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Dermoscopy > Nail melanoma > Flashcards

Nail melanoma Flashcards

1
Q

Evaluating melanonychia striata requires inspection of the nail plate, cuticle, paronychium and hyponychium

A

True

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2
Q

Pigment on any of the cuticle, paronychium, hyponychium in association with melanonychia striata is highly suggestive of melanoma

A

True

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3
Q

Hutchinson or Micro-Hutchinson sign is a melanoma specific feature of nail unit melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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4
Q

Hutchinson sign is defined as pigmentation of the proximal mail fold that can be seen with the naked eye

A

True

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5
Q

Micro-Hutchinson sign is defined as pigmentation of the proximal nail fold that can only be seen with Dermoscopy

A

True

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6
Q

In contrast to Micro-Hutchinson sign, Pseudo-Hutchinson sign is the reflection of pigment in the nail matrix visible through relatively translucent cuticular skin, and has no diagnostic significance

A

True

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7
Q

Pigment on the hyponychium should be evaluated in the same manner as for acral melanoma.

A

True

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8
Q

Pigmentation on the hyponychium with a parallel ridge pattern would be highly suggestive of melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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9
Q

Hyponychial pigment with acral melanoma specific feature is suspicious for melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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10
Q

Hyponychial pigment is defined as irregular pigmentation on the distal periungual skin

A

True

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11
Q

Triangular shape pigmentation of the nail plate is a melanoma specific feature for nail unit melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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12
Q

Triangular shape pigmentation is defined as width of the melanonychia striata wider at the proximal end of the nail plate

A

True

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13
Q

An irregular band pattern is a melanoma specific feature of nail unit melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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14
Q

Irregular band pattern is defined as multiple, longitudinal, irregular bands of different colours(I.e. black, brown, grey) with irregular spacing, thickness, and disruption of parallelism

A

True

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15
Q

Nail dystrophy is a melanoma specific feature of nail unit melanoma

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
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16
Q

Nail dystrophy is defined as complete or partial nail destruction, and/or absence of the nail plate

A

True

The features of nail unit melanoma are:
Hyponychial pigment with acral melanoma features
Hutchinson or Micro-Hutchinson sign
Triangular shape
Irregular band pattern
Nail dystrophy
17
Q

Examination of the melanonychia striata includes measurement of the width of the nail plate pigmentation at both the proximal and distal ends of the nail plate

A

A wider diameter at the proximal end resulting in a triangular shape is suggestive of rapidly growing tumours including melanoma

18
Q

Examination of the melanonychia striata should include evaluation of the individual striations/bands

A

Benign lesions are characterised by a regular parallel pattern with parallel lines spaced at regular intervals with minimal variation in colour or thickness. Colour of the lines tend to get lighter towards the lateral edges.

Melanomas have an irregular pattern with multiple longitudinal lines of differing colours (I.e. brown, black, grey) and thickness, with irregular spacing and disruption of parallelism

19
Q

Benign nail unit lesions have regular parallel pattern with:
parallel lines spaced at regular intervals
minimal variation in colour or thickness
Colour of the lines tend to get lighter towards the lateral edges

A

True

20
Q

Nail unit melanomas have an irregular pattern with:

multiple longitudinal lines of differing colours (I.e. brown, black, grey) and thickness
irregular spacing
disruption of parallelism

A

True

21
Q

DDx for longitudinal melanonychia

A

Trauma
Infection
Melanocyte activation (drug induced pigmentation, lentigo, PIH)
Melanocyte proliferation (naevus, hyperplasia, melanoma)

22
Q

Pigment granules within pigmented nail band = melanocyte proliferation

A

Absence of pigment granules = melanocyte activation

23
Q

Melanocyte activation = Absence of granules within a greyish coloured band

A

Melanocyte proliferation = Brown to black bands, pigment granules within the band, multiple prominent linear lines within the band

24
Q

Regular pigmented band = benign

A 
Brown = naevus
Grey = lentigo (pigmented keratinocytes)
25
Q

Irregular pigmented bands = melanoma

A

Multiple coloured lines (black, brown, grey)
Variation in thickness of lines
Variation in spacing of lines
Loss of parallelism

26
Q

Dermoscopy of the free edge of the nail plate -

A

Increased pigment upper part = proximal nail matrix melanocytic lesion

Increased pigment lower part = distal nail matrix melanocytic lesion

Dermoscopy (8 decks)

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