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malignant Flashcards

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Dermatology Board Prep flashcards
1
Q

MC melanoma, 30-40s, upperback MandW, legs in women, HALLMARK IS HAPHAZARD COMBO OF MANY COLORS, nodules appear when lesion is greater than 2.5 cm? dx

A

superficial spreading melanoma

at 2.5 cm marks the beginning of the vertical phse and the end of radial growth. then it gets ulceration and scaling and plaquelike elevation

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2
Q

fried egg appearnace

what are the 3 of 5 things needed to diagnose dysplastic nevus?

A

diamter >5mm

ill defined borders

irregular margin

varying shades in lesion

presence of popular + macular components

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3
Q

what does a becker’s nevus not contain?

A

nevus cells

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4
Q

often confused w/ malignant melanoma on extermities and dorsum of hands, but delvops in early chilhood and remains unchanged? dx trx

A

blue nevus

removal

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5
Q

treatment for large congenital melanocytic nevus?

A

removal still has high incidence of malignant melanoma

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6
Q

when might a halo nevus occur?

A

w/o trigger or after sunburn: auto-immune

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7
Q

patient presents w/ patchof hair and brown macule on shoulder. they have ipsilateral breast or limp hypoplasia, scoliosis, and spina bifida occulta. DX trx

A

becker’s nevus syndrome

hair shaved, laser treatment for hair or pigmentation

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8
Q

malignant melanoma MC wehre for men and women

A

back: men

arms and legs: women

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9
Q

what is the most imporant histological determination of malignant melanoma?

A

breslow depth

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10
Q

treatment for halo nevus

A

nothing in teens, but excise if parents want or atypia suspected

adults: wood’s lamp: look for vitiligo, bx if suspect malignant melanoma

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11
Q

treament for medium congenital melanocytic nevi (1.5-20cm)?

A

remove after puberty

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12
Q

what is seen on biopsy of melanocytic nevus (mole)?

A

nest of nevus cells, coarse granules, no dendrites, in dermo-epidermal jxn

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13
Q

what is the tyndall effect and what is it associated w?

A

the tyndall effect is brown pigment absorbs the longer wavelengths of light and scatter’s blue light

mongolian spots

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14
Q

pt. has short stature, gonadal dysgenesis, web neck, cubitus valgus and lymphedema at birht, DX and what lesion might they have?

A

turner’s

halo nevus

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15
Q

treatment for small (<1.5 cm) congenital melanocytic nevi? (grows w/ child)

A

leave alone and observe

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16
Q

what greatly increases risk of malignant melanoma?

A
  1. personal hx, fam hx, >76-100 moles
  2. previous nonmelanoma skin cancer
  3. congenital nevus (>20 cm)
  4. hx of melanoma
  5. immunosuprresion
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17
Q

what is the treatment for nevus spilus?

A

nothing the malignant potential is rare

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18
Q

treatment for mongoloian spots?

A

nothing, but make sure that to annotate

19
Q

treament for melancytic nevus (mole)?

A

>100 follow at 6-12 months,

ABCDE

biopsy if suspect

20
Q

what is treatment for a dysplastic nevus?

A

excisional bx

pt education on self exam and sun: use hairdryer

baseline pics. w/ follow up 6-12 mos

screen family members

refer to ophthalmoligc exams

21
Q

MC spot for becker’s nevus?

A

unilateral upper back, shoulder, upper arm, submammary

22
Q

where is a halo nevus never located?

A

palms or soles

23
Q

what melanoma has lateral growht phase and is typically in older patients 60-70s. on face MC, slow growht, and has complex pattern of brown to black macular pigmentation and blue-black nodules?

A

lentigo maligna melanoma

24
Q

what melanoma is commonly misdiagnosed? looks like a blood blister, ulcerates and bleeds and has rapid growth. MC found in 40-60y/o males? only vertical gowth no radial growth

A

nodular melanoma

25
Q

patient presents w/ discoloration in the eye. it’s an asian female. You know that is blue and black pigmentation in the 1st and 2nd branch of the trigeminal nerve. dx. trx

A

nevus of ota

laser to lighten

monitor for glaucoma

26
Q

moderately increased risk of malignant melanoma?

A

atypical nevi w/ no fam hx

  1. nevi 51-100, 26-50
  2. chronic tanning w/ UVA or PUVA for psoriasis
27
Q

what is the ABCDEF for DPP?

A

age

brown or black band

change

digit

extension onto cuticle or where hang nail might develop

fam or persona hx of unusual moles

28
Q

when should you be worried about a congenital melanocytic nevi?

A

>= 5% bsa, >20 cm

29
Q

ALL NEVUS CELLS IN DERMIS, dome shaped MC, but can be verrucous, pedunculated, sessile, has hair, common in adults.

A

dermal melanocytic nevus

30
Q

melanocytic nevus that is flat or slightly elevated. <.5-.8 cm. light brown to black and uniform. located in the epidermis and epidermis-dermal jxn. may develop into compound. MC in chilhood?

A

junctional nevi

31
Q

what is the other name for spitz nevus?

A

benign juvenile melanoma

32
Q

what is the most important prognostic factor in lesins >1mm thick?

A

systemic lymph node involvement

33
Q

what is the management for malignant melanoma

A

excisoinal bx

punch bx

NO SHAVE

f/up: self exam

f/u: 3-4 months for 1 year, then q 6 mos therafter

34
Q

may have white periphery, halo nevus. slightly elevated to dome shaped w/ nest into the upper dermis. Hairy or non hairy.

A

compound nevus

35
Q

brown, black macule on lower lip mc in young women. NO CHANGE w/ sun exposure. dx trx

A

labial melanotic macule

cryotherapy or laser if desired

36
Q

what is the other name for nevus spilus?

A

speckled lentiginous nevus

37
Q

MC in adolescence at birth or early infancy. hairless oval or irregular shaped brown macule, w/ dotted darker spots?

A

nevus spilus, speckled lentiginous nevus

38
Q

what is the ugly duckling method

A

one is darkier and larger than the others

one is small, but lack pigement

one lesion on the back. check for changes

39
Q

what is the treatment for spitz nevus that MC occurs SUDDENLY in children on the head, neck, and lower extremities? dx trx

A

spitz nevus

biopsy

40
Q

what melanoma is on the palms, sole, terminal phalanges and mucou membranes. has a tendency to remin flat? and has hutchinson sign (under nail plate)? dx prognosis?

A

acral lentiginous

very poor prognosis

MC DPP

41
Q

moderate incresae risk for MM?

A

repeated blistering sunburns 2/3

freckling

fair skin/inability to tan

red or blond hair

atypical nevus

acute risk is more risk than recurrent exposure

42
Q

where does most MM arise?

A

areas covered by clothing

43
Q

other names for dysplastic (atypical) nevus?

A

clark nevi

Derm (10 decks)

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