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Derm Block 2 Flashcards

1
Q

What type of light causes most photobiologic skin reactions and dzs

What are the 3 types of this light?

A

UV light

UVA: 320-400nm, long black light radiation
UVB: 320-390nm, middle wave sun burn
UVC: 100-290nm, short wave germicidal

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2
Q

What time of the day does most of the UVA and UVB light occur?

? is the majority of UV radiation that reaches Earths surface?

A

70% UVA/80% UVB between 10AM-3PM

UVA

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3
Q

UVA light

What happens if there is chronic exposure?

A

Constant through out day/year
Long waves penetrate deeply to dermis/SQ fat

CT degeneration
PhotoAging PhotoAllergic

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4
Q

UVB light

A

Greatest during summer and MOST harmful of waves

High amount of energy to corneum/superficial layers

Sun burn/tan
Pigmentation/inflammation

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5
Q

UV light

This form is only transmissible via ?

A

Absorbed by ozone

Germicidal lamps

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6
Q

Skin Phototype is based upon ? skin and AKA ?

The phototype characteristic of burn or tan is based on ?

A

Buttocks, Fitzpatrick scale

30-45min of exposure after winter/no exposure

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7
Q

What are the 6 phenotypes on the Fitzpatrick scale

A

1: British European, Northern
2: European Scandanavian
3: Southern, Central European
4: Mediterranean Asian Latina
5: Indian African
6: African Aboriginal

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8
Q

? ground surface can reflect UVB light

What barrier absorbs UVC light

A

Snow, Ice

Ozone layer

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9
Q

Define SPF

A

Ratio of:
Least amount UVB energy to create erythema reaction through sunscreen compared to-

Amount of UVB required to create same reaction w/out sunscreen

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10
Q

Sunscreen w/ SPF blocks ? radiations

What are steps taken to protect against UV damage

A

UVA and AVB

Avoid peak exposure times
Wear protective clothes
Apply 15-30min prior to outdoors
Reapply q2hrs, after water
Daily SPF 15-30
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11
Q

What is the body’s two natural sun protectors

What is the best protective measure

A

Stratum corneum
Melanin

Clothing

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12
Q

What are the 3 MOAs of sunscreen

A

Physical- scatter, reflect light for photosensitizing conditions (titanium dioxide, zinc oxide)

Chemical- absorbs radiation

Water resistant- proof x 80min, resistant x 40min

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13
Q

Define Photoaging

Sun induced damage can cause changes in ? 4 things

A

Skin changes from chronic sun exposure

Texture Vascular Pigment Papular

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14
Q

What are 3 types of photoaging texture changes

A

Solar Elastosis- thick skin w/ yellow hue

Atrophy- thinned skin w/ prominent vessels

Wrinkles- don’t disappear w/ stretching

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15
Q

What type of vascular changes can photoaging cause?

A

Diffuse erythema

Venous lake- ectatic lip vessel

Telangectasis

Stellate Pseudo- scars above attachment points

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16
Q

Why types of pigment change happen w/ photoaging

A

Reactive hyperplasia of melanocytes

Irregular- deep brown area w/ hypopigment

Poikiloderma of Civatte- reticulated w/ telangectasis, atrophy, prominent hair follicles

Lentigo- large brown macules

Ephelides- freckles

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17
Q

What types of papular changes can occur due to photoaging?

A

Nevi

Seborrheic Keratosis

Solar Elastosis

Favre Racouchot- open/closed comedome/inclusion cyst

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18
Q

How is photoaging Tx

What s/e needs to be prevented?

A

Prevention
Topical Retinoids- Tretinoin, Tazarotene

Inc photosensitivity, daily sun screen

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19
Q

Topical Tx for photoaging will work on all changes except for ?

How is resurfacing Tx done?

A

Coarse wrinkles
Telangiectasis

Chemical peels
Dermabrasion
Lasers

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20
Q

? is the MC light induced skin dz

What is the pathogenesis process causing this?

A

Polymorphous light eruption from UVB light

Delayed hypersensitivity response of endogenous photo induced Ag

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21
Q

When/who does polymorphous light eruption present?

This condition’s prevalence is inversely related to ?

What phenomenon can occur for Tx?

A

First 3 decades of fair skin female PTs

Latitude

Harden- gradual UV exposure

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22
Q

What are the two morphologies of Polymorphous Light Eruption?

What are the 6 types of this condition?

