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Specialty Medicine > Pigment Disorders > Flashcards

Pigment Disorders Flashcards

1
Q

What are the SALT cells in the skin?

A

Langerhans cells–APCs of the immune system

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2
Q

What is a major issue with tanning in terms of cellular damage (which cells in particular)?

A

Langerhans cells are damaged

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3
Q

What is skin type I of the Fitzpatrick skin types?

A

White people who can’t tan

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4
Q

What is skin type II of the Fitzpatrick skin types?

A

Fair skin (burns easily, but can tan a little bit) (you)

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5
Q

What is skin type III of the Fitzpatrick skin types?

A

Darker, white skin

tans after initial burn

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6
Q

What is skin type IV of the Fitzpatrick skin types?

A

Light brown skin

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7
Q

What is skin type V of the Fitzpatrick skin types?

A

Brown skin

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8
Q

What is skin type VI of the Fitzpatrick skin types?

A

Dark brown or black skin

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9
Q

Are nevi macules or papules?

A

Either

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10
Q

What happens to nevi with age, generally?

A

Regress/ go deeper

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11
Q

True or false: dark skinned people do not develop nevi

A

false

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12
Q

What are the ABCDEs of melanoma changes?

A 
Asymmetry
Border
Color
Diameter
Evolving
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13
Q

What are the two major ways to classify type of nevi?

A

By onset

By depth

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14
Q

At what age do nevi begin to form? When does it peak?

A

Age 10 ish

Peaks around age 50

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15
Q

It is unusual to develop nevi after what age?

A

50

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16
Q

What usually causes nevi? What is the genetic predisposition to them?

A
  • Sunlight

- Mutation in the BRAF gene

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17
Q

What are the two major shapes of junction nevi?

A

Flat or slightly elevated

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18
Q

What are the two major shapes of compound nevi?

A

Slightly elevated

Dome

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19
Q

What are the four major shapes of dermal nevi?

A

Dome
Warty
Polypoid
Pedunculated

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20
Q

What are junction nevi?

A

Nevus whose cells are at the dermoid-epidermal junction

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21
Q

What are compound nevi?

A

Nevus whose cells are at the derm-epidermal junction and upper dermis

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22
Q

What are dermal nevi?

A

Neves whose cells are in the dermis, sometime along with fat cells

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23
Q

What are the color of the following:

  • Junction nevi
  • Compound nevi
  • Dermal nevi
A
  • Junction nevi = uniform tan
  • Compound nevi = flesh color
  • Dermal nevi = flesh to pink
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24
Q

True or false: junction nevi are sharply demarcated

A

True

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25
Q

What makes a nevi atypical? (4)

A
  • Having flat or raised within the same nevus
  • More than 5 mm
  • Irregular pigmentation
  • Irregular borders
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26
Q

When do atypical nevi usually appear in life? How long do they progress for?

A

near puberty, and continue to develop past the fourth decade

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27
Q

True or false: atypical nevi are not a marker for a person at risk for melanoma

A

False–they are, and may even be a precursor to it

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28
Q

What is atypical mole syndrome (dysplastic nevus syndrome)?

A

a cutaneous condition described in certain families, and characterized by unusual nevi and multiple inherited melanomas

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29
Q

What is the gene that predisposes people to melanoma?

A

BRAF kinase

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30
Q

What is the prophylactic treatment for patient with the BRAF V600E gene? MOA?

A

Vemurafenib–B-Raf enzyme inhibitor

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31
Q

What is the tumor marker that is positive in melanoma?

A

S100

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32
Q

Are cafe au lait spots congenital nevi?

A

Nah dawg

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33
Q

True or false: large congenital nevi may undergo a malignant transformation

A

True

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34
Q

True or false: congenital nevi tend to be raised at birth

A

false–usually flat, but can later become raised

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35
Q

Do junctional nevi tend to be with hair or without?

A

without

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36
Q

What are the cells that give rise to junctional nevi, and where are they found?

A

Melanocytes, above the BM

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37
Q

When do junctional nevi tend to develop?

A

After 2 years

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38
Q

Junctional nevi on palms, soles, conjunctiva, or nail beds are most common in which ethnicities?

A

African or asian

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39
Q

Are junctional nevi generally symmetric or asymmetric? Regular or irregular?

