Melanoma and naevi Flashcards
Patch of malignant melanocytes proliferating radially along the dermo-epidermal junction
Lentigo maligna (Hutchinson’s malignant freckle)
What name is given to the type of melanoma when a portion of lentigo maligna becomes invasive?
Lentigo maligna melanoma
Commonest type of melanoma in the UK?
Superficial spreading melanoma (SSM)
Describe the growth pattern of SSM?
Radial growth followed by true vertical invasion
Clinical features of SSM? (3)
Irregularly bordered/pigmented
May itch/be painful
May bleed
Type of melanoma which exhibits an invasive growth pattern from the outset?
Nodular melanoma
Pigmented patch on the sole/palm/subungual, seen more commonly in Asian/Afro-Carribean populations
Acral melanoma
What history features should alert to the possibility of melanoma? (7)
Growth in an existing mole/development of a new one Irregular outline Irregular pigmentation Larger than 6mm diameter Reddish edge Bleeding, oozing or crusting lesion Itchy/painful lesion
Main determinant of prognosis in melanoma?
Breslow thickness- depth of tumour invasion.
What is the risk of possessing congenital melanocytic naevi?
Smaller ones have a slightly elevated melanoma risk later in life; larger naevi (e.g. a giant congenital melanocytic naevus) have a high risk
Diffuse blue-black patch on the lower back/buttocks of child
Mongolian blue spot, a type of congenital melanocytic naevus
Phases of an acquired melanocytic naevus (3)
Junctional
Compound
Intradermal
When do most melanocytic naevi appear?
In the first 20 years of life
What is the clinical importance of acquired melanocytic naevi? (3)
Some malignant melanomas develop in a pre-existing naevus
Large numbers of acquired melanocytic naevi is associated with increased melanoma risk
Melanocytic naevi can be confused with melanoma
Other types of acquired melanocytic naevi (4)
Sutton’s halo naevus
Dysplastic naevus
Blue naevus
Spitz naevus (characteristic brick red colour)
Types of vascular naevi (3)
Superficial capillary naevus (stork mark)
Deep capillary naevus (port-wine marks)
Childhood angioma (strawberry naevus)
Specific indications for treatment in childhood angioma (4)
Obstruction of feeding/breathing
Obstruction of vision/proximal to eye
Severe bleeding
If it remains unsightly after age of 10
Pharmaceutical options for management of childhood angioma (2)
Prednisolone
Propanolol
What are the ABCD criteria for assessing melanocytic skin lesions?
Asymmetry
Border (irregular)
Colour (heterogeneous)
Diameter (>6mm)
What is the 5y survival for melanoma in C?
100%
Management options for melanoma treatment (4)
Imiquimod (in situ lesions only)
Excision
Completion lymphadenectomy
Adjuvant radiotherapy
Benign reasons for changes in moles? (3)
Guttate psoriasis over mole
Atopic eczema over mole
Depigmentation leading to halo naevus
What is the reason for the appearance of blue naevi?
Migration of melanocytes in development stopped “too soon”- cluster of cells remaining in the dermis makes it look blue
Name given to familial tendency to have many unusual naevi?
Dysplastic naevus syndrome
