Management of Dysplastic Naevi not in 3rd Ed Flashcards
The total number of melanocytic naevi and the presence of atypical moles are independent risk factors for the development of melanoma.
T
Most melanomas arise within dysplastic naevi.
F De novo.
Dysplastic naevi rarely occur on the chronic sun-exposed skin of the face or hands.
T
7% of Caucasians have clinically atypical (dysplastic) naevi.
T
Patients with >100 uniform small naevi are not at increased risk of melanoma.
F “Cheetah phenotype” – increased risk
Dysplastic naevus / atypical mole syndrome can occur sporadically or be inherited.
T
Unlike persons with common naevi, it is not unusual for persons with atypical naevi to continue to develop new lesions throughout life.
T
‘Classical’ atypical mole syndrome is characterised by having: >100 melanocytic naevi, 1/more naevi with atypical features, and 1/more naevi >8mm diameter.
T
Individuals with dysplastic naevi who have at least one blood relative with melanoma have a lifetime risk of developing melanoma of greater than 80%.
F At least two blood relatives.
Removal of all dysplastic naevi in a patient eliminates the risk of developing melanoma.
F Most arise de novo.
A wood’s lamp can help visualise areas of naevus regression by highlighting depigmented areas.
T
Proposed surgical margin for in situ melanoma is 10mm.
F 5mm
Proposed surgical margin for less than or equal to 1.0mm thick melanoma is 10mm.
T
Proposed surgical margin for 1.0-2.0mm thick melanoma is 10mm.
F 10-20mm.
Proposed surgical margin for 2.01-4.0 mm thick melanoma is 20mm.
T
Proposed surgical margin for >4mm thick melanoma is 20mm.
T
Sentinel lymph node biopsies provide a survival advantage.
F Only provides prognostic information.
The incidence of a second primary melanoma is 25% in patients with a history of melanoma.
F 0.2-8.6%.
Risk factors that increase the chance of developing new primary melanoma(s) include male sex, older age, having atypical moles, family history of melanoma, and family history of atypical moles.
T
A focused review of systems aimed at pts with melanoma should include queries about weight loss, fatigue, headache, numbness, dizziness, SOB, cough, abdo pain and bone pain.
T
The first site of metastasis is most commonly the skin and subcutaneous tissue, followed by lymph nodes, lung, liver, brain and bone.
T
The greatest risk of recurrence of melanoma is in the first 10 years following the diagnosis.
F First 1-5 years.
The time to recurrence for patients with node-negative disease varies inversely with the thickness of the primary tumour.
T Thin melanomas can potentially recur many years after the initial diagnosis.
Regarding melanoma, men and older pts have a worse Px than women and younger pts.
T
Predictive factors for regional node metastasis include increasing tumour thickness, presence of ulceration, high mitotic index, lymphovascular invasion and Clark level greater than III.
T
Dysplastic naevi have increased recurrence rates
F 2014 questions – Dan added – this is how the question was remembered. I think false
Ophthalmology review is necessary in dysplastic naevus syndrome
F 2014 questions – Dan added
Dysplastic naevus syndrome patients have increased risk of melanoma
T 2014 questions – Dan added
