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AU'18 Oral Path II > Melanocytic Lesions - part I > Flashcards

Melanocytic Lesions - part I Flashcards

1
Q

melanocytic lesions

A
  1. ephelis
  2. actinic lentigo
  3. melanotic macule
  4. acquired melanocytic nevus
  5. congenital melanocytic nevus
  6. blue nevus
  7. melanoma
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2
Q

ephelis

A

freckles

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3
Q

clinical features of ephelis

A
  1. more pronounced with sun exposure
  2. light/medium brown macules of skin
  3. round or oval 3 mm or less
  4. sharply demarcated
  5. fair-skinned, blue eyes, red or blonde hair
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4
Q

treatment for ephelis

A

none indicated

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5
Q

prognosis of ephelis

A
  1. identify skin type that may be more susceptible to UV damage
  2. SPF products should be used
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6
Q

actinic lentigo

A

hallmark of UV damaged skin, “age spots” or “liver spots”

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7
Q

where does actinic lentigo appear?

A

on sun-exposed skin

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8
Q

clinical features of actinic lentigo

A
  1. completely macular
  2. often multiple (may coalesce)
  3. uniformly pigmented brown to tan
  4. well-demarcated irregular borders
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9
Q

treatment for actinic lentigo

A
  1. none indicated unless for esthetic reasons

2. SPF products suggested

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10
Q

what can be done to treat actinic lentigo

A
  1. cryotherapy
  2. laser ablation
  3. intense pulsed light
  4. chemical peel
  5. topicals
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11
Q

what causes melanotic macule

A

unknown etiology but similar lesions associated with systemic conditions, medications and genetic disorders

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12
Q

clinical features of melanotic macule

A
  1. maximum dimension achieved rapidly then remains constant
  2. round to oval 7 mm or less
  3. uniformly tan to dark brown
  4. demarcated margins
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13
Q

is melanotic macule common?

A

yes, common and harmless

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14
Q

T/F: melanotic macule occurs due to sun exposure

A

false, not dependent on sun exposure

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15
Q

T/F: melanotic macule has a female predilection

A

true

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16
Q

what age group is affected by melanotic macule?

A

average age 43 but broad age range

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17
Q

what is the most common location for melanotic macule?

A

lower lip vermilion zone

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18
Q

histopathologic features of melanotic macule

A
  1. increased melanin pigmentation along basal epithelial layer
  2. may show melanin incontinence
  3. normal stratified squamous epithelium
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19
Q

treatment for melanotic macule

A

none indicated unless for esthetics

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20
Q

when would an excisional biopsy be indicated for a melanotic macule?

A

if recent onset, large size, irregular pigmentation, unknown duration, recent enlargement

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21
Q

T/F: melanotic macule are malignant

A

false, considered benign

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22
Q

acquired melanocytic nevus

A

mole

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23
Q

most common of all human “tumors”

A

acquired melanocytic nevus

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24
Q

clinical features of acquired melanocytic nevus

A
  1. gradually involute with age
  2. macules or papules (flat or raised)
  3. sharply demarcated
  4. brown, black, tan, skin-colored
  5. less than 6 mm
  6. hair
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25
Q

when does acquired melanocytic nevus develop?

A

during childhood through ~4th decade

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26
Q

acquired melanocytic nevus is common in what race?

A

Caucasians

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27
Q

where are acquired melanocytic nevus most commonly found?

A

head and neck

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28
Q

T/F: most acquired melanocytic nevi are above the waist

A

true

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29
Q

sites of acquired melanocytic nevus in the oral cavity

A

hard palate or attached gingiva, but potentially any site can be affected

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30
Q

stage of acquired melanocytic nevus depends on what?

A

depends on location of nevus cells microscopically

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31
Q

stages associated with evolution of acquired melanocytic nevus

A
  1. junctional
  2. compound
  3. intradermal (intramucosal)
32
Q

junctional stage of acquired melanocytic nevus

A

nevus cells only in epithelium/epidermis

33
Q

compound stage of acquired melanocytic nevus

A

nevus cells in epithelium/epidermis and CT

34
Q

intradermal stage of acquired melanocytic nevus

A

nevus cells only in CT

35
Q

no treatment is indicated for cutaneous acquired melanocytic nevus unless what?

