pigmented lesions Flashcards
are melanin-producing cells that have their embryologic origin in the neural crest that migrate to epithelial
surfaces where they reside among basal epithelial cells.
melanocytes
in what epithelial surface does melanocytes reside?
basal epithelial cells
granules of pigment that melanocytes produces
melanosomes
ABCDE of mole or melanoma
A - asymmetry
B - Border
C - Color
D - Diameter
E - evolving
one half of a mole does not match the other
asymmetry
the edges are irregular, ragged, notched, or blurred. Normal moles are round or oval
border
the mole is not evenly colored. it may include shades of brown or black, or patches of pink, red, white or blue
color
the spot is larger than 6 mm across
less than .25in - benign
greater than .25in - malignant
diameter
the mole is changing in size, shape or color
evolving
what part of the melanocyte-keratinocyte unit transfers the melanin of melanocytes into the keratinocytes
dendritic processes
melanocytic lesion are physiologic or pathologic lesions?
physiologic lesions
linked to cigarette smoking, “smoker’s melanosis”
stimulation of melanocytes to produce more melanin
time and dose related
smoking-associated melanosis
most typically affected location of smoking associated melanosis
anterior labial gingiva
palate and buccal in pipe smoking
location of affected area in pipe smoking
palate and buccal mucosa
DD of smoking associated melanosis
diffuse melanoacanthoma
peutz-jeghers syndrome
addison’s disease
treatment of smoking-associated melanosis
smoking cessation
prognosis of SAM
biopsy if pigmentation shows irregularity or intense color
common oral pigmentation
melanotic macule
melanocytic nevi aka as
moles
presents as:
1. intraoral freckle
2. postinflammatory pigmentation
3. macules associated with systemic disease (peutz jeghers, bandler or addisons’s disease)
oral melanotic macule
systemic disease that needs to be considered if melanotic macules are seen in excess in oral and perioral distribution
- peutz-jeghers syndrome
- addison’s disease
systemic condition associated with OMM
peutz-jeghers syndrome
intestinal polyposis
autosomal-dominant inheritance
risk of cancer specifically intestinal cancer
systemic condition associated with OMM
addison’s disease
macules and diffuse bronzing
adrenal cortical insufficiency - weakness, hypotension, nausea, weight loss
systemic condition associated with OMM
laugier-hunziker syndrome
Oral, subungual, and skin macules
systemic condition associated with OMM
Bandler syndrome
Small intestine hemangiomas and mucocutaneous macules
gene mutation of peutz-jeghers syndrome
STK11/LKB1 located on chromosome 19
gene mutation in peutz jeghers is usually found in ___ organ
small intestine (jejenum)
adrenal cortical insufficiency
addison’s disease
characterized by
melanin accumulation in basal keratinocytes and normal numbers of melanocytes
melanotic macule
discrete melanin-pigmented
patches of skin that have irregular margins and a uniform
brown coloration.
Cafe-au-Lait Macules
Individuals with six or more large café-au-lait macules should be suspected of
having?
neurofibromatosis (NF)
oral lesions associated with cutaneous pigmented macuels
neurofibromatosis
neurofibromatosis of skin, oral mucosa, jaws
Cafe-au-Lait macules of skin
McCune-Albright syndrome
Polyostotic fibrous dysplasia
endocrine abnormalities
collections of nevus cells that are
round or polygonal and are typically seen in a nested pattern
melanocytic nevus
common acquired papular lesions that usually appear shortly after birth and throughout childhood.
melanocytic nevus
most common location of melanocytic nevus
palate
types of melanocytic nevus
- intramucosal nevus
- blue nevus
- compound nevus
- junctional nevus
a subtype of melanocytic nevus that when cells are located in the epithelium–connective
tissue junction, it is called?
junctional nevus
a subtype of melanocytic nevus when cells are located in connective tissue,
intramucosal nevus
a subtype of melanocytic nevus when cells are
located in a combination of these zones
compound nevus
a subtype of melanocytic nevus when cells are
spindle shaped and are found deep in the connective tissue
blue nevus
most commonly seen subtype of melanocytic nevus
intramucosal nevi
second most commonly seen subtype of melanocytic nevus
blue nevus
rarely seen subtyope of melanocytic nevus
compound and junctional nevi
treatment of melanocytic nevus
needs to be differentiated from melanoma
suspected nevi should be biopsied
all suspected oral nevi should be excised.
a lesion that ot has a high incidence in japan
oral melanoma
high risk sites of oral melanoma
palate and gingiva, more than 70% of case
subtype of melanoma
connective tissue invasion without junctional phase
poor prognosis
invasive melanoma
subtype of melanoma
prolonged preinvasive junctional phase
poor prognosis due to delayed diagnosis and undertreatment
melanoma in situ
exhibit abnormal expression of
adhesion molecules, a phenotype that would contribute to
the process of invasion
melanoma
in amelanotic melanoma,
Three reliable antibodies that react with proteins expressed by melanoma are
HMB45
melan-A (MART-1)
anti-S-100 protein
treatment for melanoma
chemotheraphy, surgical excision
prognosis of melanoma
depends on
histological subtype
depth of invasion
metastasis
survival rate of melanoma
20% after 5 years
gene mutation of melanoma
if familial
p16
p14
CDK4
MC1R
gene mutation of melanoma
if sporatic
BRAF or N-RAS
BRAF gene may also be found in ___ lesion
ameloblastoma
Melanin found within surrounding basal keratinocytes and sub adjacent connective tissue macrophages is termed as?
Melanophages
In addisons disease, overproduction of __ and __ results in stimulation of melanocytes, leading to diffuse pigmentation of the skin
ACTH and MSH
Adenocorticotropic hormone
Y-melanocyte-stimulating hormone
(melanin present within connective tissue macrophages) is typically seen within the lamina propria.
Melanophagocytosis
Characterized by melanin accumulation in basal keratinocytes and normal numbers of melanocytes
Melanotic macules
embryologic origin of melanin
neural crest cells
Predominantly in any mucosal surface and vermillion of the lips
Melanotic macule
Common location of melanocytic nevus
Palate
