Pigmented Lesions Flashcards
Pathophysiology of family atypical multiple mole and melanoma syndrome
-autosomal dominant
-mutation of CDKN2A gene (same genetic mutation seen in 40% of melanoma)
Diagnostic criteria for family atypical multiple mole and melanoma syndrome
- Malignant melanoma in at least one first or second degree relative
- > 50 nevi on body including some with clinical atypia
- Nevi with specific microscopic features
Family history of these types of cancer increases overall risk for developing MM
- pancreatic
- renal
- breast
- Uveal
- astrocytoma
- mesothelioma
gene mutations associated with MM
CDKN2
CDK4
BRAF
most common location of MM in males
back or other areas of trunk (shoulders to hips), head/neck
most common location of MM in females
arms and legs
SSM (most common type; ~70%)
-age of highest incidence
-location
40s-50s
upper back of both genders
legs of women
Nodular melanoma (second most common type; ~10-15%)
-age of highest incidence
-location
50s-60s
any but extremities and back
Lentigo maligna
-age of onset
-location
60s-70s
mostly face but sun exposed areas like neck and arms also
hutchinsons sign
pigmentation from the nail that extends to the nail fold or skin surrounding the nail plate
3 “R’s” of amelanotic melanoma
Red
Raised
Recent changes
what is Breslow thickness?
measurement in millimeters from the top of the lesion to the deepest malignant cells invading the dermis
the thicker the tumor, the greater risk for metastasis
what is clark level?
indicates invasion of the anatomic plane (how deep it goes)
what are the clark levels
L1
L2
L3
L4
L5
L1: confined to epidermis (MMIS)
L2: invasion into papillary dermis
L3: tumor fills the papillary dermis
L4: invasion into reticular dermis
L5: invasion into subcutaneous tissue
