9a - Nevi & Malignant Melanoma Part 1 Flashcards Preview

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Flashcards in 9a - Nevi & Malignant Melanoma Part 1 Deck (36)
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1
Q

What is a nevus?

A

Mole

2
Q

What are the ABCDEs of examining a mole?

A
Asymmetry
Border irregularity
Color variation
Diameter (size/enlargement)
Evolving (change in size, shape, color or a new lesion)
3
Q

Melanocytic nevus are also known as:

A

Moles

4
Q

What are melanocytic nevi?

A

Benign tumors composed of nevus cells derived from melanocytes

5
Q

Incidence and distribution of melanocytic nevus?

A

Both sexes
Become larger during 50’s and 60’s

Anywhere, but typically found in sun exposed areas

6
Q

Morphology of melanocytic nevus

A
Sharply circumscribed
Uniform colored papules or macules
Irregular surface with or without hair
Single or multiple 
Size varies greatly
7
Q

Dx of melanocytic nevus?

A

Appearance and history

Bx reveals nest of nevus cells

Bx any lesion if change in appearance

8
Q

Txt for melanocytic nevus

A

Follow-up for ABCDE changes

If >100 nevi, follow at 6-12 month intervals

Surgical excision for shady shit

9
Q

What are the three main subtypes of common (acquired) nevi?

A

Junction nevi
Compound nevi
Dermal nevi

Progress over years, affected by hormones and sun

10
Q

Slide 8

A

Illustration of development of nevi over the years

11
Q

Junctional nevi

A

Nest in the epidermis and epidermis-dermal junction

Flat or slightly elevated

Light brown to brown-black with uniform pigmentation

Size <0.5-0.8cm

Most common in childhood - may develop into compound nevi after childhood

12
Q

Compound nevi

A

Nevus with nest into the upper dermis

Slightly elevated to dome-shaped, smooth or warty surface, with or without hair

Uniformly round, oval, and symmetric

White periphery = “halo nevus”

13
Q

Dermal nevi

A

All nevus cells in dermis, sometimes in fat cells

Dome-shaped (MC), verrucous, pedunculated, sessile

Skin colored to brown-black with hair, become lighter with age

Common in grown-ups

14
Q

What are congenital melanocytic nevi?

A

Found at birth - 1-6% of all newborns

Vary in size from <1cm to >20cm

Most grow proportionally with child

Greater risk of malignant transformation if >5 BSA or >20cm

15
Q

Management of congenital melanocytic nevi?

A

Small? Leave alone

Medium? Remove after puberty

Large? Increased incidence of MM; even with removal, 2-3% overall MM risk

16
Q

What is nevus spilus?

A

AKA “speckled lentiginous nevus”

MC in adolescence

Hairless, oval or irregularly-shaped brown macule

Dotted with darker brown to black papular spots

ANYWHERE, not related to sun exposure

Txt - nothing

17
Q

What is Becker’s nevus?

A

Either a brown macule, a patch of hair, or both (NO nevus cells) (but it’s still called a nevus….)

18
Q

Where is Becker’s nevus found?

A

MC’ly unilateral upper back, shoulder, upper arm, submammary

19
Q

What is Becker’s nevus syndrome?

A

Presence of BN plus associated with ipsilateral breast or limp hypoplasia, scoliosis, spina bifida occulta

20
Q

Txt for Becker’s Nevus?

A

Usually too large to excise

Hair may be shaved or permanently removed

Laser tx for removal of hair and pigmentation

21
Q

What is the Halo Nevus?

A

Compound or dermal nevus that develops a white border

MC in adolescence

May herald onset of vitiligo

22
Q

Morphology of Halo Nevus?

A

One or more hypopigmented to white lesions that contain a central red, brown, or black nevus

No melanocytes in the halo

Nevus regresses and pigment returns (occurs over a decade or more)

23
Q

Where are Halo Nevi most commonly found?

A

On the trunk

*never on the palms / soles

24
Q

Txt for Halo Nevi?

A

Teens - none needed (tho parents may push for excision)

Adults - Wood’s lamp - look for blue vitiligo - bx if suspect MM

25
Q

What are Mongolian Spots?

A

Blue-black lesions - dermal melanocytes (more flattened)

Migratory arrest (unable to make epidermis) before birth

26
Q

Where are Mongolian Spots found?

A

Mongolia

27
Q

Ok really, where are Mongolian spots found?

A

MC’ly in scalp and pre-sacral area

Backs of hands

Face/trunk in dermatomal pattern

28
Q

What is the Tyndall Effect?

A

What causes the blue-black appearance of Mongolian spot lesions

29
Q

Txt for Mongolian spots?

A

None - usually fades during first few years of life

30
Q

What is Nevus of Ota?

A

Blue-black pigmentation in 1st-2nd branch of trigeminal nerve

Affects the sclera, conjunctiva, and skin around the eye (no visual changes)

They darken over time

Txt? Lasers to lighten the lesion, monitor for glaucoma

31
Q

What is a Spitz nevus?

A

AKA benign juvenile melanoma

MC in kids, on the head, neck, and lower extremities

Hairless, red or reddish-brown dome-shaped papules / nodules < 1.5cm, often appearing suddenly

Txt? Remove -> path

32
Q

What is a blue nevus?

A

Slightly elevated, round, regular nevus

Typically <5mm

Large amount of pigment in dermis

MC on extremities and dorsum of hands

33
Q

Blue nevus is often confused with

A

malignant melanoma

Blue nevus stays the same

34
Q

Txt of blue nevus?

A

Removal for patient piece of mind / cosmetic purposes

35
Q

What is labial melanotic macule?

A

Brown-black macules on lower lip

MC’ly in young adult women

Resembles freckles, but no change with sun exposure

Benign

Txt with cryo or lasers if desired

36
Q

How does a penguin build its house?

A

Igloos it together