Flashcards in Pigment Disorders Deck (116):
What are the SALT cells in the skin?
Langerhans cells--APCs of the immune system
What is a major issue with tanning in terms of cellular damage (which cells in particular)?
Langerhans cells are damaged
What is skin type I of the Fitzpatrick skin types?
White people who can't tan
What is skin type II of the Fitzpatrick skin types?
Fair skin (burns easily, but can tan a little bit) (you)
What is skin type III of the Fitzpatrick skin types?
Darker, white skin
tans after initial burn
What is skin type IV of the Fitzpatrick skin types?
Light brown skin
What is skin type V of the Fitzpatrick skin types?
What is skin type VI of the Fitzpatrick skin types?
Dark brown or black skin
Are nevi macules or papules?
What happens to nevi with age, generally?
Regress/ go deeper
True or false: dark skinned people do not develop nevi
What are the ABCDEs of melanoma changes?
What are the two major ways to classify type of nevi?
At what age do nevi begin to form? When does it peak?
Age 10 ish
Peaks around age 50
It is unusual to develop nevi after what age?
What usually causes nevi? What is the genetic predisposition to them?
-Mutation in the BRAF gene
What are the two major shapes of junction nevi?
Flat or slightly elevated
What are the two major shapes of compound nevi?
What are the four major shapes of dermal nevi?
What are junction nevi?
Nevus whose cells are at the dermoid-epidermal junction
What are compound nevi?
Nevus whose cells are at the derm-epidermal junction and upper dermis
What are dermal nevi?
Neves whose cells are in the dermis, sometime along with fat cells
What are the color of the following:
-Junction nevi = uniform tan
-Compound nevi = flesh color
-Dermal nevi = flesh to pink
True or false: junction nevi are sharply demarcated
What makes a nevi atypical? (4)
-Having flat or raised within the same nevus
-More than 5 mm
When do atypical nevi usually appear in life? How long do they progress for?
near puberty, and continue to develop past the fourth decade
True or false: atypical nevi are not a marker for a person at risk for melanoma
False--they are, and may even be a precursor to it
What is atypical mole syndrome (dysplastic nevus syndrome)?
a cutaneous condition described in certain families, and characterized by unusual nevi and multiple inherited melanomas
What is the gene that predisposes people to melanoma?
What is the prophylactic treatment for patient with the BRAF V600E gene? MOA?
Vemurafenib--B-Raf enzyme inhibitor
What is the tumor marker that is positive in melanoma?
Are cafe au lait spots congenital nevi?
True or false: large congenital nevi may undergo a malignant transformation
True or false: congenital nevi tend to be raised at birth
false--usually flat, but can later become raised
Do junctional nevi tend to be with hair or without?
What are the cells that give rise to junctional nevi, and where are they found?
Melanocytes, above the BM
When do junctional nevi tend to develop?
After 2 years
Junctional nevi on palms, soles, conjunctiva, or nail beds are most common in which ethnicities?
African or asian
Are junctional nevi generally symmetric or asymmetric? Regular or irregular?
Symmetric and regular
Do compound nevi tend to be with hair or without?
May have associated hair
Are compound nevi generally symmetric or asymmetric? Regular or irregular?
May be irregular or warty appearing surface
Where on the body can compound nevi occur?
How big, generally, are intradermal nevi?
Less than 1 cm
Where do intradermal lesions tend to become pedunculated?
Trunk or flexures
What are halo nevi?
Compound or dermal nevus that forms a white border
What causes halo nevi?
The formation of a halo surrounding a nevi is believed to occur when certain white blood cells called CD8+ T lymphocytes destroy the pigment-producing cells of the skin (melanocytes). The cause for the attack is unknown.
What are the characteristics of the border of halo nevi?
Round, sharply demarcated
Where on the body do halo nevi usually occur?
Trunk, never on hands/feet
What is the natural h/o halo nevi?
Repigmentation may occur, or entire lesion may disappear
What is the average age of onset for halo nevi?
What are speckled lentiginous nevi?
Hairless, oval or irregularly shaped brown lesion that is dotted with darker spots
When do speckled lentiginous nevi occur?
At any age, but tend to look like cafe au lait spots at birth
What are the size ranges for lentiginous nevi?
Are lentiginous nevi related to sun exposure?
What are Becker's nevi?
not a nevocelluar nevus
In whom do Becker's nevi occur?
Where on the body do Becker's nevi generally occur?
What are the characteristics of the borders of Becker's nevi?
Irregular, but sharply demarcated
What are the characteristics of the syndrome that may occur with Becker's nevi?
Ipsilateral hypoplasia of breast and skeletal abnormalities
True or false: Becker's nevi tend to be hairy
What is benign juvenile melanoma (spitz nevus)?
a benign melanocytic nevus, a type of skin lesion, affecting the epidermis and dermis
In whom do spitz nevi tend to occur in?
