Chapter 123 Atypical Melanocytic Nevi

Question 1

DN occur in a familial pattern; limited segregation analyses suggest an ____________ transmission of the trait

Within families having _______ germ-line mutations, DN appear to be an independent risk factor for melanoma

Answer 1

autosomal dominant

CDKN2A

Question 2

Areas of modest interest have also been linked to areas on chromosomes ________

The most common area for DN is on the trunk, primarily the _____

individuals with DN report more frequent sun exposure and sunburns, especially before age ____, than individuals without DN

Answer 2

1, 6, and X

back

20

Question 3

High risk, high anxiety, recent melanoma patients may require _____ follow up visits

Most patients follow up visits are at _______ intervals

Answer 3

3 month

6-12 month

Question 4

diagnosis of a DN are two obligate features: diameter in one dimension at least _____ and a ________ component, and

two of three other features: _____, ______, ______

Answer 4

5 mm
prominent flat

irregular, asymmetric outline, indistinct borders, and variable pigmentation

Question 5

Compared to common acquired nevomelanocytic nevi, DN tend to be_____, be entirely flat or have flat shoulders, with a degree of _____ and variable ________

Answer 5

larger
asymmetry
coloration

Question 6

Compared to DN, melanomas will be found to be

(1) unusual (_________), this is due to the rare combination of mutations giving rise to the melanoma and its growth pattern, they will be
(2) ______ (this due to defective growth control), and progressively more
(3) _______

Answer 6

ugly duckling
growing
nonuniform

Question 7

Evidence of chronic solar injury is also associated with an increased risk of ______ in men with DN, especially in ______

______ and variations in _______ both increase the risk of melanoma in CDKN2A mutation carriers

Answer 7

melanoma
older men

DN
MC1R

Question 8

Architectural features include a junctional component of scattered atypical melanocytes which may be most of the lesion, or an_____________________ several retia beyond a dermal component

Answer 8

edge or shoulder extending

Question 9

The cytologic features include atypical melanocytes with abundant cytoplasm along the _____________ that are one-third to one-half larger than the melanocytes in the normal surrounding skin

Answer 9

dermal-epidermal junction

Question 10

Patients with DN should be considered for _____.

Even one unequivocal DN, increases the risk of melanoma ______. More than ten DN increased the risk ______

Answer 10

TBP

twofold
12-fold

Question 11

The most frequent complication for patients with DN is _______ due to numerous biopsies

Individuals who have had one melanoma are at substantially increased risk of developing another primary melanoma (_________ of melanoma during the first 5 years)

Answer 11

scarring

tenfold increased risk

Question 12

A previous history of nonmelanoma skin cancer approximately _____ the risk for melanoma, especially in _______

Answer 12

doubles

older men

Question 13

Other cancers in the patient or family such as _________ in a member of a family where multiple individuals have had melanoma may warrant consideration of _________ if it changes clinical care

Answer 13

pancreatic cancer

genetic testing

Question 14

The treatment for DN is ________

_______ does not substantially decrease a patient’s risk of developing a melanoma

If a lesion is worrisome for melanoma, the entire
lesion should be ________ (if possible) with visibly clear
margins

Answer 14

observation

Removal of DN

excised

Question 15

For DN shave biopsies are discouraged.

_______ and ________ can occur.

Answer 15

Repigmentation and regrowth