Benign pigmented lesions (Seborrheic keratosis & Ephelis) Flashcards

1
Q

What population is sebhorrheic keratosis common in?

A

older people

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2
Q

What is seborrheic keratosis?

A

acquired benign proliferation of epidermal basal cells

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3
Q

Cause of sebhorrheic keratosis?

A

Unknown.

Positive correlation with sun exposure

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4
Q

What kind of mutation is asosciated with sebhorrheic keratosis?

A

somatic mutations in the FGFR3

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5
Q

Does sebhorrheic keratosis occur in the mouth?

A

does NOT occur in the mouth

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6
Q

Where does sebhorrheic keratosis develop?

A

skin of the face, trunk and extremities

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7
Q

How do sebhorrheic keratosis lesions appear?

A

Usually multiple and begin as small tan/brown macules.

Gradually enlarge and elevate.

End as sharply demarcated plaques. Surfaces may be finely fissured, pitted or verrucous, or smooth.

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8
Q

What is dermatosis papulos nigra?

A

seborrheic keratosis that occurs in 30% of blacks

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9
Q

What is observed in the histology of the acanthotic form of sebhorrheic keratosis?

A

Considerable acanthosis

Surface hyperkeratosis

Numerous pseudocysts

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10
Q

Where does the epidermal proliferation extend in the histopathology of sebhorrheic keratosis?

A

Extends upwards above the normal epidermal surface

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11
Q

What are the pseudocysts in the histopathology of sebhorrheic keratosis?

A

Keratin filled invaginations

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12
Q

How do surrounding epithelial cells appear in the histopathology of sebhorrheic keratosis?

A

Basaloid in appearance

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13
Q

Is sebhorrheic keratosis often removed?

A

seldom removed unless for aesthetic reason

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14
Q

How are sebhorrheic keratosis lesions removed?

A

liquid nitrogen or simple curettage

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15
Q

Is there malignant potential of sebhorrheic keratosis?

A

No malignant potential

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16
Q

What is Lesar-Trelat sign?

A

Sudden appearance of numerous sebhorrheic keratosis with pruritis that has been associated with internal malignancy

17
Q

What is ephelis?

A

Common small hyperpigmented macule of the skin.

Represents a region of increased melanin production not a local increase in number of melanocytes.

18
Q

In what population is ephelis most observed and where on the body?

A

Seen most often on the face, arms and back of fair skinned, blue-eyed, red or light blond haired persons

19
Q

When does ephelis become noticeable?

A

first decade of life

20
Q

Is there a sex association with ephelis?

A

No sex predilection

21
Q

How does each macule in ephelis appear?

A

Each individual macule is round or oval and typically remains less than 3mm in diameter.

Uniform light brown coloration, color intensifies after sun exposure

22
Q

How do ephelis spots compare to lentigo simplex?Melanocytic nevus?

A

Not as dark as lentigo simplex

Never elevated like melanocytic nevus

23
Q

What is the histopahtology of ephelis composed of?

A

stratified squamous epithelium with abundant melanin deposition in the basal cell layer

NORMAL melanocytes number or somewhat reduced

24
Q

How do the rete ridges appear in ephelis in comparison to lentigo simplex?

A

Rete ridges are not elongated like in lentigo simplex

25
Tx for ephelides?
No tx necessary Use of suncreen can prevent appearance of new freckles
26
What is seborrheic keratosis that occurs in 30% of blacks
dermatosis papulos nigra