pigmented lesion Flashcards
intravascular pigmentation
blanches
hemangioma, vascular malformation, varix, kaposis sarcoma
extravascular pigmentation
does not blanch
petichiae, ecchymosis, hematoma
hemagioma
not present at birth, rapid onset
tumor of infancy
gradual involution (go away)
venus malformation
present at birth and persist through life
anomalies of blood vessels
hemangioma tx
will regress on their own or use systemic corticosteroids
venus malformation tx
small - no tx
large - sclerosing agent
biopsy is contraindicated
sturge-weber syndrome
non hereditary developmental condition
leptomeningeal angiomas may cause convulsive disorder or retardation
tx of sturge-weber
may require neurosurgical tx
varix
abnormally dilated and tortuous veins usually in older adults
loss of CT tone
common location of varix
sublingual varix
kaposi’s sarcoma
caused by HHV8
associated with HIV
painless blue-purple macules/plaques
sarcoma
originates in mesenchymal tissue
carcinoma
originates in epithelial tissue
petechiae
very small hemorrhages into skin, mucous, serosa
doesn’t blanche
ecchymosis
blood accumulation greater than 2cm
doesn’t blanche
hematoma
accumulation produces a mass
doesn’t blanche
ephelis
freckle
increased melanin production
more pronounced after sun exposure
oral melanotic macule
increased melanin production
flat
not related to sun exposure
not premalignant
melanoacanthoma is most common in his race
african americans
management of melanoacanthoma
biopsy to rule out melanoma
nevus
proliferation of melanocytes
t/f oral nevus is considered premalignant and should be completely excised
true
t/f melanoma can always be distinguished
false
melanoma
malignant neoplasm of melanocytes due to acute sun exposure
top 3 most common skin cancers
- basal cell
- squamous cell
- melanoma
what are we most worried about, horizontal or vertical growth?
vertical
4 clinicopathologic types of melanoma
- superficial spreading melanoma
- nodular melanoma
- lentigo maligna melanoma
- acral lentiginous melanoma
most common type of melanoma
superficial spreading melanoma
can occur in young adults
nodular melanoma
deeply invaseive, rapid growth
dome shaped annd dark pigmented
lentigo maligna melanoma
most common on face of older pts
arise in solar lentigo
slowest growthing
acral lentiginous melanoma
melanomas of oral mucosa
t/f. the most important prognostic indicator is the histologic depth of invasion
true.
what is BANS and what does it stand for
areas of poor prognosis interscapular area of Back post upper Arm post and lat Neck Scalp
what does oral melanoma look like in the begining
brown black macule
t/f benign and malignant melanocytic lesions are all clinically indistiguishable
true.
5 yr survival rate of oral melanoma
13-22%
peutz jeghers syndrome
freckle-like genetic mutation
GI features of peutz jeghers
intestinal polyps (not premalignant), intestinal obstruction, maligancy 33% by age 60
oral lesion seen in 90% of puetz jeghers pts
vermillion zone, labial/buccal mucosa, and tongue
1-4mm blue/gray macules
addisons
destruction of the adrenal cortex or pit gland (increased ACTH)
is smoking-associated melanosis premalignant
no
how does smoking cause pigmentation of the oral soft tissues
stimulation of melanocyte activity by tobacco
melasma
aka, the mask of pregnancy, is irregular, symmetric, brown macules on sun exposed face and lips
the use of ____ may also cause melasma
oral contraceptives
drugs that can cause pigmentation
AZT, tetracycline, minocyclines
neurofibromatosis
syndrome including axillary freckling, neurofibromas, lisch nodules (eye pigmentation), cafe au lait spots (6 at least)
heavy metals that can pigment epithelium
arsenic, bismuth, platinum, lead, silver, mercury
gingival line associated with lead and bismuth
Burtons line
chronic silver intoxication
argyria
amalgam tattoo appearance
macular and gray with soft moderately defined lines
sturge-weber syndrome signature color
port wine
t/f. melanoacanthoma often demonstrates slow growth
false. rapid
