Module 2: Chaos and Clues Flashcards

1
Q

Excluding seborrheic keratosis

A
Multiple orange or yellow clods
Multiple white clods
Thick curved lines
Well demarcated border
Multiple grouped similar lesions
If in doubt bx
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2
Q

Which clue is most sensitive for melanoma on face

A

Grey color

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3
Q

Which clue is most specific for melanoma on face

A

Dot vessels
then grey circles
then pigmented circles

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4
Q

Exceptions to decision algorithm

A

changing lesions in adults
nodular or small lesions with any clue
Head/neck pigmented circles or dermatoscopic grey
Acral parallel ridge patterns (can be symmetrical)

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5
Q

Polarizing specific white lines

A

BCC
Melanoma
Spitz nevus
Dermatofibroma

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6
Q

Where to look for dot vessels in melanoma?

A

Flat sections

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7
Q

Do you get dot vessels in BCC?

A

Few, but not a pattern.

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8
Q

Do you get serpentine vessels in SCC?

A

No

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9
Q

What is significance of looped vessels?

A

Raised lesion = invasive

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10
Q

List vessel structures

A

Dot, Clod
Line, Looped
Curved, Sepentine
Helical, Coiled

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11
Q

List vessel patterns

A

Random, Clustered
Serpiginous, linear,
Central, Radial
Reticular, Branched

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12
Q

Priority pigment vs vessel

A

Pigment takes priority over vessel

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13
Q

Nail matrix melanoma

A

Lines of varying width interval and color

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14
Q

GET BLACK LOLLIPOPS - most to least sensitive

A

Grey or blue structures
Eccentric structureless areas
Thick lines reticular

Black dots or clods peripheral

Lines radial OR pseudopods, segmental
Lines white
Lines parallel ridges

Polymorphous vessels
Polygons

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15
Q

Tyndall effect

A

Air particles scatter light which becomes visible to observer.
Short wavelength light (blue) is scattered 16x more than long wavelength light (red). Sky therefore appears blue.

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16
Q

Chaos and clues has been designed to

A

assess all pigmented lesions
detects any type malignancy
no need to decide if melanocytic
applied at exam speed

17
Q

C+Clues Algorithm

A

Chaos, look for 1 of 9 clues.
If 1 of 9 clues biopsy unless can make unequivocal diagnosis.
Exception - consider bx anyway

18
Q

RPA

A

Pattern + colours + clue = diagnosis

19
Q

5 basic structures

A
line 
pseudopod
circle
clod
dot
20
Q

5 type of lines

A
reticular
branched
parallel
radial 
curved
21
Q

Define line

A

2 dimensional continuous object L&raquo_space;W

22
Q

Define Pseudop

A

line + bulbous end

23
Q

Define circle

A

curved lines sensible equidistant from central point

24
Q

Define clod

A

well circumscribed solid object > dot. Any shape and colour.

25
Q

Define Dot

A

Too small to have discernable side and shape

26
Q

Define Structureless

A

Area with no basic structure predominating

27
Q

C+C sens and spec and malignancy

A

90.6 and 62.7

28
Q

Eccentric structureless area …

A

any colour except skin
if white usually regressioim
red = increased blood flow
coloured - dense chaotic melanon deposition

29
Q

Lines reticular exclude

A

BCC and SCC

30
Q

could a new lesion be a nevus at 40

A

unlikely

31
Q

could a new lesion be a nevus at 50

A

no

32
Q

polygons definition

A

geometric polygonal shape complete or incomplete bounded by straight lines or a straight pigment interface, meeting at angles, larger than the holes of single follicles and larger by far than holes bounded by reticular lines.

33
Q

Pigmented circles are …….% specific for melanoma

A

76

34
Q

Grey circles are …. % specific for melanoma

A

83

35
Q

Grey colour is … % specific for melanoma

A

31