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Flashcards in Derm 1 Deck (36):
1

T/F- melanocytes are absent in albinism?

False, melanocytes are present but do not make melanin properly

2

What is the mutation responsible for albinism?

Tyrosinase mutations

3

In vitiligo, are melanocytes present or absent?

absent

4

what is the average age of onset in vitiligo?

20 yrs

5

Lentigo presents with brown macules but no seasonal variation. Are melanocyte numbers changed or is melanin production changed?

melanocyte numbers are increased

6

In a compound nevus, nests are present in the dermal epidermal junction and in the ______.

dermis

7

in a dermal nevus, the cells are confined to what layer?

dermis

8

With a giant congenital nevus, what is a concern in infants?

risk of CNS involvement when located on the head and neck, and an approximately 5% risk of melanoma

9

A blue nevus, what is the color from?

dermal pigment

10

What will you see in the dermis of a blue nevus histologically?

spindled melanocytes and melanophages

11

A dysplastic nevus is also called what?

atypical or clarks nevus

12

T/F- multiple dysplastic nevi are a marker for increased risk of melanoma

true

13

Name 3 characteristic features of a dysplastic nevus

-melanocytes show "atypia" and bridge across rate bridges
-dermal fibroplasia is seen in the papillary dermis
-epidermal component extends beyond the dermal component "shouldering"

14

Do white males or females get more melanoma?

males

15

Name environmental risk factors for melanoma (5)

-intense intermittent sun exposure
-chronic sun exposure
-tanning bed use
-immunosuppression
-live near equator

16

What is the median age of diagnosis of melanoma?

57

17

Name the most common type of malignant melanoma which starts with intraepidermal disease and then invades

superficial spreading type

18

T/F- the nodular type of melanoma is invasive from onset so prognosis is poorer because patients present with deeper tumors.

true

19

Name they type of melanoma that is especially common in elderly patients and has a prolonged inset phase and is usually >3 cm

lentigo maligna melanoma

20

If you have melanoma on your foot what is it called? Which ethnic group gets it the most? How's the prognosis?

-acral lentiginous melanoma
-risk not stratified by ethnic pigmentation
-presents with thick lesions so poor prognosis

21

What two genetic mutations are most common in non-chronically sun damaged skin (CSD)?

BRAF>KIT

22

What genetic mutation predominates in CSD, acral, and mucosal melanomas?

KIT

23

Are BRAF mutations common in normal nevi as well?

yes

24

What is pagetoid spread?

upward spreading of melanocytes in melanoma

25

Review clark levels for melanomas

I: In situ
II: Invades papillary dermis
III: Expands, but confined to papillary dermis
IV: Invades reticular dermis
V: Invades fat

26

What is breslow depth as it relates to melanomas?

-Microscopic measurement from the granular layer of the epidermis to the point of deepest tumor invasion
-Most important prognostic factor

27

What is the basal cell carcinoma to squamous cell carcinoma ratio in immunocompetent normal people?

20:1 BCC/SCC

28

Which type of skin cancer is more common in immunosuppressed people?

SCC > BCC

29

Over 90% of basal cell carcinomas occur where?

head and neck

30

T/F- basal cell carcinoma is not related to chronic sun exposure?

False, it is

31

Do BCC's metastasize often?

no

32

T/F- actinic keratosis presents with scaly papules on SUN EXPOSED skin and a small percentage will develop into invasive SCC

true

33

What is the primary risk factor for SCC?

ultraviolet light exposure

34

What percentage of SCCs metastasize?

5%

35

What areas of body have increased risk of SCC?

ear, lip, genitalia

36

BCC occurs on _____ lip and SCC occurs on ______ lip

BCC: upper lip
SCC: lower lip