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HealthCert Education > Module 6: Facial lesions > Flashcards

Module 6: Facial lesions Flashcards

1
Q

Ddx pigmented macule on the face

A

Pigmented AK
LPLK
LM

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2
Q

What does term “pseudo-network” refer to?

A

Structureless brown pigment interrupted by follicular openings.

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3
Q

Is the term “pseudo-network helpful?

A

No. Pattern is non specific.

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4
Q

Why do we not see pigmented network on the face?

A

Rete ridges are flat

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5
Q

Types of circles

A
  1. Thin lines around follicular opening.

2. Dots arranged in circles around follicular openings,

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6
Q

What type of pattern is dots arranged evenly throughout lesion.

A

Pattern of dots

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7
Q

Pattern of curved lines is clue to …

A

Solar lentigo, no matter where located

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8
Q

Classical Dermoscopy criteria for melanoma in situ on face

A

grey dots arranged around follicular openings
thin grey circles
angulate lines- polygons (rhomboids)
annular granular pattern

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9
Q

What is the mimic or LM?

A

Pigmented AK - can have exactly the same features

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10
Q

Which pattern is most specific for early LM? (MIS)

A

Circles - 30% of all lesions with circles turn out to be MIS

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11
Q

Why do 14% of MIS contain reticular or curved lines?

A

These are collision structures - SL

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12
Q

Which pattern is most specific for solar lentigo?

A

Structureless
Curved lines
Reticular lines

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13
Q

Why reticular lines in SL?

A

Rete ridges regrow

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14
Q

Do one or two circles make a melanoma?

A

No, not if overall pattern = SL

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15
Q

What is accuracy of grey on face?

A

Highly sensitive, will not miss melanoma.
Not specific.
50% SL has grey
Majority of MM has grey

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16
Q

Most specific pattern for AK?

A

White circles
Scale
4 dots in square - polarized dermatoscopy
(May have any pattern)

17
Q

Why reticular lines in PAK?

A

Collision lesions

18
Q

What % PAK have scale?

A

1/3

19
Q

What % PAK have white circles

A

2/3

20
Q

Can white circles be present in other lesions?

A

Yes, e.g. BCC

21
Q

Sensitive of 4 dots in square for AK

A

Not sensitive or specific.

Can be found in normal skin

22
Q

Dermoscopy of mucosal lesions

A

Brown - likely benign

Any Grey, Blue, White, r/o malignancy

23
Q

Are AK usually pigmented

A

No

24
Q

Non pigmented AK typical

A

Scale
Erythematous background
Hypopigmented follicular openings
White circles are clue

25
Q

Significance of AK + prominent vessels

A

Consider that the lesion is already invasive

26
Q

AK, prominent vesses, management

A

Biopsy. Do not treat with liquid n2.

27
Q

Common mutations AK and SCC

A

P53

28
Q

How many AK regress spontaneously?

A

Most

29
Q

Patient with > 20 AK have ? Risk developing SCC

A

20% increased risk

30
Q

Which lesions of AK should we treat?

A

All

31
Q

Ulcerated red nodule Ddx

A

Amelanotic melanoma
SCC, poorly diff
Merckle Cell Ca
Metastasis

32
Q

Features seb gland hyperplasia

A

Vessels not as sharp
Vessels do no cross centre
White clods in centre correspond to seb glands.

33
Q

Arborizing vessels are produced by …

A

any tumour that grows underneath superficial vascular plexus.

34
Q

White globules/ structureless areas in lesions could be …

A

Keratin - usually also on surface
Fibrosis (particular pattern) - usually associated white lines
Pus
Necrosis

35
Q

Pilomatricoma

A

Nodule
White structures - Produces hair like substance - white under dermatoscope
Bleeding

36
Q

Discoid lupus erythematosis dermoscopy features

A 
Perifollicular Whitish halo - may resemble white circles
Erythematous background my resemble 
Follicular keratitis plugs
Telangiectatic vessels - non specific
White scales
Pigmentation
Structureless white areas
Follicular red dots
37
Q

Pilomatricoma characteristics

A

Benign adnexal neoplasm
Common in children
Any age
Rapid growth

38
Q

Discoid lupus erythematosis characteristics

A

Inflammatory condition

Usually on chronically sun exposed skin

39
Q

Discoid lupus erythematosis Ddx

A

Need to distinguish from dermatitis/ Bowen’s disease.

HealthCert Education (24 decks)

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