Pigmented skin lesions Flashcards
Give the 3 kinds of acquired melanocytic naevi
Junctional- nests of melanocytes at DEJ
Compound- at DEJ and in dermis (lighter brown)
Intradermal- predominantly in the dermis (lighter brown again)
how do congenital naevi differ from acquired? (3)
larger and slightly raised
become more rugose and levanted with age
increased risk of melanoma in large naevi
Name the 5 other kinds of naevi
blue naevus atypical/dysplastic naevus halo naevus naevus spilus Spitz naevus
risk factors for melanoma? (7)
fam hx genetic markers UV exposure and sunburn in childhood, high socioeconomic status congenital/atypical naevi hx melanoma immunosuppression
Name the subtypes of melanoma
superficial spreading Nodular lentigo maligna Acral lentiginous amelonotic (absent or minimally invasive pigment)
superficial spreading
- area of presentation
- appearance
- development
- occurs on trunk/legs
- macule with irregular border/colour
- slow radial growth phase and then vertical growth phase
Nodular
- area of presentation
- appearance
- development
-any site, older patients
-blue black/red/skin coloured nodule may be ulcerated or bleeding
no satellite lesions
-develops rapidly, vertical growth
Lentigno maligna
- area of presentation
- appearance
- development
- face in elderly
- pigmented macule
- neoplastic melanocytes along the basal layer become malignant
Acral lentiginous
- area of presentation
- appearance
- palms/soles/nails in the elderly
- Hutchinson sign-pigmented extension into nail fold
name the 4 melanoma mimics
- describe
- treatment
Seborrheic Keratosis -brown/black greasy lesion, found on trunk, have stuck on appearance warty with regular border -freeze, curette or shave
Dermatofibroma
- deep brown/grey firm nodule
- reassure or excise
Subcorneal haematoma
-due to trauma, large black patch on the heel
BCC
-can be pigmented
Sites of Met for melanoma?
skin, soft tissue, brain, bone, lung, GI tract
treatment of non-melanoma skin cancer? (7)
Surgery photodynamic therapy cryotherapy chemo/radiotherapy 5-flurouracil solaraze imiquimod cream
melanoma treatment?
SURGERY!!
complications of skin biopsy?
bleeding wound dehiscence (smokers) infection scarring motor/sensory nerve damage loss of function cut to ^^
