Malignant Melanoma

Question 1

Malignant Melanoma Clinical Feature

Answer 1

malignant characteristics of a mole: “ABCDE” mnemonic

Question 2

“ABCDE” mnemonic meaning

Answer 2

Asymmetry
Border (irregular and/or indistinct)
Colour (varied)
Diameter (increasing or >6 mm)
Enlargement, elevation, evolution (i.e.
change in colour, size, or shape)

Question 3

ABCDE Sensitivity Specificity

Answer 3

Sensitivity 92% (CI 82-96%)

Specificity 100% (CI 54-100%)

Question 4

Malignant Melanoma sites

Answer 4

sites: skin, mucous membranes, eyes, CNS

Question 5

Malignant Melanoma clinical origin

Answer 5

~2/3 arise de novo without an associated nevus

Question 6

Clinical Subtypes of Malignant Melanoma

Answer 6

lentigo maligna
lentigo maligna melanoma
superficial spreading melanoma
nodular melanoma
acral lentiginous melanoma

Question 7

lentigo maligna definition

Answer 7

malignant melanoma in situ (normal and malignant melanocytes confined to the epidermis)

Question 8

lentigo maligna melanoma definition

Answer 8

malignant melanocytes invading into the dermis

Question 9

lentigo maligna lesion and its course

Answer 9

2-6 cm, tan/brown/black uniformly flat macule or patch with irregular borders.
lesion grows radially and produces complex colours

Question 10

lentigo maligna. Affected population

Answer 10

often seen in the elderly

Question 11

lentigo maligna pronostic

Answer 11

10% evolve to lentigo maligna melanoma

Question 12

** lentigo maligna melanoma ** % and Affected population

Answer 12

15% of all melanomas)

older individuals, ~7th decade

Question 13

** lentigo maligna melanoma ** origin

Answer 13

associated with pre-existing solar lentigo, not pre-existing nevi

Question 14

** lentigo maligna melanoma ** lesion

Answer 14

flat, brown, stain-like, gradually enlarging with loss of skin surface markings

Question 15

** lentigo maligna melanoma ** lesion appareance evolution

Answer 15

with time, colour changes from uniform brown to dark brown with black and blue

Question 16

superficial spreading melanoma . Incidence

Answer 16

60-70% of all melanomas

Question 17

superficial spreading melanoma. Pahtophysiology

Answer 17

atypical melanocytes initially spread laterally in epidermis then invade the dermis

Question 18

superficial spreading melanoma Lesion

Answer 18

irregular, indurated, enlarging plaques with red/white/blue discolouration, focal papules or nodules
ulcerate and bleed with growth

Question 19

superficial spreading melanoma. Origin

Answer 19

subtype most likely associated with pre-existing nevus

Question 20

nodular melanoma. Prevalence

Answer 20

30% of all melanomas

Question 21

nodular melanoma. Pathophysiology

Answer 21

atypical melanocytes that initially grow vertically with little lateral spread

Question 22

nodular melanoma lesion

Answer 22

uniformly ulcerated, blue-black, and sharply delineated plaque or nodule

Question 23

nodular melanoma prognosis

Answer 23

rapidly fatal

Question 24

nodular melanoma. Color variant

Answer 24

may be pink or have no colour at all, this is called an amelanotic melanoma

Question 25

nodular melanoma. clinical feature (mnemonic)

Answer 25

EFG = elevated, firm, growing

Question 26

acral lentiginous melanoma incidence

Answer 26

5% of all melanomas

Question 27

acral lentiginous melanoma. Lesion

Answer 27

ill-defined dark brown, blue-black macule

Question 28

acral lentiginous melanoma. Sites

Answer 28

palmar, plantar, subungual skin

Question 29

acral lentiginous melanoma. Prognosis

Answer 29

melanomas on mucous membranes have poor prognosis