Melanocytic lesions Flashcards
What is the term for freckles?
Ephelides
What is actinic lentigines?
macular “age spots” or “liver spots” that are on your face or back of the hands. They are usually bigger than and don’t wax and wane in the sun like ephelides
a patient has uniformly pigmented brown lesions on the lip as well as intraorally that do not change with sun exposure. What is the diagnosis?
Melanotic macule. could represent post traumatic melanosis.
what is special microscopically about melanotic macules?
no nevus cells present. Clusters of melanocytes at rete ridge tips. INCREASED amount of melanin pigment of basal layer of connective tissue
How do you treat melanotic macules?
vermillion lesions can be excised for esthetics and submitted for examination. IF INTRAORAL, may need to take out to rule out melanoma.
What does Harrington call a mole?
Acquired melanocytic nevus. The most common of all human tumors.
What are the 3 types of melanocytic nevi?
- Junctional nevus
- Compound nevus
- Intradermal nevus
These terms are based on where the nevus cells are located microscopically
What can you tell me about junctional nevi?
They are the first stage, flat, and dark in color
What can you tell me about compound nevi?
They can evolve from a junctional nevus. Their cells begin to “drop off” into the connective tissue and start to become raised lesions. Compound nevi can have hair
What can you tell me about intradermal nevi?
They have proliferated until they are completely contained inside the connective tissue. Elevated, and a wide range of colors. Often skin colored.
T/F moles can appear inside the mouth
gross but true! it is rare but they mostly occur on the hard palate or attached gingiva. They can be present on any oral site though.
what are the indications for tx of melanocytic nevi?
no tx for cutaneous nevi unless 1. esthetic concern, 2. chronically irritated, or 3. has had changes in color
What is the risk of nevi turning into melanoma?
low, 1 in 3,000 to 10,000
T/F Early oral mucosal malanoma can look like mucosal nevi
True! Biopsy ALL unexplained pigmented oral lesions
What percentage of newborns have nevi at birth?
1% have congenital melanocytic nevi. These moles can be large (bathing suit or garment nevi) or small, but most are less than 15cm and can have hypertrichosis (excess hair)
what percentage of congenital nevi can turn malignant?
1% for small, 2-3% for larger nevi
tx for congenital nevi
excise totally if small, may have to do it in stages if large. Close follow up is necessary
where can blue nevi occur and why are they blue?
ANY cutaneous or mucosal surface. Blue color due to depth of melanin (Tyndall effect)
Blue nevi has what microscopic appearances?
a collection of dendritic melanocytes within connective tissue with abundant melanin content. Melanocytes appear normal.
tx and prognosis of blue nevus?
excise. excellent prognosis and rarely is malignant or recurs
The 3rd most common skin cancer is?
Melanoma (BCC most common)
malanoma is what percent of skin cancers and causes what percent of skin cancer deaths?
5% but causes 75% of the deaths
who gets more melanoma, men or women?
slightly more men. Young women are prone to get it and older men are too
what are the risk factors of melanoma and the high risk locations (BANS)?
family hx of melanoma, personal hx of melanoma,
BANS =back, arms, neck, scalp
