Pigment Lesions Flashcards

(36 cards)

1
Q

if a mole is small and been there since childhood…is it likely to be melanoma?

A

NO

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2
Q

what do congenital nevus look like?

A

dome shaped with mammillated and hypertrichosis

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3
Q

what is hypertrichosis?

A

increase in hairiness

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4
Q

what does it mean for congenital moles to be mammillated?

A

they have small protuberances

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5
Q

if congenital nevus is bigger than 20 cm…what are we worried about?

A

melanoma

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6
Q

what tool helps evaluate a pigmented lesion in the clinic?

A

dermatoscope

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7
Q

when do you usually get acquired nevi?

A

in first two decades of life

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8
Q

if acquired nevi appear after 50 yo what are we concerned about?

A

melanoma

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9
Q

how do nevi change over time with age? is this normal?

A

often change from brown at young age to a pink or skin color in older age…completely normal

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10
Q

name the ABCDEs of evaluating a mole

A
asymmetry
border
color
diameter
evolving
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11
Q

how big are melanomas usually?

A

greater than 6 mm

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12
Q

how does color appear in melanomas?

A

usually different throughout the nevi

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13
Q

what is an atypical nevi?

A

nevus with different colors or fried egg appearanc

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14
Q

are atypical nevi precancerous? what should you tell patient to do with these?

A

not pre cancer…but patients should monitor because at higher risk for melanoma

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15
Q

why cant you just remove all atypical nevi and prevent melanoma?

A

because melanoma can occur from the regular normal skin too so removing all of them does not decrease the risk

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16
Q

how many nevi are needed for atypical mole syndrome?

A

more than 50 and usually appear in puberty

17
Q

if you are worried about a pigmented lesion…what should you do?

A

biopsy the entire lesion

18
Q

what is the most important prognostic indicator in melanoma?

A

Breslow depth

19
Q

what percent of melanomas have familial or genetic basis?

20
Q

what two genes do we know are common for melanoma?

A

CDKN2A and CDK4

21
Q

where do most melanomas occur? where else can they occur?

A

sun exposed areas…anywhere else even genitalia

22
Q

how do melanomas usually appear? describe them

A

pigmented papule plaque or nodule

23
Q

what is breslows depth?

A

for melanoma eval…is depth between the granulosa tissue and the deepest part of the tumor

24
Q

name the five types of melanoma

A
superficial spreading
nodular
lentigo maligna
acral lentiginous 
amelanotic
25
what is the most common type of melanoma? describe it
superficial spreading...horizontal growth of tumor
26
which type of melanoma grows vertically?
nodular
27
which type of melanoma grown on sun spots?
lentigo maligna
28
which type of melanoma is common in asians and AAs?
acral lentiginous type
29
what is the amelanotic type of melanoma?
pink appearance so can be confused with psoriasis and SCC/BCC and dermatitis
30
if breslow depth is less than 0.8 mm then what do you do?
surgical excision and follow up
31
if breslow depth is greater than 0.8 mm then what do you do?
surgical excision, eval of sentinel lymph nodes and follow up
32
what is the common pathway involved in melanomas that can targeted with therapy?
MAPK pathway
33
what two inhibitor types can be used to target the MAPK pathway in melanoma?
BRAF inhibitor | MEK inhibitor
34
name the BRAF inhibitor for melanoma
vemurafenib and dabrafenib
35
name the MEK inhibitor for melanoma
trametinib
36
name the three immune checkpoint spots that can be targeted with therapy for melanoma
CTLA4 PD1 PDL1