Derm path II

Question 1

anucleate ghost cells

Answer 1

pilomatrixoma

Question 2

hemangioma

Answer 2

red lump

Question 3

xanthoma

Answer 3

yellow lump/bump

Question 4

fibrohistiocytic lesion

Answer 4

tan

Question 5

tan brown papule <1cm

sometimes tender

Answer 5

benign fibrous histiocytoma

Question 6

dermatofibroma

Answer 6

same as benign fibrous histiocytoma

Question 7

skin pigment where increased melanin in keratinocytes, no increase in # melanocytes

Answer 7

sun tan
freckles
cafe au lait spots
melasma

Question 8

skin pigment wehre increased melanin in keratinocytes and small increase in # melanocytes

Answer 8

solat lentigo

Question 9

loss of melanin in keratinoctes

Answer 9

vitiligo, acute transient

albinism

Question 10

loss of melanocytes, permanent

Answer 10

vitiligo, chronic

Question 11

what are types of acquired pigmentation

Answer 11

skin tattoo

amalgam tattoo

Question 12

physiologic purpose suntan

Answer 12

increased protection against solar radiation (UV-B spectrum)

Question 13

what is melasma

Answer 13

hypermelanosis

Question 14

signs melasma

Answer 14

sharply demarcated blotchy brown macules on face
symmetrical distribution over cheeks and forehead
less frequently on upper lip and neck

Question 15

what is chloasma

Answer 15

melasma on that face of someone who is pregnant

Question 16

when does melasma occur

Answer 16

during pregnancy
in women taking oral contraceptive
at menopause

Question 17

solar lentigo

Answer 17

benign discrete

hyperpigmented macule occurin in chronically sun exposed skin in adults (back of hand and forehead)

Question 18

what causes solar lentigo

Answer 18

increased melanin pigment in keratinocytes

variable increase in number of junctional melanocytes

Question 19

what does lentigo mean

Answer 19

proliferation of melanocytes

Question 20

lentigo maligna

Answer 20

in situ melanoma in sun exposed skin of face

Question 21

what is vitiligo

Answer 21

loss of melanin in keratinocytes

Question 22

Tx for acute vitiligo

Answer 22

keratinolytic agents

removes layers of keratinocytes

Question 23

what is albinism

Answer 23

defect in tyrosinase, enzyme necessary for melanin production

Question 24

mutation in melanocytic nevi

Answer 24

acquired mutations in Ras signaling like NRAS and BRAF

Question 25

what are junctional nevi

Answer 25

maculopapular visible appearance | small, flat and uniform

Question 26

what are compound nevi

Answer 26

papular visible appearance raised and dome shaped nests and cords of dermal nevus cells

Question 27

what are intradermal nevi

Answer 27

frequently nodular visible appearance | NO nests of melanocytes at dermal epidermal junction

Question 28

large congenital nevus at risk for

Answer 28

melanoma risk

Question 29

what do blue nevi look like

Answer 29

non nested ermal infiltration assoc with fibrosis highly dendritic and heavily pigmented

Question 30

blue nevus can be confused with what

Answer 30

melanoma

Question 31

what is a spitz nevus

Answer 31

spindle and epithelioid cell nevus | fascicular growth, large plump cells with pink-blue cytoplasms anf fusiform cells

Question 32

spitz nevus confused with

Answer 32

hemangioma and melanomas

Question 33

what is a halo nevus

Answer 33

lymphocytic infiltration surrounding nevus cells

Question 34

what causes halo nevus

Answer 34

host immune response against nevus cells and surrounging normal melanocytes

Question 35

nevus with cytologic atypida

Answer 35

dysplastic nevus

Question 36

dysplastic nevus is a potential marker for

Answer 36

precursor melanoma

Question 37

familial clark/dysplastic necus

Answer 37

autosomal dominant | CDKN2A and CDK4 mutations

Question 38

appearance of dysplastic nevus

Answer 38

assymmetric border irregular color uneven diameter >6mm

Question 39

histo of dysplastic nevus

Answer 39

melanocytes as nests at tips of rete ridges rete ridges are bridged papillary dermis has increased fibrosis "fibroplasia"

Question 40

subtypes of malignant melanoma

Answer 40

lentigo maligna superficial spreading nodular acral lentiginous

Question 41

what is lentigo maligna

Answer 41

in situ sun exposed area

Question 42

superificial spreading malignant melanoma

Answer 42

in situ or invasive with mostly horizontal growth phase

Question 43

nodular malignant melanoma

Answer 43

invasive mostly vertical growth phase

Question 44

acral lentiginous

Answer 44

palms soles and subungual, non-caucasian, insitu or invasive

Question 45

how do majority malignant melanomas originate

Answer 45

de novo, as isolated lesion | not usually next to melanocytic nevus

Question 46

where does malignant melanoma mets to

Answer 46

lymph nodes, liver, lungs, brain

Question 47

risk factors malignant melanoma

Answer 47

caucasians with fair skin male gender 3 episodes of severe sunburn before age 20 prolonged MCB UV exposure with repeated sunburn

Question 48

types of conditions of fair skin that increase risk of malignant malanoma 50-100 x

Answer 48

albinism or Xeroderma pigmentosa

Question 49

mutation in majoirty of skin melanomas

Answer 49

increased telomerase activity from mutated TERT gene

Question 50

Kit mutations

Answer 50

non sun exposed melanomas

Question 51

mutations in dysplastic nevus and melanoma familial syndromes

Answer 51

CDKN2A mutations that inhibit P16 inhibition | CDK4 mutations block P16 inhbition