Pigmented Lesions

Question 1

what are the benign melanocytic lesions?

Answer 1

ephilides
lentigines
naevi

Question 2

what are melanocytic naevi due to?

Answer 2

melanocytes which have failed to mature or migrate in-utero

Question 3

what are the 3 types of acquired melanocytic naevi?

Answer 3

• junctional
• compound
• intradermal

Question 4

what does a junctional naevus look like?

Answer 4

brown macule

Question 5

what happens in junctional naevus?

Answer 5

nests of melanocytes at the derma-epidermal junction

Question 6

what does a compound naevus look like?

Answer 6

brown papule, usually lighter shade of brown than junctional naevi

Question 7

what happens in a compound naevus?

Answer 7

nests of melanocytes at the DEJ but also some within the dermis

Question 8

what does an intradermal naves look like?

Answer 8

skin-coloured or light brown papule, usually lighter shade of brown than compound naevi

Question 9

what happens in an intadermal naevus?

Answer 9

nests of melanocytes predominantly in the dermis with little/no DEJ nests

Question 10

when will congenital melanocytic naevi appear?

Answer 10

present at birth

Question 11

what are congenital melanocytic naevi?

Answer 11

benign proliferations of melanocytes in the epidermis and/or dermis

Question 12

how are congenital melanocytic naevi categorised?

Answer 12

by size:

• small
• medium
• large

Question 13

how are congenital melanocytic naevi different from acquired histologically & clinically?

Answer 13

larger & slightly raised

become more rugose & elevated as child grows

Question 14

what is the ABCDE rule of diagnosing melanoma?

Answer 14

• Asymmetry
• Border
• Colour
• Diameter
• Elevation, Evolution

Question 15

where is superficial spreading melanoma usually found?

Answer 15

trunk of men or legs of women

Question 16

what does superficial spreading melanoma look like & how does it develop?

Answer 16

usually macule with irregular border & colour which may have been increasing in size before developing a nodule

Question 17

in which age group are nodular melanomas usually found?

Answer 17

older patients

Question 18

what do nodular melanomas look like & who does it develop?

Answer 18

blue-black or red-skin-colourednodule which may be ulcerated or bleeding & has usually developed rapidly over preceding months

Question 19

in which age group are acral lentiginous melanomas usually found?

Answer 19

elderly patients

also increased in asian & african people

Question 20

where are cral lentiginous melanoma found?

Answer 20

palms, soles or nails & hutchinson sign

Question 21

what is hutchinson sign?

Answer 21

pigmented extension into the nail fold

Question 22

what are amelanotic melanomas?

Answer 22

melanomas with absent or minimal visible pigment

Question 23

who are seborrheic keratoses common in?

Answer 23

older caucasians

Question 24

what do seborrheic keratoses look like?

Answer 24

brown/black greasy lesions, stuck on appearance, often warty but may be flat with regular border

Question 25

where are seborrheic keratoses usually found?

Answer 25

on trunk

Question 26

what is the treatment of a seborrheic keratoses?

Answer 26

may detach spontaneously, reassurance, freeze, curette or shave

Question 27

what does a dermatofibroma look like?

Answer 27

deep (dermal), brown/grey,firm nodule

Question 28

what is the treatment of a dermatofirboma?

Answer 28

reassurance or excise