Benign Lesions, Nevi, & Oncology Flashcards
Basal Cell Nevus Syndrome (cause, sxs, tx)
Genetic disease causing loss of tumor suppression → hundreds of BCCs, palmar pits, and mandibular cycts.
Photoprotection is imperative.
Important to check palms to aid diagnosis.
Common Melanocytic Nevi - Moles (presentation, population, timing, risk, tx)
Groups of melanocytes. Symmetric.
Lighter skinned individuals tend to have more total nevi than dark-skinned people, who tend to have more on acral sites (palms, soles, nail beds).
Total number associated w/ melanoma risk.
People are typically not born w/ nevi. Accumulate from childhood to 30’s, which then mature and eventually involute.
Tx w/ photoprotection or excision if changing, atypical, repeatedly traumatized, or for cosmetic reasons. Importat to reassure patients that they are not dangerous.
Junctional Nevi (presentation and skin layer)
Flat, not raised, and brown. Melanocytes in epidermis.
Compound Nevi (presentation and skin layer)
Melanocytes in both epidermis and dermis. Less likely to create visible pigment on surface. Become lighter and more raised as it progresses from junctional to compound.
Dermal Nevi (presentation and skin layer)
Melanocytes entirely in dermis. Look pinkish, even more raised.
Congenital Nevi (timing, presentation, risk)
Present at birth and darken over time. May be large w/ color irregularity. Often cobbled w/ coarse hair. Giant congenital nevi have risk of melanoma
Dysplastic Nevi (presentation, histology, location, population, timing, tx)
Atypical cells on histology.
Variegated (different colors) including tan, brown, and pink. Irregular shape, indistinct borders, and often >5mm.
Most common on trunk and in light-skinned people.
Usually don’t appear until puberty, and unlike common nevi, these continue to develop throughout life.
Tx – observe if mild, excise if moderate / severe
Risk factors for melanoma
Intermittent sunburns causes higher risk than chronic sun exposure. Higher risk in high SES.
Radial growth phase
Long duration and includes changing shape, size, or color.
Vertical growth phase
Fast duration. Papules / nodules become present.
ABCDE’s
Asymmetry Borders - irregular / poorly defined) Color - more than one is bad) Diameter (>6mm) Evolving - most important factor
Superficial spreading melanoma / Melanoma in situ (skin layer, level of risk)
Confined to epidermis. Lowest risk.
Nodular Melanoma (characteristics and level of risk)
Shortest radial growth phase and fastest overall growth. Highest risk of metastasis
Lentigo Maligna Melanoma (sxs, dif dx, population, location)
Longest radial growth phase. Flat, asymmetric w/ color variation. May mimic seborrheic keratosis. Most common in people > 70 yo. Commonly located on face.
Acral Lentiginous Melanoma (population, location, diagnostic)
Most common type among dark-skinned people.
Palmar, plantar, or subungual location. Hutchinson sign is diagnostic (when spreads beyond nail and appears on cuticle).