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Dermatology > Pigmented lesions condensed > Flashcards

Pigmented lesions condensed Flashcards

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Dermatology Board Prep flashcards
1
Q

these are entirely dermal and consist of pigment rich dendritic spindle cells. The cellular variant may have mitoses and mimic melanoma

A

Blue naevi

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2
Q

Dendritic spindle cells in which type of naevi?

A

Blue naevi!

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3
Q

Halo naevi are overun by which type of cell?

A

lymphoctyes

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4
Q

have a peripheral halo of depigmentation. They show inflammatory regression and are overrun by lymphocytes

A

Halo naevi

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5
Q

Dendritic spindle cells?

A

Blue naevi!!

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6
Q

Consist of large spindle and/or epithelioid cells

A

Spitz naevi

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7
Q

Problems with spitz naevi?

A

May closely mimic melanoma
Most are entirely benign
Difficult area as there is a malignant variant!

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8
Q

Colour of spitz naevus?

A

Pink/red due to prominent vascularisation

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9
Q

Commonest site for superficial spreading melanoma?

A

Trunk and limbs

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10
Q

Commonest site for nodular melanoma?

A

Varied sites but often trunk

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11
Q

Commonest site for acral/mucosal melanom?

A

Acral and mucosal duh

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12
Q

Commonest site for lentigo maligna?

A

Sun damaged face/scalp

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13
Q

How to recognise superficial spreading melanoma?

A

Looks like a well dodgy flat brown patchy patch with different colours
AREAS of REGRESSION!! i.e. may also have paler splotches within it!

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14
Q

Why is nodular melanoma different?

A

No radial growth phase!! (RGP)

Only VGP

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15
Q

Breslow thickness

A

Deepest tumour from granular layer mm

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16
Q

Strong adverse indicator for melanoma prognosis?

A

Ulceration

High mitotic rate, lymphovascular invasion, satellites, sentinel lymph node involvement

17
Q

Suffix b indicates what

A

Ulceration

18
Q

Satellite

A

Satellite lesions are small nodules of tumour/melanoma located more than 0.05mm from the primary lesion, but less than 2cm

19
Q

Hoe does malignant melanoma spread?

A

1) Satellite deposits of MM
2) Regional lymph node metastases
3) Blood spread (skin/soft tissue, heart, lungs, GI tract, Liver, Brain)

20
Q

Treatment for melanoma?

A

Primary excision to give clear margins
Some also receive a sentinel node biopsy
If SN positive - regional lymphadenectomy

Treatment of advanced disease difficult
Chemo, immunotherapy, genetic therapies

21
Q

If in situ-clear by

A

5mm

22
Q

If invasive but less than 1mm thick, clear by

A

1cm

23
Q

If invasive and more than 1mm thick, clear by

A

2cm

24
Q

When would you do SNB?

A

If >1mm thick or thinner with mitoses

SNB = sentinel node biopsy

25
Q

Imatinib

A

Acral melanomas (c-kit mutation)

26
Q

Dabrafenib and vemurafenib interfere with which pathway?

A

MEK/ERK pathway
(BRAF)
-some melanomas on intermittendly sun-exposed skin may have a BRAF mutation

27
Q

Difference between ephilides and lentigines?

A

Lentigines do not darken following sun exposure

28
Q

Increased basal melanocytes (nests) with downgrowths at dermo-epidermal junction

A

Navei

29
Q

Acquired melanocytic naevi?

A

Junctional
Compound
Intradermal

30
Q

How do congenital melanocytic naevi differ from acquired naevi?

A

Larger, slightly raised
Become more rugose and elevated as child grows older
Increased risk of melanoma in large naevi

31
Q

In atypical naevus syndrome, how does your risk of melanoma increase?

A

Increases by 2 if you have 2

Increases by 6 if you have 6

32
Q

Dermoscopy of melanoma

A

atypical pigment network, black dots, irregular streaks,

focally a blue-whitish veil and a white regression zone with hairpin vessels

33
Q

Most common subtype of melanoma?

A

Superficial spreading

34
Q

Increased melanoma in asian and african people?

A

Acral lentiginous melanoma

35
Q

Hutchinson sign

A

Pigmented excision into the nail fold

ACRAL MELANOMA

36
Q

Stuck on appearance

A

Seborrhoeic keratoses

37
Q

very common
older Caucasians
brown / black

greasy lesions
often on trunk
usually multiple
“stuck-on” appearance

often “warty” but may be flat
regular border

may detach spontaneously or
in part

A

Seborrhoeic keratoses

38
Q

Talon noir

A

Black heel due to haematoma

-caused by trauma

Dermatology (27 decks)

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