A

unless 1. chronically irritated

  1. an esthetic concern
  2. changes in size or color
36
Q

what is advised of all unexplained pigmented oral lesions?

A

excisional biopsy

37
Q

what can resemble oral mucosal nevi?

A

early melanoma

38
Q

what is the risk of malignant transformation from an individual cutaneous nevus to melanoma?

A

low

39
Q

is oral nevi currently considered an increased risk for melanoma?

A

no

40
Q

congenital melanocytic nevus

A
  1. present at birth

2. very large “bathing trunk nevus,” “garment nevus”

41
Q

sites for congenital melanocytic nevus

A
  1. trunk and extremities

2. 15% H&N

42
Q

small congenital melanocytic nevus resembles what?

A

acquired melanocytic nevi

43
Q

what is the difference between congenital melanocytic nevus and acquired melanocytic nevi?

A

tend to be larger (greater than 6 mm), darker and hairier

44
Q

clinical features of congenital melanocytic nevus

A

hypertrichosis (excess hair)

45
Q

how are congenital melanocytic nevus classified?

A

by projected adult size

46
Q

small congenital melanocytic nevus

A

<1.5 cm

47
Q

medium congenital melanocytic nevus

A

up to 20 cm

48
Q

large congenital melanocytic nevus

A

greater than or equal to 20 cm

49
Q

treatment for congenital melanocytic nevus

A

excise for esthetic reasons

50
Q

how would you get rid of the congenital melanocytic nevus?

A
  1. dermabrasion
  2. chemical peel
  3. laser
  4. cryotherapy
  5. partial surgical excision
51
Q

what is the percent risk of malignant transformation for congenital melanocytic nevus?

A

~1% for small

52
Q

what is the percent risk of large congenital melanocytic nevus to transform to melanoma?

A

2-3%

53
Q

what should be done after treating congenital melanocytic nevus?

A

close clinical follow-up

54
Q

cutaneous sites for blue nevus

A

hands, feet, scalp, face

55
Q

mucosal sites for blue nevus

A

mucosal sites, esp. oral and conjunctival

56
Q

why is the blue nevus blue?

A

bluish or blue-gray due to the depth of melanin pigment (Tyndall effect)

57
Q

T/F: blue nevus has a male predilection

A

false, female

58
Q

who can have a blue nevus?

A

children, young adults

59
Q

clinical features of blue nevus

A
  1. less than 1 cm

2. macule or papule

60
Q

what is the most common oral site of blue nevus?

A

palate

61
Q

histopathologic features of blue nevus

A
  1. elongated dendritic melanocytes in CT
  2. abundant melanin pigment
  3. no atypia
62
Q

treatment of blue nevus

A

conservative excision

63
Q

prognosis of blue nevus

A

excellent

64
Q

is recurrence of blue nevus common?

A

no, it’s rare

65
Q

is malignant transformation of blue nevus common?

A

no, it’s rate but reported

66
Q

melanoma

A

malignancy of melanocytic differentiation

67
Q

what is the third most common skin cancer?

A

melanoma

68
Q

melanoma makes up what percent of all skin cancers?

A

5%

69
Q

what percent of skin cancer deaths are due to melanoma?

A

75%

70
Q

T/F: the lifetime risk of melanoma is increasing

A

true

71
Q

T/F: incidence rate of melanoma is increasing

A

true

72
Q

T/F: mortality rate of melanoma is increasing

A

false, not increasing as much

73
Q

risk factors for melanoma

A
  1. whites esp. fair-skinned
  2. light hair/eyes
  3. family history of melanoma (genetic predisposition)
  4. personal hx of melanoma
  5. tendency to sunburn/freckle easily
  6. history of blistering sunburn early in life (acute sun exposure > chronic)
  7. indoor occupation; outdoor recreation
  8. hx dysplastic or congenital nevus
  9. > 100 common nevi
  10. immunocompromised (organ transplant)
74
Q

clinical features of melanoma

A
  1. 40-70 yo
  2. female predilection under age 40
  3. male predilection in older pts
75
Q

which sex has overall slight predilection of melanoma

A

male

AU'18 Oral Path II (31 decks)

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