A

LPP: grouped pruritic, erythematous papules
DPP: group of pin-size papule

Papular- MC
Plaque- 2nd MC, superficial, urticarial or eczematous
Papulovesicular 
Eczematous 
Erythema multiforme
hemorrhagic
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23
Q

What location of the body is Polymorphous Light Eruption MC to be in?

How does this present in clinic?

What PT education may be beneficial

A

V of chest
Back of hand
Extensor of forearm
Lower legs of women

30m-hrs after exposure w/ malaise, chills, HA, nausea

No scarring w/ lesion healing

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24
Q

How does Polymorphous Light Eruption presentation distinguish it from SLE

What studies are mandatory to r/o SLE from plaque type PLE?

How is the Dx confirmed

A

Delayed onset, morphology
Quick resolution

Biopsy
Immunofluorescence

Phototesting- eruption w/ UVA/B= confirm
Do not harden prior to Derm

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25
How is Polymorphous Light Eruption Tx They can be referred to Derm for ? Tx methods?
Topical CCS group 2-5 PO steroid- wide pruritis Desensitize w/ photo therapy Psoralen UVA Last line- Hydroxychloroquine
26
What is the name of the hereditary form of Polymorphic Light Eruption and ? population is it seen in? How does it present How is it Tx
Actinic Prurigo Inuit/Native American w/ childhood onset and FamHx Itching plaques, MC on face, Actinic cheilitis- may be only feature Topical CCS group 2-5 PO steroid- wide pruritis Desensitize w/ photo therapy
27
# Define Phototoxicity What are the two possible etiologies What type of phototoxicity reactions are more intense?
Non-allergic skin response to topical/systemic agents UVA Phytophotodermatitis- bizarre patterns of sun exposed area Photo drug eruptions
28
What are the two types of responses that can occur w/ Phototoxicity
Minimal: erythema then hyperpigmentation Max: tingling erythema after exposure leading to desquamation Hyper pigmentation x 12mon
29
What topical can be phototoxic agents? What plants can be phototoxic agents? What meds can be phototoxic?
Perfume Parsnip Celery Meadow grass Fig Lime Wild carrot 5 FIFTHS DIA 5-FU FQs Isotretinoin Furosemide TCNs HCTZ Sulfonamides Diltiazem Ibuprofen Amiodarone
30
How is Phototoxicity Tx
I SPAS Identify Sunscreen PUVA Avoidance Steroids
31
# Define Vitiligo What are the two etiologies When does is present in PTs?
Acquired loss of melanocyte/pigment Autoimmune Abs to melanocytes Genetics M>F, half before 20y/o
32
What are the two types of Vitiligo How do the different types present?
Type A- MC, generalized Type B- segmental A: symmetric pattern of white macules B: asymmetric, doesn't cross midline
33
Type A Vitiligo can have ? phenomenon present? What is this condition also associated w/?
Koebner phenomenon Halo Nevi
34
What are two differentiating facts about Type B Vitiligo What are the associated concerns of any type?
Follicles depigment Earlier onset Psych Depigmented retinal- uveritis Depigmented labyrinth- hearing Leptomeningeal melanocyte destruction- aseptic meningitis
35
What are the comorbidites assoiciated w/ vitiligo How is this condition Dx
Graves Addisons Pernicious DM1 Hypothyroid Alopecia Melanoma Clinical Woods lamp accentuates depigmentation
36
What are the goals of Vitiligo Tx What meds are used for Vitiligo Tx
Stabilize depigmentation Stimulate repigmentation Topical CCS- first line Vit D3 analog- Calcitriol Camouflage- dihydroacetone (FDA approved) Depigment w/ Monobenzone, Hydrquinone)
37
# Define Idiopathic Guttate Hypomelanosis What would be seen on biopsy results
ASx white spots w/ sharp borders from seborrheic keratoses, lentigines and xerosis in same area Dec melanocytes
38
How is Idiopathic Guttate Hypomelanosis prevented? How is it Tx
Avoid sun Sunscreen w/ SPF Tretinoin Abrasion Low potency steroids LN2
39
# Define Solar Lentigo These may be AKA ?
Tan macules in Caucasian >60y/o from chronic sun exposure Liver spots
40
How are cases of Solar Lentigo differentiated from freckles? Although rarely needed, what Tx is offered?
Freckles darken after light exposure, Solar does not Topical retinoid Cryotherapy Hydroquinone + Retinoid
