Pigmented skin lesions Flashcards

1
Q

What are the main types of benign melanocytic lesions?

A

Ephilides, lentigines, naevi

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2
Q

What is the difference between each of the main types of melanocytic lesion?

A

Ephilides - increased melanin production with normal melanocyte number

Lentigines - increased number of melanocytes with normal melanin production

Naevi - increased basal melanocytes (nests) with downgrowths at the DEJ

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3
Q

What are the visual differences between an ephilides and lentigines?

A

Lentigines are usually darker and larger than ephilides and may darken with UV exposure but do not fade in water

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4
Q

How do melanocytic naevi develop?

A

From melanocytes which fail to mature/migrate in utero

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5
Q

What are the three classifications of melanocytic naevi?

A

Junctional, compound and intradermal

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6
Q

How do junctional naevi appear?

A

Brown macules

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7
Q

How do compound naevi appear?

A

Brown papule (usually light brown)

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8
Q

Is hair on a naevi a good or a bad sign?

A

Good sign

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9
Q

How to intradermal naevi appear?

A

Skin coloured/light brown papule

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10
Q

What are congenital naevi?

A

Benign proliferations of melanocytes in dermis & epidermis

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11
Q

What are the clinical and histological differences between acquired and congenital naevi?

A

Congenital naevi are usually larger and more raised than acquried naevi, they become more wrinkled and elevated with growth & there is a higher risk of melanoma in large naevi

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12
Q

What is the relationship between atypical/dysplastic naevi syndrome and risk of melanoma?

A

As the number of dysplastic naevi increases so does the risk of melanoma

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13
Q

What is naevus spilus?

A

A light brown macule which is speckled with smaller, darker macules/papules

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14
Q

What is the typical dermatoscope appearance of malignant melanoma?

A

Atypical pigment network, black dots, irregular streaks, blue/white veil, white regression zone, hairpin vessels

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15
Q

What is the typical dermatoscope appearance of a benign naevus?

A

Pale homogenous centre OR fading border with featureless pale centre, etc

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16
Q

Where is the most common site of superficial spreading melanoma on men and woman respectively?

A

Men - trunk

Woman - legs

17
Q

What is the natural history of a superficial spreading melanoma?

A

Macule with irregular border and colour which may have been increasing in size for years before developing a nodule

18
Q

What is the pace of development of a nodular melanoma?

19
Q

Do nodular melanomas have surrounding macular pigmentation?

A

No (but superficial spreading melanomas do)

20
Q

What is a lentigo maligna melanoma?

A

Invasive melanoma developing within a lentigo maligna

21
Q

What is hutchinson sign? What is it a sign of?

A

Pigmented extension into the nail fold. Acral lentiginous malignant melanoma

22
Q

Which groups of patients usually get acral lentiginous malignant melanoma?

A

Elderly patients, asian & african patients

23
Q

Where does acral lentiginous malignant melanoma usually present?

A

Soles, palms or nails

24
Q

What is an amelanotic melanoma?

A

A melanoma with absent or minimal visible pigment

25
What is a seborrheic keratosis?
A black/brown greasy lesion that arises from keratinocytes
26
What does a seborrheic keratosis look like?
Black/brown lesion with a regular border which may be flat or warty. May detach spontaneously or in part
27
Which group of patients typically acquires seborrheic keratosis?
Older white people
28
How are seborrheic keratosis treated?
Reassure patient, freezing, curette or shaving
29
Where are seborrheic keratosis usually found?
On the trunk
30
What are dermatofibromas?
Deep/dermal, brown/grey, firm nodules commonly arising from insect bites
31
How are dermatofibromas treated?
Reassure patient and/or excision
32
What is a talon noir? How does it arise?
Subcorneal haematoma. Trauma
33
What is a basal cell papilloma?
A benign lesion which may mimic skin cancer especially when inflammed
34
How does a basal cell papilloma present under a dermatoscope?
Moth eaten border with a polymorphous vascular pattern
35
Early diagnosis is essential in the treatment of melanoma. T/F
True