Pigmented Lesions Flashcards
what are dome-shaped papules on the face that are generally smaller than 4 mm with sharp borders. can be mammillated (with small protuberances) and have hypertrichosis
- congenital nevi
what is hypertrichosis
- growth of hairs out of the mole
for small and medium-sized congenital nevi, what is the risk of developing melanoma
< 1%
what size are large or giant nevi
> 20 cm
for large/giant nevi, the risk of developing melanoma is
5-10%
treatment fo small/medium-sized congenital nevi
- shave removal or excision if bothersome
when do common acquired nevi occur
- 1st or 2nd decade
consider _____(technique) for new lesions after age 50
- biopsy
common acquired nevi are more common where
- sun-exposed areas - increased sun exposure
changes of nevi over time
- brown macules and papules in youth - progress to skin-colored or pink papules
nevi in an individual tend to share a similar pattern, called a ___________
- signature nevus
ABCDEs of melanoma
- asymmetry - border - color - diameter - evolving
what makes a nevus atypical
- variegated color - fried egg appearance
fried egg appearance of a nevi has a peripheral _____ component
- macular
fried egg appearance of a nevi has a central _____ component
- papular
patients with how many atypical nevi are at an increased risk for developing melanoma over their lifetime
> 5
are atypical nevi precancerious
- no
what is the syndrome where a patient may have > 50 nevi and may exceed 100
- atypical mole syndrome
atypical mole syndrome usually appears near what age
- puberty
when you biopsy a lesion, how do you biopsy it
- biopsy the ENTIRE LESION
what is Breslow depth
- full thickness of the lesion
what is a dark blue to black plaque demonstrating asymmetry, irregularly notched borders, and a pink erythematous rim
- melanoma
genes identified in melanomas
- CDKN2A - CDK4 - p53 - BRCA2
cell of origin for melanoma
- melanocyte
etiology of melanoma
- prolonged UVB/UVA exposure
what is the single most important prognostic factor for survival and clinical management
- Breslow depth
what subtype of melanoma is the most common type where the growth of the tumor is primarily horizontal rather than down into the dermis
- superficial spreading type
superficial spreading type involves ____ in men and ____ in women
- back in men - legs in women
what subtype of melanoma has rapid growth that is vertical and gives the tumor an increased breslow’s depth
- nodular type
what subtype of melanoma occurs on chronically sun-damaged skin with slow progression
- lentigo maligna
what subtype of melanoma is more common in people with darker skin color and diagnosis if often delayed so the lesions tend to be many centimeters in diameter
- aural lentiginous
what subtype of melanoma has a variable appears and can be confused with psoriasis, dermatitis, BCC, SCC, and is difficult to diagnose
- amelanotic type
< 0.8 mm Breslow depth requires what for treatment
- surgical excision
> 0.8 mm Breslow depth requires what for treatment
- local excision - sentinel node biopsy
treatment for metastatic melanoma
- BRAF inhibitor and MEK inhibitor - (fenib) and trametinib