41
? is AKA the Mask of Pregnancy What can cause this
Melasma/Chloasma Thyroid dysfunction OCPs Phenytoin
42
What are the 3 patterns of melasma? What is the most important part of Tx?
Centrofacial: FCCL Malar: cheek nose Mandibular Protection from UVA/B
43
What meds can be used for hypopigmentation of melasma
Hydroquinone- best Azelaic/Tretinoin- slow Tri-Luma x 8wks- combo, more effective than single agent Refer if no improvement
44
What are the Benign Epidermal Proliferations, Mulitples
DDS FLAPS Dermatosis papulosa nigra Disseminated superificial actinic porokeratosis Seborrheic keratosis Flegel Dz Lichenoid keratosis Acrokeratosis verruciform Porokeratosis palamris
45
What are the Benign Epidermal Proliferations, Solitary
``` CELIAC Cutaneous horn Epidermolytic acanthoma Large cell acanthoma Invertied follicular keratosis Acantholytic acanthoma Clear cell acanthoma ``` Lichenoid keratosis Warty dyskeratoma
46
What are the Benign Epidermal Proliferations, Linear
``` NMILE Nevous comedonicus Mosaic of Darier dz Inflammatory LVEN Linear porokeratosis Epidermal nevus ```
47
? is the MC benign cutaneous neoplasm What can cause this How does it present
Seborrheic Keratosis Proliferation of immature keratinocytes Evolve from macule Progress to papule/verrucous Stuck on/Greasy appearance in sebaceous areas
48
How are seborrheic keratosis differentiated from malignancy How are SKs Tx
Melanoma- smooth surface w/ color variety SK- uniform appearance LN2/Curettage
49
# Define Leser Trelat sign When do SKs need to have malignancy r/o?
Sudden appearance of multiple SKs, rare sign of internal malignancy Dark lesions
50
# Define Stucco Keratosis What is the etiology of Stucco Keratosis Who/what is the classical presentation
Benign proliferation of keratinocytes Vascular insufficient- Xerosis Elderly light skin PTs w/ peripheral edema
51
How is Stucco Keratosis different than SK Where are these lesions seen on the body? How is Stucco Keratosis Tx
Stuck on appearance of white warty lesions in non-sebaceous areas Ankles, Dorsal feet Curettage Cryosurgery
52
# Define Dermatosis Papulosa Nigrans How does it present? Where does it present?
Smaller SKs in darker skin tone PTs that are completely benign Dome shaped brown/black papule, Hereditary in teen female AfAm/Hispanic PTs Cheeks/Bilateral peri-orbital in photodistribution
53
What Tx has to be done cautiously in Dermatosis Papulosa Nigra PTs How can they be Tx
Cryotherapy- hypopigmentation risk Small: scissor, cautery, curette Large: anesthetize removal w/ shave/excision
54
Skin tags are AKA ? Where are these commonly found? What PTs are these more commonly seen in?
Acrochordon Areas of skin rubbing Obese >25y/o
55
# Define Dermatofibroma How do they present?
Fibrous reactive process from trauma causing collection of fibroblasts, endothelial and histocytes Early pruritic/tender leading to ASx
56
How are Dermatofibromas differentiated during PE? Where are these likely to be found on the body?
Hard growth that retract down when squeezed- dimpling Anterior lower leg- MC Shoulders Upper back
57
How are Dermatobfibromas Tx What form of Tx is avoided?
Punch Biopsy Excision Cryosurgery- can cause divot/deformity Can be used conservatively to reduce color
58
How are hypertrophic scars and keloids the same? How are they different
Firm Raised Red/hyper pigment Shiny/smooth Scar: confined to wound, starts early but regresses Keloid- abnormal large scar beyond borders, rarely subsides
59
Where are keloids more commonly seen? Define Keratoacanthoma
Shoulder/chest Benign epithelial tumor w/ smooth, dome shaped w/ rapid expansion Distinct hyperkeratotic core
60
Where are Keratoacanthoma MC seen on the body? These are indistinguishable from ? and require ? Tx
Limbs w/ sun exposure SCC- excision for Path Recurrent- Tx w/ 5-FU or Methotrexate
61
How do cutaneous horns present? Most are benign but ? How are they Tx
Hard keratonic cone lesion in M on sun exposed sites In situ/invasive SCC LN2 Excision Shave
62
# Define Sebaceous Hyperplasia What is their characteristic appearance on presentation? What PT populations do these show in?
Small tumors of enlarged sebaceous glands Dome shape w/ central puncta on face PTs w/ sun damage and oily skin +30y/o
