Week 1 Flashcards
Macule: Localized: Erythematous: Vascular
- Port Wine Stain (Nevus flammeus) is a darker and larger nevus simplex that does not resolve over time. What are the two syndromes could it be part of and what are the associated conditions.
Sturge-Weber Syndrome: Port Wine Stain over distribution of trigeminal nerve. Epilepsy and mental retardation.
- Seizures, hemiparesis, learning disorders, and occasional GLAUCOMA.
Klippel-Trenaunay-Weber Syndrome:
Presence of port wine stain + hypertrophy of affected limb
Macule: Localized: Erythematous: Infectious
- What is a “herald patch” and if a patient presents with it, what condition are you thinking?
- What other buzzword is associated with this?
Thinking of Pityriasis Rosea
- Herald patch = single macule on the trunk, some central clearing and peripheral scale
- Christmas tree configuration on the back
Pityriasis Rosea
- What is the treatment management?
No treatment needed (self limiting) and not contagious
Erthematous macular eruptions: What is the histologic difference between capillary hemangiomas (birth marks) and Juvenile Strawberry hemangioma?
Capillary hemangioma are composed of NORMAL size and structure capillaries (At birth)
Juvenile strawberry hemangioma are packed blood-filled masses of capillaries. (within first few months, fades)
Ring shape with red, raised, border representing active inflammation with a healing center
- What is it called and what is associated with it?
“Ring worm”, associated with dermatophytes (tinea)
- it is pruritic!
Simple Lentigo vs Solar Lentigo
Simple: not limited to the sun and occurs in childhood while solar, since it is related to sun exposure, is seen in adulthood
Which skin pathology is associated with polyps in GI tract and therefore increase in GI Cancer?
- Genetic inheritance is…
Peutz-Jeghers Syndrome
- Autosomal dominant, see pigmented macules on lips and buccal mucosa
Which of the macules should raise suspicion of neurofibromatosis type 1.
Cafe Ole Macules
- may have axillary freckling
Neurofibromatosis type 1 is a condition characterized by changes in skin coloring (pigmentation) and the growth of tumors along nerves in the skin, brain, and other parts of the body. The signs and symptoms of this condition vary widely among affected people.
African American, where do you have to check for melanoma?
Feet, Acral lentiginous melanoma, the only one that doesn’t have to do with UV (occurs in dark skinned individuals)
Most powerful prognostic indicator of skin cancer + 2nd most important.
Tumor thickness and mitotic rate
(>6 mm) - more concerning
Better or worse prognosis?
- Presence of TIL (tumor infiltrating lymphocytes)
- Regression
TIL = better prognostic indicator
Regression = high risk for distance metastasis
Most common melanoma subtype
Superficial Spreading Melanoma (SSM)
A type of melanoma that lacks pigment + the subtype that it’s in.
Amelanotic Melanoma => Nodular melanoma
- Note: Nodular melanoma, rapid growth (hallmark)
- Note: Nodular melanoma comes from NORMAL skin
Managing Patients with Melanoma
Stage 0 =
Stage 2 =
Stage 3 =
Stage 0 = Lifelong follow up at least yearly
Stage 2 = Yearly CXR
Stage 3 = Excision 2 cm margins, complete LN dissection
Used to measure the thickness of the excised (removed) tumor
ocular micrometer