A

Symmetric and regular

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40
Q

Do compound nevi tend to be with hair or without?

A

May have associated hair

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41
Q

Are compound nevi generally symmetric or asymmetric? Regular or irregular?

A

May be irregular or warty appearing surface

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42
Q

Where on the body can compound nevi occur?

A

Anywhere

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43
Q

How big, generally, are intradermal nevi?

A

Less than 1 cm

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44
Q

Where do intradermal lesions tend to become pedunculated?

A

Trunk or flexures

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45
Q

What are halo nevi?

A

Compound or dermal nevus that forms a white border

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46
Q

What causes halo nevi?

A

The formation of a halo surrounding a nevi is believed to occur when certain white blood cells called CD8+ T lymphocytes destroy the pigment-producing cells of the skin (melanocytes). The cause for the attack is unknown.

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47
Q

What are the characteristics of the border of halo nevi?

A

Round, sharply demarcated

48
Q

Where on the body do halo nevi usually occur?

A

Trunk, never on hands/feet

49
Q

What is the natural h/o halo nevi?

A

Repigmentation may occur, or entire lesion may disappear

50
Q

What is the average age of onset for halo nevi?

51
Q

What are speckled lentiginous nevi?

A

Hairless, oval or irregularly shaped brown lesion that is dotted with darker spots

52
Q

When do speckled lentiginous nevi occur?

A

At any age, but tend to look like cafe au lait spots at birth

53
Q

What are the size ranges for lentiginous nevi?

54
Q

Are lentiginous nevi related to sun exposure?

55
Q

What are Becker’s nevi?

A

not a nevocelluar nevus

56
Q

In whom do Becker’s nevi occur?

A

Adolescent men

57
Q

Where on the body do Becker’s nevi generally occur?

A

Shoulder
Submammary area
Upper/lower back

58
Q

What are the characteristics of the borders of Becker’s nevi?

A

Irregular, but sharply demarcated

59
Q

What are the characteristics of the syndrome that may occur with Becker’s nevi?

A

Ipsilateral hypoplasia of breast and skeletal abnormalities

60
Q

True or false: Becker’s nevi tend to be hairy

61
Q

What is benign juvenile melanoma (spitz nevus)?

A

a benign melanocytic nevus, a type of skin lesion, affecting the epidermis and dermis

62
Q

In whom do spitz nevi tend to occur in?

63
Q

Why are spitz nevi also called benign juvenile melanomas?

A

Look like melanoma, but are benign

64
Q

What are the characteristics of Spitz nevi?

A

Hairless, dome shaped papule around 1 cm in size that is highly vascular

65
Q

What is the classic presentation of a Spitz nevi?

A

Nevi that occurred suddenly (within a week)

66
Q

What are the borders like with Spitz nevi?

A

Sharply demarcated

67
Q

What are blue nevi?

A

a type of melanocytic nevus. The blue colour is caused by the pigment being deeper in the skin than in ordinary nevi. In principle they are harmless

68
Q

Blue nevi are usually less than what size?

69
Q

When do blue nevi generally occur? Where on the body?

A
  • Childhood

- Extremities and dorsum of the hand

70
Q

True or false: melanomas can arise from blue nevi

71
Q

What are labial melanotic macules?

A

Benign brown macules on the lower lip (usually). Appear like a freckle, but do not darken with sun exposure

72
Q

In whom do labial melanotic macules occur?

A

Young women

73
Q

What is pityriasis alba? Who does it usually occur in, and what is the prognosis?

A

A common skin condition mostly occurring in children with atopic disease, and usually seen as dry, fine-scaled, pale patches on the face.

It is self-limiting (usually resolving after puberty) and only requires use of moisturizer creams

74
Q

What is koebner’s phenomenon?

A

also called the isomorphic response, refers to the appearance of lesions along a site of injury. This phenomenon is seen in a variety of conditions; for example, lichen planus, warts, molluscum contagiosum, psoriasis, lichen nitidus, and the systemic form of juvenile rheumatoid arthritis

75
Q

What is vitiligo?

A

Acquired loss of pigmentation (absence of melanocytes) d/t autoimmune antibodies

76
Q

Is vitiligo localized or generalized?

77
Q

What are the two autoimmune diseases that are related to vitiligo?

