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Derm > Dermoscopy > Flashcards

Dermoscopy Flashcards

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Dermatology Board Prep flashcards
1
Q

Dermal naevus derm features

A

Often cobblestone

Comma or curvi linear vessels

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2
Q

What do globules represent

A

Junctional nests of melanocytes

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3
Q

What does cobblestone reflect

A

Large dermal nests of melanocytes

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4
Q

The most common type of combined naevi

A

Blue naevus and overlying junctional naevus

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5
Q

How does a halo naevus develop

A

Immune system attacks the melanocytes within a naevus and surrounding skin causing depigmentation - first stay is the formation of a halo of depigmentation around a naevus followed by depigmentation of the central naevus

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6
Q

Spitz naevus derm features

A

Predominant vascular pattern composed of dotted vessels

Combination of vessels and variable pigmentation may also be present - mimicking amelanotic/hypomelanotic melanoma

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7
Q

What type of naevi do you get as a teenager, 30s and >50

A

Globular teenager
Reticular adults
Homogenous >50

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8
Q

Seven features of melanoma

A 
Eccentric atypical network 
Blue white veil
Regression structures
Irregular streaks
Atypical vessels
Eccentric homogenous pigmentation
Asymmetrical pigmented globules
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9
Q

MIS derm features

A

Maybe localized to specific focus within the lesion

Eccentric atypical network
Regression structures
Eccentric homogenous pigmentation
Asymmetrical pigmented globules

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10
Q

Thin invasive melanoma findings

A 
Eccentric atypical network
Blue white veil 
Regression structures
Irregular streaks
Eccentric homogenous pigmentation
Asymmetric pigmented globules

Compared to MIS more colours and asymmetry

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11
Q

What do you see in more intermediate thickness melanomas

A

Atypical blood vessels and blue white veil

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12
Q

What does the variability in colour reflect in multicoloured melanoma

A

Different depths affected by Tumour cells
Pink: neovascularisation and atypical vessels
Brown: epidermal
Blue: dermal

Few colours are seen in very thick tumours as boundaries become less distinct

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13
Q

Hypopigmented melanoma derm features

A

Pigmented remnants
Dotted vessels
Linear irregular vessels
Foci of eccentric pigmentation and atypical vessels

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14
Q

Nodular melanoma derm features

A

Regular things seen in SSMM may be lacking

Pseudolacunaes (also see in pigmented nodular BCCs)
Blue white veil
Irregular vessels
Ulceration
Homogenous pigmentation
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15
Q

Featureless melanoma derm

A

Look closely for multicoloured macular with areas of ill defined pigmentation and change in background vascular pattern

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16
Q

Where do you see negative networks

A

Early melanoma and Spitz naevi

White reticular pattern is due to elongation of rete ridges

17
Q

What is regression

A

Immune mediated response by the host to melanoma
Gradual replacement of melanocytic diagnostic detail by grey and white structures representing fibrosis in the papillae dermis and pigmentation in melanophages

18
Q

Seb k derm features

A 
Cerebriform
Comedo like openings 
Hairpin vessels
Fingerprint structure
Milia like cysts
Moth eaten border
19
Q

Features that solar lentigines and seb ks share

A

Pseudofollicular openings
Homogenous pigmentation
Fingerprint structure
Moth eaten border

20
Q

Lichenoid keratosis derm

A

Inflammatory destruction of an epidermal lesion
Inflammation then oigmentation
On dermoscopy: grey granular pigment evenly distributed throughout the lesion

21
Q

Ink spot lentigo dermoscopy

A

Hyperpigmentation of basal keratinocytes

Uniformly hyperpigmented network on dermoscopy

22
Q

Solar lentigo derm

A

Result from basal keratinocytes hyperpigmentation and may be a precursor to seb k

Pseudofollicular openings
Homogenous pigmentation
Fingerprint structure
Moth eaten border

23
Q

Clear cell acanthoma derm

A

Seb k with distinct vascular pattern: multiple dotted, hair pin or even glomerular vessels course a linear pattern throughout the lesion _ ‘string of pearls’

24
Q

Porokeratosis dermoscopy

A

Central erythema

Double line at margin

25
Q

Haemangioma dermoscopy

A

Dilated subepidermal blood vessels form large vascular spaces which may thrombose
Homogenous lacunaes

26
Q

Angiokeratoma dermoscopy

A

Dark lacunae seen more commonly than red lacunae
The darker the higher the degree of thrombosis within the vascular spaces
Whitish veil: due to hyper keratosis and acanthosis

So multicoloured lacunae and blue white veil

27
Q

Sebaceous hyperplasia dermoscopy

A

Comedo like openings
Yellow sebaceous gland aggregates
Crown vessels

28
Q

Dermatofibroma dermoscopy

A

Benign proliferation of dermal connective tissue

Pseudo network (from acanthotic epidermis with elongation and basilar pigmentation of the rete ridges)
Central scar - central papilas component effaced the overlying epidermis replacing the pseudo network
29
Q

AL dermoscopy

A

Keratin plugs
Erythema
Scale

Can have increased prominence of follicular units - seeds of strawberry

30
Q

Bowens dermoscopy

A

Glomerular vessels - focal nests of tortuous vessels resembling the vessels in the renal glomerulus
Keratosis
Scale
Erythema

31
Q

SCC/KA dermoscopic

A

Central yellow keratinous plugs
Arborising vessels centrally
Hairpin vessel in milky halo peripherally

Well differentiated will have more keratinising structures, less diff have more vascular features

32
Q

BCC features dermoscopy

A 
Multiple blue grey dots and globules
Spoke wheel pigmentation
Leaf like areas
Blue grey ovoid nests
Arborizing vessels and erythema 
Erosions and ulceration
33
Q

SBCC dermoscopy

A 
Pear lines to edge
Anastomusing telangiectasias 
Macro and micro arborising vessels 
Peripheral pink homogenous mantle when pressure obscures the blood vessels of the clinical pearly border 
Short fine telangiectasia also seen
34
Q

NBCC dermoscopy

A 
Leaf like and spoke wheel pigmentation
Blue grey ovoid nests
Blue grey pigmentation
Arborising vessels
Erythema
Focal erosions
Ulceration
35
Q

Morphoeic BCC derm

A

Arborising telangiectasia

Derm (57 decks)

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