63
Sebaceous Hyperplasia presenting w/ ? need to be differentiated from ? How is this differentiation done?
Telangiectasia, BCC Dermoscopy- BCC- vessels on surface SH- vessels in valley w/ yellow lobule border
64
# Define Syringoma Who do these present in If attempted, how are they Tx
Sweat duct tumor under eyes ASx in F PTs 20-30y/0 Electrodessication Elevation and Excision Shaved w/ 11 blade
65
# Define Neurofibroma How is this unique presentation ID'd
Benign tumor on nerve sheath Button hole sign- invaginates w/ pressure
66
What other derm findings may be seen in PTs w/ Neurofibromas When can these possible be cancerous?
Axillary freckles Cafe au Lait spot (von Reckling, NF1) 2 or more= Von Reck/NF1 suspicion, malignant potential
67
? is the MC vascular malformation and almost always in ? PTs How does this MC look on PE? Define Telangiectasia and their max size
Cherry Angioma on PTs >30y/o on trunk/extremity .5-5mm smooth deep red papule Permanently dilated vessels of 1mm
68
Spider angiomas are types of ? What are the two types of angiomas How are they Tx
Telangiectasia Arterioles- spider body Capillaries- spider legs Electrodessication Laser ablation
69
# Define Pyogenic Granuloma What two PT populations may have unique presentations? What issue do these typically present w/?
Acquired vascular lesion of skin and mucus membrane Pregnant- gingival lesion Isotretinoin- cyst acne Tx Rapidly grow, easily friable, bleeding
70
How do Pyogenic Granulomas present? Where are these distributed through the body?
Rapidly growing dome shapes w/ moist to scaly surface Finger Gingiva Head/neck
71
How are Pyogenic Granulomas Tx ? is the MC benign soft tissue tumor
Curettage base/border Electro dissection eradicates lesion Lipomas
72
? is the MC skin CA and MC malignant neoplasm in humans What is the origin of this MC What is the most important RF?
BCC Sun induced from intense, intermittent exposure Inability to tan
73
What is the MC form of BCC to be seen on presentation What buzz words may be used to describe it
Nodular Pearly papule Ulcerates, elevates w/ rolled border and tangelectasis- rodent ulcer
74
What is the reassuring part of a BCC Dx What is the MC presenting complaint?
Almost always doesn't metastasize Bleeding/scabbing sore Zit that won't go away
75
Where are most BCCs located on the body How does this form of Ca lead to death
Nodular MC- nose Superficial MC- trunk Direct extension destruction of tissue/organs
76
How are BCC cases Tx How long is management done?
Refer to Derm for: Early: excision Late: Mohs micrograph Annual TBSE D/c after 3yrs tumor free
77
# Define Actinic Keratosis Who is more likely to develop this type? What would be seen on micro exam?
SCC confined to epidermis pre-malignancy Chronic UVB exposure in fair skin PTs Atypical squamous cells in epidermis
78
How will actinic keratosis be describe in test questions? This can present as a ? w/ underlying ?
Hard crusty yellow scale Erythema w/ scale Hyperkeratinic lesion on ear/hand dorsum Cutaneous horn SCC AK Wart SebK
79
What Dx is considered for Actinic keratosis seen on the pinna that is tender? How is it Tx
Chondrodermatitis Nodularis Helicis- degeneration of underlying collagen Excision w/ special pillow
80
How is Actinic Keratosis managed How can the lesions be Tx
Photo protection TBSE One/Few: LN2 Multiple: F-FU Imiquimod (alternative)
81
What is the prognosis for PTs w/ Actinic Keratosis How does this type of CA evolve into a new Dx
SCC development <20yrs *Photo protection dec new lesions and allows small lesions to self resolve AK= SCC of epidermis Once invades dermis= SXX
82
# Define Bowen Dz How is this form different than others
SCC in Situ Histological Dx
83
What does In Situ of Bowen Dz mean How does it appear on PE
Keratinocytic dysplasia involving full thickness of epidermis only Well define border w/ elevated/red scaly plaque
84
What are the MC locations for SCC In Situ by gender How is it Tx How often are f/us needed?
M: scalp/ear F: LE LN2 Curretage Excision Large- 5-FU or Imiquimod 6mon
85
