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Derm > Pigment Lesions > Flashcards

Pigment Lesions Flashcards

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Dermatology Board Prep flashcards
1
Q

if a mole is small and been there since childhood…is it likely to be melanoma?

A

NO

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2
Q

what do congenital nevus look like?

A

dome shaped with mammillated and hypertrichosis

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3
Q

what is hypertrichosis?

A

increase in hairiness

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4
Q

what does it mean for congenital moles to be mammillated?

A

they have small protuberances

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5
Q

if congenital nevus is bigger than 20 cm…what are we worried about?

A

melanoma

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6
Q

what tool helps evaluate a pigmented lesion in the clinic?

A

dermatoscope

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7
Q

when do you usually get acquired nevi?

A

in first two decades of life

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8
Q

if acquired nevi appear after 50 yo what are we concerned about?

A

melanoma

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9
Q

how do nevi change over time with age? is this normal?

A

often change from brown at young age to a pink or skin color in older age…completely normal

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10
Q

name the ABCDEs of evaluating a mole

A 
asymmetry
border
color
diameter
evolving
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11
Q

how big are melanomas usually?

A

greater than 6 mm

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12
Q

how does color appear in melanomas?

A

usually different throughout the nevi

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13
Q

what is an atypical nevi?

A

nevus with different colors or fried egg appearanc

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14
Q

are atypical nevi precancerous? what should you tell patient to do with these?

A

not pre cancer…but patients should monitor because at higher risk for melanoma

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15
Q

why cant you just remove all atypical nevi and prevent melanoma?

A

because melanoma can occur from the regular normal skin too so removing all of them does not decrease the risk

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16
Q

how many nevi are needed for atypical mole syndrome?

A

more than 50 and usually appear in puberty

17
Q

if you are worried about a pigmented lesion…what should you do?

A

biopsy the entire lesion

18
Q

what is the most important prognostic indicator in melanoma?

A

Breslow depth

19
Q

what percent of melanomas have familial or genetic basis?

A

10%

20
Q

what two genes do we know are common for melanoma?

A

CDKN2A and CDK4

21
Q

where do most melanomas occur? where else can they occur?

A

sun exposed areas…anywhere else even genitalia

22
Q

how do melanomas usually appear? describe them

A

pigmented papule plaque or nodule

23
Q

what is breslows depth?

A

for melanoma eval…is depth between the granulosa tissue and the deepest part of the tumor

24
Q

name the five types of melanoma

A 
superficial spreading
nodular
lentigo maligna
acral lentiginous 
amelanotic
25
Q

what is the most common type of melanoma? describe it

A

superficial spreading…horizontal growth of tumor

26
Q

which type of melanoma grows vertically?

A

nodular

27
Q

which type of melanoma grown on sun spots?

A

lentigo maligna

28
Q

which type of melanoma is common in asians and AAs?

A

acral lentiginous type

29
Q

what is the amelanotic type of melanoma?

A

pink appearance so can be confused with psoriasis and SCC/BCC and dermatitis

30
Q

if breslow depth is less than 0.8 mm then what do you do?

A

surgical excision and follow up

31
Q

if breslow depth is greater than 0.8 mm then what do you do?

A

surgical excision, eval of sentinel lymph nodes and follow up

32
Q

what is the common pathway involved in melanomas that can targeted with therapy?

A

MAPK pathway

33
Q

what two inhibitor types can be used to target the MAPK pathway in melanoma?

A

BRAF inhibitor

MEK inhibitor

34
Q

name the BRAF inhibitor for melanoma

A

vemurafenib and dabrafenib

35
Q

name the MEK inhibitor for melanoma

A

trametinib

36
Q

name the three immune checkpoint spots that can be targeted with therapy for melanoma

A

CTLA4
PD1
PDL1

Derm (22 decks)

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