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CMT > Pigmented Lesions > Flashcards

Pigmented Lesions Flashcards

1
Q

define ABCDE of skin exams

A
  • A: asymmetry
  • B: border
  • C: color
  • D: diameter
  • E: evolving
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2
Q

what is the ugly duckling sign?

A

a lesion that stands out compared to other lesions on the pt’s skin

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3
Q

when to consider biopsy?

A
  • pigmentary changes
  • changes in border or diameter of lesion
  • bleeding or itching in the lesion
  • a new lesion in pt over 50 y/o
  • ugly duckling sign
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4
Q

what to do prior to biopsy?

A
  • take a photo of the lesion
  • record landmarks
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5
Q

how much of the lesion should be biopsied?

A

the entire lesion, unless extremely large in size

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6
Q

Lentigo

common names for lentigo?

A

freckles, sun spots, age spots

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7
Q

Lentigo

what is lentigo?

color, distribution, where, characteristics

A

benign, solitary or multiple, uniform, brown macules and patches that are typically found in sun exposed areas of the body

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8
Q

Lentigo

what causes lentigo

A

UV damage

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9
Q

Lentigo

treatment for lentigo

A
  1. no treatment
  2. sun avoidance in use of sunscreen to minimize appearance
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10
Q

Melasma/Chaloasma

clinical manifestation

A

characterized by patchy light to dark brown hyperpigmentation of the face

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11
Q

Melasma/Chaloasma

who does this typically affect?

A

women, hereditary

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12
Q

Melasma/Chaloasma

what causes worsening of hyperpigmentation?

A

exposure to UV light

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13
Q

Melasma/Chaloasma

associated with?

risk factor

A
  • hormonal changes (OCP, hormone replacement therapies)
  • can be idiopathic
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14
Q

Melasma/Chaloasma

tx

A
  • strict sun avoidance
  • hydroquinone 4% cream (QD/BID, 1 mo)
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15
Q

Melasma/Chaloasma

when should hydroquinone use be reserved for?

A

fall/winter months

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16
Q

Acanthosis Nigricans

Clinical Manifestations

A
  • velvets
  • hyperpigmented plaques on intertriginous areas (neck/axillary)
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17
Q

Acanthosis Nigricans

associated with what?

A
  • insulin resistance (DM, metabolic syndromes, PCOS)
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18
Q

Acanthosis Nigricans

labs to order if pt has this?

A
  1. fasting insulin
  2. fasting glucose
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19
Q

Acanthosis Nigricans

tx

A

strict control of blood sugar to minimize sx

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20
Q

Seborrheic Keratosis

clinical manifestations

6 things

A
  • well demarcated
  • round/oval
  • velvety, warty lesions
  • greasy or stuck appearance
  • variety of colors
  • can be scaly
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21
Q

Seborrheic Keratosis

tx

A
  • no tx necessary
  • can be symptomatically treated with cryotherapy
22
Q

Seborrheic Keratosis

common in who?

A
  • fair skin
  • elderly
  • pts with hx of prolonged sun exposure
23
Q

Melanocytic Nevi

what is it?

A
  • common benign skin lesion due to localizaed proliferation of melanocytes
24
Q

Melanocytic Nevi

differentiate congenital vs acquired

how long they last?

A
  • congenital: tend to be the most prominent & persist through life
  • acquired: follow sun exposure, may fade away
25
Q

Melanocytic Nevi

more common in who?

A

fair skinned individuals

26
Q

Melanocytic Nevi

clinical manifestations

A
  • variety of presentations/sizes on any part of the body
  • flat/raised
  • flesh colored/pink/dark brown/black
27
Q

Melanocytic Nevi

tx

A

observation

28
Q

Atypical/Dysplastic Nevi

define

A
  • melanocytic nevi w/ atypical features
29
Q

Atypical/Dysplastic Nevi

clinical manifestations

5

A

Nevus w/ at least 3 of the following:
* size > 5 mm
* ill definied/blurry borders
* irregular margin/unusal shape
* vareity of colors w/in lesion
* flat/bumpy components

30
Q

Atypical/Dysplastic Nevi

procedure to order?

A

shave biopsy

31
Q

Atypical/Dysplastic Nevi

spectrum of atypica?

A
  • mild
  • moderate
  • severe
  • melanoma in situ
  • malignant melanoma
32
Q

Atypical/Dysplastic Nevi

tx mild

A

monitor for recurrence

33
Q

Atypical/Dysplastic Nevi

tx for moderate/severe

A

excision

34
Q

Blue Nevus

define

A

melanocytic nevus which are located deep within the dermis

35
Q

Blue Nevus

common in which population?

A
  • twice as common in women as men
  • prevalent among Asian populations
36
Q

Blue Nevus

can transform into?

A

melanoma

37
Q

Blue Nevus

clinical manifestations

A
  • solitary
  • blue/gray
  • smooth-surfaced macule, papule, or plaque
38
Q

Blue Nevus

tx

A

observation

39
Q

Melanoma

pathogenesis (cell of origin)

A

melanocyte

40
Q

Melanoma

who most commonly gets these?

A
  • young women ages 15-29
41
Q

Melanoma

caused by?

A
  • cumulative & prolonged UV exposure
42
Q

Melanoma

risk factors

7

A
  1. increasing age
  2. Fitzpatrick skin types 1 & 2
  3. greater than 25 acquired nevi
  4. atypical nevi
  5. immunosuppression
  6. family/personal hx
  7. UV exposure (tanning, blistering)
43
Q

Melanoma

Clinical Manifestations

A
  • usually asx, pigmented papule, plaque, or nodule
  • can bleed, be eroded, or crusted
  • hx of changing appearance
  • msot are de novo (arise from w/in existing lesion)
  • more common in sun exposed areas
44
Q

Melanoma

prognosis

A

high cure rates if dx and tx early

45
Q

Melanoma

prognosis factors

A
  1. increased Breslow’s depth
  2. ulceration
  3. involvement of lymph nodes or distant metasteses
46
Q

Melanoma

what is Breslow’s depth

A

thickness or depth of tumor invasion

47
Q

Melanoma

what to do if you suspect melanoma in pt?

A

refer to derm for biopsy

48
Q

Melanoma

Tx depends on?

3

A

Stage
* based on Breslow’s depth
* ulceration
* lymph node involvement

49
Q

Melanoma

likely tx course

2

A
  1. surgical excision w/ wide margins
  2. +/- lymph node biopsy
50
Q

Melanoma

required follow up

3

A
  1. visits every 6 mo for 10 years, then every 12 mo for life
  2. annual eye exam
  3. annual physical

CMT (78 decks)

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