# Define Erythroplasiz of Queyrat How does it present What causes this and who does it present in
SCC In situ of mucus membranes Moist red raised plaque HPV-8 Uncircumcised older male Vulva older female
86
How is E of Q Tx ? is the 2nd MC skin Ca and how is this MC different
5-FU or Imiquimod Laser SCC, high chance of metastases
87
What are the RFs and MC precursor of SCC What words may be used to describe it?
UVA/B radiation Precursor- AKs Persistent red scale w/ deeper involvement Hypertrophic lesion w/ ulcer/hyperkeratosis Lip ulcer w/ induration
88
How are PTs w/ SCC managed ? part of the body has the highest potential for metastasis?
Small from AK- EDnC Larger/lips- Excision F/u q12mon for life Lips
89
# Define Mole How are these nevus cells different from melanocytes
Benign growth of nevus cells derived from melanocytes Larger Abundant cytoplasms No dendrites Contains coarse granule
90
What are the ABCDEs of assessing moles?
``` Asymmetry Border irregularity Color variation Diameter >5mm Evolution (size shape color new) ```
91
When are melanocytic incidence high? If PTs have more than ? nevus, they need f/u every ?
Larger during pregnancy/puberty Peak 4-5th decade >100 q6-12mon
92
What are the 3 types of nevus? What extrinsic factors affect hem
Junction Compound Dermal Hormone Sun
93
Junctional nevus
Flat/slight elevated brown/black lesion <0.6cm MC in childhood, generally after 2y/o Can develop into Compound Nevi
94
Compound Nevi
Slightly elevated dome w/ smooth surface possibly w/ hair White periphery- halo nevus
95
Dermal Nevus
MC dome shaped Brown/black that fades w/ age Common in adults Nevus cells in dermis and possibly fat cells
96
Nevus Spilus is AKA ? When are these MC seen Benign Juvenile Melanoma is AKA ?
Speckled lentiginous nevus Adolescence Birth Early infancy Spitz nevus
97
# Define Congential Melanocytic Nevi When are these concerning for Ca
Birthmark >5% BSA or, >20cm
98
Size categories for congenital melanocytic nevus Define Nevus Spilus What is unique about their prevalence and how are they Tx
Small <1.5cm Med 1.5-20cm Large >20cm Hairless oval brown macule dotted w/ black papules Not related to sun exposure None
99
? is not a true nevus How does it present Where do they MC appear
Becker's nevus Brown macule w/ or w/out hair in adolescent males Unilateral upper back Shoulder/upper arm Submammary
100
How are Becker's Nevus Tx Halo nevus may signal upcoming Dx of ?
Laser removal of macule and hair Vitiligo but rarely converts to malignancy
101
Where are Halo Nevus more commonly and never seen? Spitz nevus are AKA and named because ? Where are they commonly found
MC trunk Never palms/soles Benign Juvenile Melanoma Histologic similarity to melanoma Head Neck LE
102
How do Spitz Nevus look on exam? Define Blue Nevus presentation How is this growth is commonly mistaken for Ca, how is it differentiated from Ca
Hairless red dome w/ sudden appearance Elevated round nevus w/ large amount of pigment on extremities/hand dorsum Develops in childhood, never changes
103
Where are Mongolian Spots MC found where in ? PTs These appear due to ? effect
Scalp/Presacral African/Asian Tyndall effect of melanin deeper in skin
104
# Define Nevus of Ota Other than the skin what other structures does it affect and in ? PT population What Tx/f/u is needed
Blue pigmentation of 1st and 2nd branch of trigeminal nerve Sclera, Conjunctiva Asian females Laser lightens lesion Monitor for glaucoma
105
# Define Labial Melanotic Macule How is this differentiated from Ca How is it Tx if desired
Brown macule on lower lip in young women No change w/ sun exposure Cryotherapy/laser
106
# Define Nevus Flammeus Define Dysplastic Nevus
Port Wine Stain- not a nevus Congenital vascular malformation Atypical nevus in Caucasians appearing from puberty to 4th decade
107
How do Dysplastic/Atypical nevus look on exam? How is this lesion's presence different
Fried Egg appearance Appears in sun protected areas- back, UE/LE
108
What are the Dx criteria needed for Dysplastic Nevus How often do these PTs need f/u?
``` 3 of: >5mm diameter Ill defined border Irregular margin Varying pigmentation Papular and Macular parts ``` TBSE q6-12mon w/ base line pictures
109