A

DM I

Autoimmune thyroid disease

78
Q

What is the distribution of type A vitiligo?

A

Non-dermatomal

79
Q

What is the distribution of type B vitiligo?

A

Dermatomal

80
Q

What is the difference in age of onset between type A and B vitiligo?

A 
A = any age
B = young
81
Q

What is the difference in progression between types A and B vitiligo?

A 
A = Lifelong
B = rapid spread in 1 year
82
Q

Which has Koebner phenomenon: type A or B vitiligo? Which is associated with immunological diseases

A

A for both

83
Q

What is idiopathic guttate hypomelanosis? What does it look like? S/sx?

A
  • Acquired white spots on arms and legs, usually 2-5 mm in size.
  • Sharply demarcated borders
  • Asymptomatic
84
Q

What predisposes patients to developing idiopathic guttate hypomelanosis?

A

Sun exposure

85
Q

What is nevus anemicus?

A

A localized and congenital disorder characterized by macules of varying size and shape, that are paler than the surrounding skin and cannot be made red by trauma, cold, or heat. The paler area is due to the blood vessels within the area which are more sensitive to prostaglandins

86
Q

Where on the body is nevus anemicus usually found?

87
Q

Are melanocytes and/or melanin present with nevus anemicus?

88
Q

Are melanocytes and/or melanin present with idiopathic guttate hypomelanosis?

89
Q

What is the defect in tuberous sclerosis?

A

TSC is caused by a mutation of either of two genes, TSC1 and TSC2, which code for the proteins hamartin and tuberin, respectively.

90
Q

What, generally, is tuberous sclerosis?

A

Diffuse growth of hamartomas throughout the body

91
Q

Where are the ash leaf spots usually found with tuberous sclerosis?

A

Extremities and trunk

92
Q

What can be used to help located the ash leaf spots of tuberous sclerosis?

A

Woods lamp

93
Q

What are ephelides?

94
Q

What is a lentigo? When do they develop?

A

(liver spots)–a small pigmented spot on the skin with a clearly defined edge, surrounded by normal-appearing skin. It is a benign hyperplasia of melanocytes which is linear in its spread

-Develop with increasing age

95
Q

What happens to Freckles with age?

96
Q

What is the difference in gender between ephelides and lentigo?

A 
Males = lentiges
Females = ephelides
97
Q

Where on the body are lentigo?

98
Q

Are lentigo affected by sunlight?

99
Q

What is melasma (chloasma)? What causes it?

A

Mask of pregnancy

  • Acquired hyperpigmentation of the face and neck during prego
  • Caused by UV light and estrogen/progesterone levels
100
Q

Is there inflammation associated with melasma?

101
Q

True or false: you can cause melasma with oral contraceptives

102
Q

What number of cafe au lait spots suggest NF?

103
Q

What is erythema ab igne? Prognosis?

A

Erythema, hyperpigmentation, telangiectasia, and/or scaling, caused by prolonged exposure to heat

may fade over time or not

104
Q

How does UV light cause skin damage?

105
Q

Which type of UV light can go through window glass?

106
Q

What type of UV light causes CT changes and photoaging?

107
Q

Which type of UV light has the most harmful effects?

108
Q

What is elastosis?

A

Coarsening and yellow discoloration of the skin

109
Q

What kind of wrinkles does UV light cause?

A

Coarse, deep wrinkles

110
Q

what is poikiloderma of civatte?

A

a common, benign skin condition that mainly affects the skin on the sides of the neck. It mainly affects women. It characteristically spares the shaded area under the chin. The skin in the affected skin is red-brown with prominent hair follicles.

111
Q

What is polymorphous light eruption? Prognosis?

A

Recurring, light induced pruritic/burning rash, that may be genetic. Chronic sun exposure lessens the likelihood, but

112
Q

Is there scarring with polymorphous light eruption?

113
Q

Which gender is usually affected more by polymorphus light eruption?

114
Q

What are the three types of polymorphous light eruption?

A
  • Papular type
  • Papulovesicular type
  • Plaque type
115
Q

What are the abx that can cause phototoxicity?

A

Tetracyclines

Fluoroquinolones

116
Q

What diameter is concerning inn terms of the ABCDEs?

A

More than 6 mm

Specialty Medicine (36 decks)

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