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Dermatology > Melanoma > Flashcards

Melanoma Flashcards

1
Q

What is melanoma?

A

A malignancy originating from the melanocytes of the skin

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2
Q

What are some risk factors for melanoma?

A
  • Multiple atypical moles
  • Female (2:1)
  • Middle age
  • UV exposure
  • Genetics
  • Skin prototype
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3
Q

What are the 2 phases of melanoma growth?

A

Radial growth phase (Horizontal)
Vertical growth phase

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4
Q

What is meant by radial growth phase?

A

This is the growth of a melanoma as a macule, either in situ or with dermal micro invasion, spreading out but not down

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5
Q

What is meant by vertical growth phase?

A

The invasion of the melanoma into the dermis, forming an expansile mass with mitoses

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6
Q

Which growth phase of melanoma can metastasise?

A

Vertical growth phase

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7
Q

What are some genetic factors of melanoma?

A

BRAF mutation
MEK ans ERK up-regulation in the tumour driving proliferation

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8
Q

What are some presentations of melanoma?

A

A - Asymmetry
B - Irregular border
C - Variable colour
D - Diameter >6mm
E - Elevation and evolution

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9
Q

What are the major diagnostic criteria of melanoma?

A

Lesion that changes in shape, size and colour

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10
Q

What are the minor diagnostic criteria of melanoma?

A

Diameter >6mm, bleeding, sensory changes, inflammation

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11
Q

What are the 4 sub-types of melanoma?

A

Superficial
Nodular
Lentigo maligna melanoma
Acral metastatic melanoma

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12
Q

What is meant by the ugly duckling sign in melanoma?

A

Look for the mole amongst the others that stands out and is different

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13
Q

What is meant by lentigine (Lentigo)?

A

This is a slow, radially growing macule that remains for many years

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14
Q

What is meant by lentigo maligna?

A

This is when a lentigine begins to grow vertically, forming a melanoma

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15
Q

Name the condition

A

Melanoma

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16
Q

Name the condition

A

Melanoma - Erratic pigment network (Abnormal projection of dermis into the epidermis)

17
Q

Name the condition

A

Superficial spreading melanoma - Asymmetry of shape and colour, irregular border, large, slightly elevated in the centre

18
Q

Name the condition

A

Nodular melanoma

19
Q

Name the condition

A

Nodular melanoma

20
Q

Name the condition

A

Nodular melanoma

21
Q

Name the condition

A

Lentigine formation (Lentigo)

22
Q

Name the condition

A

Lentigo maligna melanoma

23
Q

Name the condition

A

Melanoma

24
Q

What are some mole features that are suspicious of melanoma?

A
  • Change in shape
  • Irregular pigmentation
  • Bleeding
  • Development of satelite nodules
  • Ulceration
  • New pigmented lesion in adulthood
25
Q

How should a melanoma be managed?

A

Primary excision to give clear margins
Diagnosis using histology
Secondary excision based on Breslow thickness

26
Q

What is meant by Breslow thickness?

A

The depth from the granular layer of the epidermis to the deepest point of the tumour

27
Q

What are the stages of Breslow thickness and their prognosis?

A
  • pTis-melanoma is in-situ-100% survival
  • pT1-tumour < 1mm-90% survival
  • pT2-tumour is 1-2mm-80% survival
  • pT3-tumour is 2-4mm-55% survival
  • pT4-tumour > 4mm thick-20% survival
28
Q

What are some indicators of adverse prognosis?

A

Ulceration
High mitotic rate
Lymphovascular invasion
Satelite nodes
Sentinel lymph node involvement

29
Q

How is ulceration denoted with breslin thickness?

A

By adding the suffix ‘b’ (E.g. pT3b is a tumour between 2-4mm with ulceration)

30
Q

Describe the features of superficial spreading melanoma?

A
  • Large, flat, irregularly pigmented lesion
  • Commonest in trunk and limbs
  • Grows laterally before vertical invasion develops
31
Q

Describe the features of nodular melanoma?

A
  • The most aggressive type
  • Occurs on varied sites but often trunk
  • Presents as a rapidly growing pigmented nodule, which bleeds or ulcerates
32
Q

Describe the features of lentigo maligna melanoma

A
  • Invasive tumour that develops within pre-existing lentigo maligna
  • Occurs on sun damaged face/neck/scalp
33
Q

Describe the features of acral metastatic melanoma

A

Arise as pigmented lesions on the palm or sole or under the nail, and usually present late

34
Q
A

Dermatology (38 decks)

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