Malignant melanoma is _th most common Ca in men and _MC Ca in women What is the highest relative risk for this
5th in men 6th in women Hx of atypical moles FamHx of melanoma >75moles
110
Greatly increased risk factors for malignant melanomas
Hx/FamHx/>75moles Congenital nevus >20cm Hx/FamHx of melanoma ImmSupp Previous non-melanoma Ca
111
Moderate increased risks for malignant melanoma
``` Clinically atypical nevi Larger number of nevi 26-100 nevi Chronic tanning w/ UVA >250 PUVA psoriasis Txs ```
112
Skin Phototype Chart
1: always, never 2: easy, light 3: some, gradual 4: minimal, always 5: rare, deep tan 6: never, deep pigment
113
Where are malignant melanomas MC located in men and women What location is MC for non-white PTs
M: back W: arm, leg Mucosal
114
What are the two parts to a malignant melanoma exam? What labs are ordered to look for ?
Skin phototype TBSE CBC CMP UA Leukocytosis Sign of metastases
115
What test/procedure is not done on PTs w/ malignant melanoma How often do they need f/u? What is the most important histological determinant?
Shave biopsy q3-4mon x 12mon then q6mon Breslow Mircrostage Depth in mm In Situ: 95-100% 5yr survivial >4mm 50% 5yr survival
116
Define Clark Level for Malignant Melanomas
``` Depth at anatomic site: Epidermis Papillary dermis Fills papillary dermis Reticular dermis Enters SQ fat ```
117
What are the 4 histological types of malignant melanoma
Superficial spreading- MC Nodular Lentigo maligna Acra lentiginous
118
Superficial Spreading Melanoma
MC type of melanoma MC in 30-40y/o Hallmark: haphazard combo of many colors Nodule appears when lesion >2.5cm
119
Nodular Melanoma This one is commonly mis-Dx as ?
Completely vertical growth usually 40-60y/o male MC dark/red/black brown lesion ``` Blood blister Hemangioma Dermal necus SK Dermatofibroma ```
120
? is a poor prognostic factor of nodular melanoma seen on PE Lentigo Maligna Melanoma
Ulcer/blister w/ pressure means Breslow depth >4mm Older PT 60-70y/o MC on face Slow growth over 5-20yrs Brown/black macula w/ raised blue/black nodule
121
Acral Lentiginous What PE sign may be seen in these PTs?
MC form in dark pigmented PTs on palms, soles, terminal phalanges and mucous membranes Hutchingson sign- sudden pigment band at proximal nail fold
122
What is the relation between malignant melanoma in light and dark pigmented PTs
Light- most Ca were on sun exposed area Dark- most Ca were on sun COVERED area, more likely on subungual, mucosa, plantar and palm
123
When doing TBSE on dark pigment PTs, what areas need to be focused on more? What are the modified ABCDEFs for dark pigment PTs
Palms Fingers Soles Toes Subungual and Mucosal ``` Age: 5-6th decade Brown/black band Change- recent/rapid Digit MC involved Extension of brown pigment on cuticle Fam/Hx of unusual moles ```
124
What phase of malignant melanomas have better prognosis? What is the most important prognosis factor of malignant melanoma?
Horizontal/radial growth Sentinal lymph node imvolvement in lesions >1mm thick
125
80% of malignant melanomas arise in ? areas Table
Covered by clothes Slide 82 MM
126
Why/how do hypertrophic scars/keloids reoccur after Tx removal? ? test/tx step is avoided in keratoacanthomas
Collagen production Just debride, excise to r/o SCC
127
Pts w/ FamHx of multiple lipomas need to be referred to ? for Tx Bowen's Dz only involves ? layer of skin
MSK Ortho surgeon Epidermis
128
? infection is precursor for SCC Excision of melanocytic nevus can only be done by ? methods
HPV Shave/Excisional biopsy
129
? type of nevi has 'halo nevus' Where will the 3 different types of nevi have cells on histology results
Compound Junction: junction Compound: junction and upper dermis Dermal: dermis, fat cells
130
When/how are congenital melanocytic nevi Tx Halo nevus can be either of ? two nevus types What age do these typically present but they can fade in ?
Small/Med: elective removal after puberty Large/Giant: prophylactic removal Compound Dermal 15y/o, fade over decades due to T-cells attacking
131
Epidemiology of malignant melanoma
``` 5th MC M/6th MC F Dx age: 57 Age of death: 67 M>F White 10x>others ```

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