm

sole or

beneath the nail (subungual melanoma)

28
Q

Who is acral melanoma more common in?

A

dark skin individuals

29
Q

How quickly does acral melanoma invade?

30
Q

What are the benign differentials of melanoma?

A

atypical naevus

blue naevus

seborrheic wart

dermatofibroma

pyogenic granuloma

31
Q

What is the most common type of firm lesion found on the arms and legs?

A

Dermatofibroma

32
Q

If an atypical naevus is found how should you assess its risk for malignancy? (on a very basic level)

A

Ugly duckling sign:

Look at other moles and if it stands out it is more likely to be a melanoma

33
Q

What are the malignant mimics of melanoma?

34
Q

On what does the prognosis of melanoma depend?

A

The depth of invasion

35
Q

What is the special name for the depth of invasion of melanoma?

A

Breslow thickness

36
Q

What is the management of melanoma?

A
  1. Confirmation via histology
  2. Wide local excision (2cm margin)
  3. If palpable lymph nodes then lymph node clearance for regional metastasis is done.
37
Q

What is the treatment strategy for distant melanoma mets?

A

There is no standard regime

38
Q

Does sentinal node biopsy increase survival? (its where you inject dye into skin to find 1st draining lymph node, where it is removed and sent for histology)

A

It has not been shown to increase survival

39
Q

Is someone burns in the sunlight in 10 mins, how long will it take for them to burn with SPF 15 suncream on?

40
Q

What is the prevelance of atypicals moles?

41
Q

How doe nodular melanomas tend to invade?

A

Vertically

42
Q

What is the prognosis of melanoma depending on breslow thickness?

A

5-year survival:

in situ 100%

Less than 1mm ~95%

1-3mm ~70%

grtr than 3mm ~40% or less

Dermatology (11 decks)

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