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Flashcards in Pathology Deck (38):
1

Localised overgrowth of blood vessels in the dermis =

Haemangiomas causes a port wine stain

2

melanoblasts migrate from neural crest to _+_+_

skin
uveal tract
leptomeninges

3

gene that determines balance of pigment in skin and hair

MC1R (melanocortin 1 receptor)

4

MC1R turns __ to __melanin

phaeo to eu

5

hair colour caused by phaeomelanin

red

6

1 defect in MC1R =
2 defects =

freckles
red hair and freckles

7

ephilides

freckles - patchy increase in melanin pigmentation

8

actinic/solar lentigines

age/liver spots
increased melanin and basal melanocytes
face, forearms and dorsal hands
elongated rete ridges in epidermis

9

acquired naevi in childhood = junctional naevus -

melanocytes proliferate and cluster at DEJ

10

acquired naevi in adolescence = compound naevus -

junctional clusters and groups of melanocytes in dermis

11

acquired naevi in adults = intradermal naevus -

no junctional activity, entirely dermal

12

dysplastic naevi 2 types =
increase in melanoma risk

sporadic - slight risk increase
familial - 100% increase risk

13

dysplastic naevi histological findings

architectuarl and cellular atypia
host-reaction inflam and fibrosis
epidermis not effaced (unlike melanoma)

14

characteristics of halo naevi

peripheral depigmented halo
inflammatory regression and overrun by lymphocytes

15

Blue skin pigmentation is caused by

brown deep in skin scatters light

16

blue naevi characteristics

entirely dermal and consist of pigment rich dendritic spindle cells.

17

Characteristics of spitz naevi

in <20yos
large spindle +/epithelioid cells
most entirely benign

18

rare sites for malignant melanoma

oesophagus
meninges
eye
biliary tract
anus

19

Radial growth phase of melanoma =

macules grow either entirely in situ or with dermal microinvasion

20

Vertical growth phase of melanoma =

invade dermis with formation of expansile mass with mitoses
only VGP metastasise

21

melanomas that have a radial and vertical growth phase (RGP and VGP)

superficial spreading
acral/mucosal lentiginous
lentigo maligna

22

melanoma type that only has a VGP (vertical growth phase)

nodular

23

common site of nodular melanoma
grows quickly in __ causing __ to stretch thin

trunk
dermis
epidermis stretched thin

24

suffix b added to staging of melanoma -

ulceration

25

If have advanced melanoma which is difficult to treat with Sx alone =

chemo, immunotherapy or gene therapy

26

C-kit mutations are usually in ___ melanomas
Rx -

acral
imatinib

27

melanomas on intermittently sun-exposed areas have __ mutation
Rx -

BRAF
dabrafenib + vemurafenib (combo with a MEK inhibitor)

28

benign melanocytic lesions (3)

ephilides (freckles)
lentigines (macule)
naevi

29

classification of congenital melanocytic naevi by size

small <1.5cm diameter
medium 1.5-19.9cm
large 20+cm

30

congenital naevi characteristics that are different from acquired

larger
slightly raised
more rugose and elevated as they age

31

neoplastic melanocytes along the basal layer with can become invasive
usually on ace of elderly with sun damage =

lentigo maligna melanoma

32

macule with irregular border and colour which has a slow RGP and rapid VGP (develops nodule)

superficial spreading melanoma

33

blue-black/red-skin coloured nodule which may be ulcerated/bleed and develops rapidly over months
no surrounding macular pigmentation =

nodular melanoma

34

Hutchinson sign =
in ___

pigmented extension into nail fold
acral lentiginous melanoma

35

multiple black/brown greasy "stuck-on" lesions often on trunk with a regular border

seborrheic keratoses

36

Rx for seborrheic keratoses

reassure
freeze
curette

37

firm nodule of dermal connective tissue, brown/grey
may be caused by insect bites
reassure and excise

dermatofibroma

38

talon noir =

subcorneal haematoma = black heel
due to trauma