Why are spitz nevi also called benign juvenile melanomas?
Look like melanoma, but are benign
What are the characteristics of Spitz nevi?
Hairless, dome shaped papule around 1 cm in size that is highly vascular
What is the classic presentation of a Spitz nevi?
Nevi that occurred suddenly (within a week)
What are the borders like with Spitz nevi?
What are blue nevi?
a type of melanocytic nevus. The blue colour is caused by the pigment being deeper in the skin than in ordinary nevi. In principle they are harmless
Blue nevi are usually less than what size?
When do blue nevi generally occur? Where on the body?
-Extremities and dorsum of the hand
True or false: melanomas can arise from blue nevi
What are labial melanotic macules?
Benign brown macules on the lower lip (usually). Appear like a freckle, but do not darken with sun exposure
In whom do labial melanotic macules occur?
What is pityriasis alba? Who does it usually occur in, and what is the prognosis?
A common skin condition mostly occurring in children with atopic disease, and usually seen as dry, fine-scaled, pale patches on the face.
It is self-limiting (usually resolving after puberty) and only requires use of moisturizer creams
What is koebner's phenomenon?
also called the isomorphic response, refers to the appearance of lesions along a site of injury. This phenomenon is seen in a variety of conditions; for example, lichen planus, warts, molluscum contagiosum, psoriasis, lichen nitidus, and the systemic form of juvenile rheumatoid arthritis
What is vitiligo?
*Acquired* loss of pigmentation (absence of melanocytes) d/t autoimmune antibodies
Is vitiligo localized or generalized?
What are the two autoimmune diseases that are related to vitiligo?
Autoimmune thyroid disease
What is the distribution of type A vitiligo?
What is the distribution of type B vitiligo?
What is the difference in age of onset between type A and B vitiligo?
A = any age
B = young
What is the difference in progression between types A and B vitiligo?
A = Lifelong
B = rapid spread in 1 year
Which has Koebner phenomenon: type A or B vitiligo? Which is associated with immunological diseases
A for both
What is idiopathic guttate hypomelanosis? What does it look like? S/sx?
-Acquired white spots on arms and legs, usually 2-5 mm in size.
-Sharply demarcated borders
What predisposes patients to developing idiopathic guttate hypomelanosis?
What is nevus anemicus?
A localized and congenital disorder characterized by macules of varying size and shape, that are paler than the surrounding skin and cannot be made red by trauma, cold, or heat. The paler area is due to the blood vessels within the area which are more sensitive to prostaglandins
Where on the body is nevus anemicus usually found?
Are melanocytes and/or melanin present with nevus anemicus?
Are melanocytes and/or melanin present with idiopathic guttate hypomelanosis?
What is the defect in tuberous sclerosis?
TSC is caused by a mutation of either of two genes, TSC1 and TSC2, which code for the proteins hamartin and tuberin, respectively.
What, generally, is tuberous sclerosis?
Diffuse growth of hamartomas throughout the body
Where are the ash leaf spots usually found with tuberous sclerosis?
Extremities and trunk
What can be used to help located the ash leaf spots of tuberous sclerosis?
What are ephelides?
What is a lentigo? When do they develop?
(liver spots)--a small pigmented spot on the skin with a clearly defined edge, surrounded by normal-appearing skin. It is a benign hyperplasia of melanocytes which is linear in its spread
-Develop with increasing age
What happens to Freckles with age?
What is the difference in gender between ephelides and lentigo?
Males = lentiges
Females = ephelides
Where on the body are lentigo?
Are lentigo affected by sunlight?
What is melasma (chloasma)? What causes it?
Mask of pregnancy
-Acquired hyperpigmentation of the face and neck during prego
-Caused by UV light and estrogen/progesterone levels
Is there inflammation associated with melasma?
True or false: you can cause melasma with oral contraceptives
What number of cafe au lait spots suggest NF?
What is erythema ab igne? Prognosis?
Erythema, hyperpigmentation, telangiectasia, and/or scaling, caused by prolonged exposure to heat
may fade over time or not
How does UV light cause skin damage?
Which type of UV light can go through window glass?
What type of UV light causes CT changes and photoaging?
Which type of UV light has the most harmful effects?
What is elastosis?
Coarsening and yellow discoloration of the skin
What kind of wrinkles does UV light cause?
Coarse, deep wrinkles
what is poikiloderma of civatte?
a common, benign skin condition that mainly affects the skin on the sides of the neck. It mainly affects women. It characteristically spares the shaded area under the chin. The skin in the affected skin is red-brown with prominent hair follicles.
What is polymorphous light eruption? Prognosis?
Recurring, light induced pruritic/burning rash, that may be genetic. Chronic sun exposure lessens the likelihood, but
Is there scarring with polymorphous light eruption?
Which gender is usually affected more by polymorphus light eruption?
What are the three types of polymorphous light eruption?
What are the abx that can cause phototoxicity?