Melanocytes and Disorders of Pigmentation Flashcards

1
Q

Melanocytes:

What are they derived from? What is their function?

A

derived from neural crest and produce pigment (melanin)

  • They are dendritic cells with dendrites that extend to multiple keratinocytes facilitating melanin transfer via melanosomes
  • Epidermal-melanin unit:
    • melanocyte and its surrounding keratinocytes
    • roughly 1:10 (varies by location and sun-damage)
      *
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2
Q

What is an epidermal-melanin unit?

A

melanocyte and its surrounding keratinocytes

roughly 1:10 (varies by location and sun-damage)

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3
Q

Where are melanocytes located?

A

the basale layer, with dendrites branching up and out

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4
Q

What are racial differences in skin color determined by?

A

characteristics of melanosomes. not size or number or melanocytes!

the size, number and distribution of the melanosomes. melanosomes are the pigment granules within a keratincyte

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5
Q

What is pigmentation and what is it dependent on?

A

melanocyte number and density does not vary by race

pigementation dependent on the size, number, and density of melanosomes (pigment granules in keratinocytes)

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6
Q

what is the relationship between melanocytes, melanosomes and melanin

A

melanocytes (cells) transfers melanosomes (granules) that are filled with melanin (pigment)

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7
Q

What is:

hyperpigmentation

hypopigmentation

depigmentation

A
  • hyperpigmentation: darker than surrounding of normal color; increased pigment
  • hypopigmentation: lighter than surrounding skin; decreased pigment
  • Depigmentation: white; no pigment

to differentiate between white and light areas for hypo vs. depigmentation

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8
Q

WHat is this? hyper, hypo or de

A

hyperpigmentation

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9
Q

what is this? hyper.,hypo or de

A

hypo

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10
Q

How do you get tuberous sclerosis? What does it causes?

A
  • majrity (2/3) new spontaneous mutations, autosomal dominant genetic disorder
  • 1/5800-1/10,000 births
  • TSC1 (hamartin), TSC2 (tuberin) mutation
  • causes non-malignant tumors of the brain, eyes, heart, kidney, skin, lungs
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11
Q

what 4 things do you usually have if you have tuberous sclerosis?

A
  1. hypopigmented macules (3 or more)
  2. Angiofirbomas and fibrous plaque
  3. shagreen patch
  4. periungual fibromas
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12
Q

What are these?

A

angiofibromas and fibrous plaque

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13
Q

what are these

A

shagreen patch

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14
Q

what are these

A

periungal fibromas

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15
Q

what does this little girl have?

A

depigmentation

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16
Q

what is the pathogenesis of vitiligo? How do you get it?

A
  • T-cell mediated autoimmune
  • typically acquired, not present at birth
  • progressive (worsening) course is typical. unpredicatable course and repigmentation can occur
  • destruction of melanocytes with subsequent development of depigmented patches
  • hair in affected area often becomes white (poliosis)
17
Q

what is oculocutaneous albinism?

A
  • genetic disorder (autosomal dominant or recessive)
  • defect in tyrosinase or related proteins leading to impaired melanin production
  • white to yellow/red hair with light to white skin depending on type of albinism
  • high risk of skin cancer due to lack of melanin
18
Q

what are the possible brown spot diseases?

A
  • Ephelides
  • Cafe au lait macules
  • solar lentigo/lentigines
  • dermal melanocytosis
  • melanocytic nevi (acquired)
  • congenital melanocytic nevi
19
Q

What is this?

A

ephelides (freckles)

occur in sun-exposed areas of bdy

they darker with sun exposure. markers of UV induced damage and are a risk factor for melanoma

20
Q

What is this?

A

cafe au lait macules

  • well circumscribed uniformly light to dark brown macules or papules which typicall occur in infancy or early childhood
21
Q

how do you get Neurofibromatosis 1 (NF1)? what is another name for it?

A

also called Von Recklinghausen’s Disease

  • autosomal dminant but up to 50% spontaneous mutations
  • mutations in neurofibromin
  • incidence is 1/3000 births
22
Q

What happens to the skin during Neurofibromatosis 1 (NF1)

A
  • cafe au lait pigmentation
  • axillary/inguinal freckling
  • neurofibromas
23
Q

What are these?

A
24
Q

What are these

A

axillary freckling

25
Q

What are these?

A

neurofibromas

26
Q

what are these?

A

plexiform neurofibromas

27
Q

What is solar lentigo?

A

“sun spots” “liver spots”

sun-exposed ares, bigger than ephelids

28
Q

What is dermal melanocytosis?

A

aka “Mongolian spot”

  • deper pigament (in lower dermis) creates the bluish color
  • lumbrosacral most common: fading over time typical in this location

**often confused with child abuse or ecchymoses

29
Q

what are melanocytic nevi

A

acquired moles that are probably benign

  • subtypes have more histological significance than clinical (refer to location og melanocytic nests)
    • junctional-DEJ
    • compound- DEJ and in the dermis
    • intradermal- in the dermis
30
Q

Congenital melanocyte nevi

A
  • larger than acquired nevi, range in size from 1cm to greater than 20cm at birth
  • risk of melanoma
    *
31
Q

How do you assess risk of malignant transformation to melanoma for melanocytic nevi?

A

ABCDE

  • A=asymmetry
  • B=border irregularity/blurred border
  • C=heterogenity
  • D=diameter
  • E=evolution or change

**not applicable to congenital lesions

32
Q

What is the significance of having a large congenital myelanocytic nevi?

A
  • higher riskfor melanoma than smaller CMV
  • risk for neurocutaneous melanosis
    • leptomeningeal melanosis or even melanoma
33
Q

what white skin diseases are associated with early life?

A

TV: ash leaf macules> 3 cm

Oculocutaneous albinsim

34
Q

what is associated with white disease later?

A

vitiligo

35
Q

brown spots early in life

A
  • ephelides
  • neurofibromatosis
    • cafe au laites>6
    • congenital melanocytic nevi
  • later
    • acquired melanocytic nevi
    • solar lentigo