Melanocytic Lesions - part I Flashcards
(75 cards)
1
Q
melanocytic lesions
A
- ephelis
- actinic lentigo
- melanotic macule
- acquired melanocytic nevus
- congenital melanocytic nevus
- blue nevus
- melanoma
2
Q
ephelis
A
freckles
3
Q
clinical features of ephelis
A
- more pronounced with sun exposure
- light/medium brown macules of skin
- round or oval 3 mm or less
- sharply demarcated
- fair-skinned, blue eyes, red or blonde hair
4
Q
treatment for ephelis
A
none indicated
5
Q
prognosis of ephelis
A
- identify skin type that may be more susceptible to UV damage
- SPF products should be used
6
Q
actinic lentigo
A
hallmark of UV damaged skin, “age spots” or “liver spots”
7
Q
where does actinic lentigo appear?
A
on sun-exposed skin
8
Q
clinical features of actinic lentigo
A
- completely macular
- often multiple (may coalesce)
- uniformly pigmented brown to tan
- well-demarcated irregular borders
9
Q
treatment for actinic lentigo
A
- none indicated unless for esthetic reasons
2. SPF products suggested
10
Q
what can be done to treat actinic lentigo
A
- cryotherapy
- laser ablation
- intense pulsed light
- chemical peel
- topicals
11
Q
what causes melanotic macule
A
unknown etiology but similar lesions associated with systemic conditions, medications and genetic disorders
12
Q
clinical features of melanotic macule
A
- maximum dimension achieved rapidly then remains constant
- round to oval 7 mm or less
- uniformly tan to dark brown
- demarcated margins
13
Q
is melanotic macule common?
A
yes, common and harmless
14
Q
T/F: melanotic macule occurs due to sun exposure
A
false, not dependent on sun exposure
15
Q
T/F: melanotic macule has a female predilection
A
true
16
Q
what age group is affected by melanotic macule?
A
average age 43 but broad age range
17
Q
what is the most common location for melanotic macule?
A
lower lip vermilion zone
18
Q
histopathologic features of melanotic macule
A
- increased melanin pigmentation along basal epithelial layer
- may show melanin incontinence
- normal stratified squamous epithelium
19
Q
treatment for melanotic macule
A
none indicated unless for esthetics
20
Q
when would an excisional biopsy be indicated for a melanotic macule?
A
if recent onset, large size, irregular pigmentation, unknown duration, recent enlargement
21
Q
T/F: melanotic macule are malignant
A
false, considered benign
22
Q
acquired melanocytic nevus
A
mole
23
Q
most common of all human “tumors”
A
acquired melanocytic nevus
24
Q
clinical features of acquired melanocytic nevus
A
- gradually involute with age
- macules or papules (flat or raised)
- sharply demarcated
- brown, black, tan, skin-colored
- less than 6 mm
- hair
25
when does acquired melanocytic nevus develop?
during childhood through ~4th decade
26
acquired melanocytic nevus is common in what race?
Caucasians
27
where are acquired melanocytic nevus most commonly found?
head and neck
28
T/F: most acquired melanocytic nevi are above the waist
true
29
sites of acquired melanocytic nevus in the oral cavity
hard palate or attached gingiva, but potentially any site can be affected
30
stage of acquired melanocytic nevus depends on what?
depends on location of nevus cells microscopically
31
stages associated with evolution of acquired melanocytic nevus
1. junctional
2. compound
3. intradermal (intramucosal)
32
junctional stage of acquired melanocytic nevus
nevus cells only in epithelium/epidermis
33
compound stage of acquired melanocytic nevus
nevus cells in epithelium/epidermis and CT
34
intradermal stage of acquired melanocytic nevus
nevus cells only in CT
35
no treatment is indicated for cutaneous acquired melanocytic nevus unless what?
unless 1. chronically irritated
2. an esthetic concern
3. changes in size or color
36
what is advised of all unexplained pigmented oral lesions?
excisional biopsy
37
what can resemble oral mucosal nevi?
early melanoma
38
what is the risk of malignant transformation from an individual cutaneous nevus to melanoma?
low
39
is oral nevi currently considered an increased risk for melanoma?
no
40
congenital melanocytic nevus
1. present at birth
| 2. very large "bathing trunk nevus," "garment nevus"
41
sites for congenital melanocytic nevus
1. trunk and extremities
| 2. 15% H&N
42
small congenital melanocytic nevus resembles what?
acquired melanocytic nevi
43
what is the difference between congenital melanocytic nevus and acquired melanocytic nevi?
tend to be larger (greater than 6 mm), darker and hairier
44
clinical features of congenital melanocytic nevus
hypertrichosis (excess hair)
45
how are congenital melanocytic nevus classified?
by projected adult size
46
small congenital melanocytic nevus
<1.5 cm
47
medium congenital melanocytic nevus
up to 20 cm
48
large congenital melanocytic nevus
greater than or equal to 20 cm
49
treatment for congenital melanocytic nevus
excise for esthetic reasons
50
how would you get rid of the congenital melanocytic nevus?
1. dermabrasion
2. chemical peel
3. laser
4. cryotherapy
5. partial surgical excision
51
what is the percent risk of malignant transformation for congenital melanocytic nevus?
~1% for small
52
what is the percent risk of large congenital melanocytic nevus to transform to melanoma?
2-3%
53
what should be done after treating congenital melanocytic nevus?
close clinical follow-up
54
cutaneous sites for blue nevus
hands, feet, scalp, face
55
mucosal sites for blue nevus
mucosal sites, esp. oral and conjunctival
56
why is the blue nevus blue?
bluish or blue-gray due to the depth of melanin pigment (Tyndall effect)
57
T/F: blue nevus has a male predilection
false, female
58
who can have a blue nevus?
children, young adults
59
clinical features of blue nevus
1. less than 1 cm
| 2. macule or papule
60
what is the most common oral site of blue nevus?
palate
61
histopathologic features of blue nevus
1. elongated dendritic melanocytes in CT
2. abundant melanin pigment
3. no atypia
62
treatment of blue nevus
conservative excision
63
prognosis of blue nevus
excellent
64
is recurrence of blue nevus common?
no, it's rare
65
is malignant transformation of blue nevus common?
no, it's rate but reported
66
melanoma
malignancy of melanocytic differentiation
67
what is the third most common skin cancer?
melanoma
68
melanoma makes up what percent of all skin cancers?
5%
69
what percent of skin cancer deaths are due to melanoma?
75%
70
T/F: the lifetime risk of melanoma is increasing
true
71
T/F: incidence rate of melanoma is increasing
true
72
T/F: mortality rate of melanoma is increasing
false, not increasing as much
73
risk factors for melanoma
1. whites esp. fair-skinned
2. light hair/eyes
3. family history of melanoma (genetic predisposition)
4. personal hx of melanoma
5. tendency to sunburn/freckle easily
6. history of blistering sunburn early in life (acute sun exposure > chronic)
7. indoor occupation; outdoor recreation
8. hx dysplastic or congenital nevus
9. >100 common nevi
10. immunocompromised (organ transplant)
74
clinical features of melanoma
1. 40-70 yo
2. female predilection under age 40
3. male predilection in older pts
75
which sex has overall slight predilection of melanoma
male
