Melanocyte diseases Flashcards

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1
Q

risk factors

A

FHx and PMH
sever sunburn (childhood), and UV exposure/sunburn
multiple dysplastic naevi, large congenital naevi
immunosuppression
fair skin (type I/II)

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2
Q

melanocytic naevi types

A
freckles
congenital: hairy, prigmented
acquired: getting deeper
-junctional: dark macules
-compound: dark and warty papules
-intradermal: raised papule, paler colour
halo (pale ring) blue: extremities
atypical naevi: suspicious but benign; melanoma risk
malignant melanoma
-lentigo maligna
-MIS
-superficial spreading
nodular
lentigo maligna
acral
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3
Q

melanoma features

A

ABCDE

asymmetry
border (irregular)
colour (irregular)
diameter (>7mm)
evolving and elevated

other: itching, bleeding, inflammation

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4
Q

melanoma checklist

A

major: colour change, shape, size
minor: bleeding, inflammation, itching, >7mm

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5
Q

melanoma types

A

in-situ: lentigo maligna, MIS

invasive: superficial spreading, nodular, lentigo maligna melanoma, acral

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6
Q

in-situ melanoma

A

lentigo maligna: slow growth, changing colour/shape/size, sun-exposed
MIS: any site; ABCDE (histology confirms no invasion)

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7
Q

superficial spreading melanoma

A

commonest (70%)
thin, radial growth
trunk (M), legs (F)
high intensity UV; young/middle-aged

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8
Q

nodular melanoma

A
raised, thick, circ'd
vertical invasion
can be pale
trunk; young/middle-aged; high intensity UV
poor prognosis
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9
Q

lenitgo maligna melanoma

A

slow growth
good prognosis
long cumulative UV, elderly, facial

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10
Q

acral melanoma

A
palms/soles/nails; all skin types
rapid invasion
rarest
not related to sun
increasing incidence >20yo
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11
Q

melanoma prognosis

A

Breslow thickness:
in situ 100% 5ys; 3mm 40% 5ys

Clarke score: intraepi/partial papillary/expanded papillary/reticular dermis/subcut

Male, older, head/neck, ulcerated

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12
Q

melanoma DDx

A

seborrhoeic wart: matted, warty, ‘stuck on’, keratin plugs; no Rx
pigmented BCC: pearly edge
dermatofibroma: firm lesion, arms/legs
pyogenic granuloma: red lump, friable, rapid appearance
atypical mole

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13
Q

melanoma Mx

A

histological confirmation agter excision

wide local excision: 1-2cm peripheral margin (1cm lateral for every 1mm depth)
?LN clearance or SN biopsy
no standard Rx for mets

F/U: local recurrence (usually subcut nodular)
5 years: 3-monthly for 3y, 6-monthly for 2y

sun protection and advice!

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14
Q

benign lesions (melanoma mimics)

A
atypical molesblue naevus
seborrhoeic wart
pigmented BCC
dermatofibroma
pyogenic granuloma: C&C, lasers, cryo, imiquimod, excision
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