Pigmented Lesions Flashcards
Definition: nevus cells migrate from neural crest to skin and occasionally mucous membranes?
nevi (common mole)
Present at birth in about 1% of newborns, larger “garment nevus”
congenital nevus
Genetic influence and the average person has about 15?
acquired nevus
Definition: flat macule, nevus cell in basal epithelium at “junction” of epithelium and connective tissue
junctional nevus
Definition: Nodule +/- hair, nevus cells in dermis or lamina propria?
intradermal nevus
Definition: Nodule, combination of junctional and intradermal?
compound nevus
Definition: dendritic nevus cells deep within connective tissue?
blue nevus
Your patient is black with a mole on his cheek that is reactive, but resolves upon irritant removal. It appears as a reactive proliferation of intraepithelial dendritic melanocytes. What is it?
Melanoacanthoma
Your patient recently did a lot of activity in the sun and came back to your office with multiple flat, tan macule on head and neck skin. What is it?
Ephelis (freckles)
What causes freckles from sun exposure?
localized overproduction of melanin, not an increase in the number of cells
Your patient is over 40 and/or elderly and has multiple flat evenly discolored macule from chronic UV damage. What are they?
actinic or senile lentigo AKA age spots or liver spots
Your female age 43, has multiple 6.8mm tan to brown flat macule like a big freckle in the lower lip, palate, or gingiva. What are they?
melanotic macule
What is the 3rd most common skin cancer?
malignant melanoma
How do individuals get melanoma?
Acute sun damage
Fair complexion
multiple moles, freckles
family history
What do the clinical features ABCD stand for for melanoma?
Assymetry - elevated surface as well
Borders - irregular
Color - variation
Diameter - growth, change, >6mm
Melanoma has 2 growth phases. What are they?
Radial (75-85%)
Vertical (grown down into tumor)
Most common clinical melanoma?
superficial (70%) in the trunk
Second most common clinical melanoma?
nodular melanoma in Head and Neck
Third most common melanoma?
lentigo maligna melanoma (old age) and on face
Where does aural lentiginous melanoma grow?
palms, soles, subungual (toenail), mucous membranes
Where does oral melanoma occur and how does it grow?
palate
Maxillary gingiva
radial growth
Melanoma Tx?
excision with 1mm margin
lymph node dissection
chemo, radiation, immunotherapy
Most important factor influencing survival of melanoma?
depth of invation
metastasis decreases survival
What type of melanoma has a worse survival prognosis?
oral =
What drugs cause multifocal pigmentation?
antimalarials
antiarrythmics (quinidine)
Tranquilizers (thorazine)
cis-platinum
Patient walks in with a bronze coloration all over his body. What caused it and how?
adrenocortical insufficiency triggers hypothalamus to stimulate anterior pituitary to produce ACTH and MSH (melanin stimulating hormone)
Patient walks in with oral and perioral freckles, especially on the lips and cheek and is complaining of intestinal polyps. What is it?
autosomal dominant
Peutz-Jeghers Syndrome
A person walks in with cafe au laits spots. Name the generic condition and the syndrome?
Neurofibromatosis
McCune Albright syndrome
A patient walks in with melanin pigmentation on his palate especially and possibly on the gingiva. What caused this?
smoker’s melanosis
Name the last 4 multifocal pigmentations not covered
Physiologic
Satellite lesions
Kaposi’s sarcoma
Petechiae, ecchymosis, purpura
