pigmented lesion

Question 1

intravascular pigmentation

Answer 1

blanches

hemangioma, vascular malformation, varix, kaposis sarcoma

Question 2

extravascular pigmentation

Answer 2

does not blanch

petichiae, ecchymosis, hematoma

Question 3

hemagioma

Answer 3

not present at birth, rapid onset
tumor of infancy
gradual involution (go away)

Question 4

venus malformation

Answer 4

present at birth and persist through life

anomalies of blood vessels

Question 5

hemangioma tx

Answer 5

will regress on their own or use systemic corticosteroids

Question 6

venus malformation tx

Answer 6

small - no tx
large - sclerosing agent
biopsy is contraindicated

Question 7

sturge-weber syndrome

Answer 7

non hereditary developmental condition

leptomeningeal angiomas may cause convulsive disorder or retardation

Question 8

tx of sturge-weber

Answer 8

may require neurosurgical tx

Question 9

varix

Answer 9

abnormally dilated and tortuous veins usually in older adults
loss of CT tone

Question 10

common location of varix

Answer 10

sublingual varix

Question 11

kaposi’s sarcoma

Answer 11

caused by HHV8
associated with HIV
painless blue-purple macules/plaques

Question 12

sarcoma

Answer 12

originates in mesenchymal tissue

Question 13

carcinoma

Answer 13

originates in epithelial tissue

Question 14

petechiae

Answer 14

very small hemorrhages into skin, mucous, serosa

doesn’t blanche

Question 15

ecchymosis

Answer 15

blood accumulation greater than 2cm

doesn’t blanche

Question 16

hematoma

Answer 16

accumulation produces a mass

doesn’t blanche

Question 17

ephelis

Answer 17

freckle
increased melanin production
more pronounced after sun exposure

Question 18

oral melanotic macule

Answer 18

increased melanin production
flat
not related to sun exposure
not premalignant

Question 19

melanoacanthoma is most common in his race

Answer 19

african americans

Question 20

management of melanoacanthoma

Answer 20

biopsy to rule out melanoma

Question 21

nevus

Answer 21

proliferation of melanocytes

Question 22

t/f oral nevus is considered premalignant and should be completely excised

Answer 22

true

Question 23

t/f melanoma can always be distinguished

Answer 23

false

Question 24

melanoma

Answer 24

malignant neoplasm of melanocytes due to acute sun exposure

Question 25

top 3 most common skin cancers

Answer 25

1. basal cell 2. squamous cell 3. melanoma

Question 26

what are we most worried about, horizontal or vertical growth?

Answer 26

vertical

Question 27

4 clinicopathologic types of melanoma

Answer 27

1. superficial spreading melanoma 2. nodular melanoma 3. lentigo maligna melanoma 4. acral lentiginous melanoma

Question 28

most common type of melanoma

Answer 28

superficial spreading melanoma can occur in young adults

Question 29

nodular melanoma

Answer 29

deeply invaseive, rapid growth | dome shaped annd dark pigmented

Question 30

lentigo maligna melanoma

Answer 30

most common on face of older pts arise in solar lentigo slowest growthing

Question 31

acral lentiginous melanoma

Answer 31

melanomas of oral mucosa

Question 32

t/f. the most important prognostic indicator is the histologic depth of invasion

Answer 32

true.

Question 33

what is BANS and what does it stand for

Answer 33

``` areas of poor prognosis interscapular area of Back post upper Arm post and lat Neck Scalp ```

Question 34

what does oral melanoma look like in the begining

Answer 34

brown black macule

Question 35

t/f benign and malignant melanocytic lesions are all clinically indistiguishable

Answer 35

true.

Question 36

5 yr survival rate of oral melanoma

Answer 36

13-22%

Question 37

peutz jeghers syndrome

Answer 37

freckle-like genetic mutation

Question 38

GI features of peutz jeghers

Answer 38

intestinal polyps (not premalignant), intestinal obstruction, maligancy 33% by age 60

Question 39

oral lesion seen in 90% of puetz jeghers pts

Answer 39

vermillion zone, labial/buccal mucosa, and tongue | 1-4mm blue/gray macules

Question 40

addisons

Answer 40

destruction of the adrenal cortex or pit gland (increased ACTH)

Question 41

is smoking-associated melanosis premalignant

Answer 41

no

Question 42

how does smoking cause pigmentation of the oral soft tissues

Answer 42

stimulation of melanocyte activity by tobacco

Question 43

melasma

Answer 43

aka, the mask of pregnancy, is irregular, symmetric, brown macules on sun exposed face and lips

Question 44

the use of ____ may also cause melasma

Answer 44

oral contraceptives

Question 45

drugs that can cause pigmentation

Answer 45

AZT, tetracycline, minocyclines

Question 46

neurofibromatosis

Answer 46

syndrome including axillary freckling, neurofibromas, lisch nodules (eye pigmentation), cafe au lait spots (6 at least)

Question 47

heavy metals that can pigment epithelium

Answer 47

arsenic, bismuth, platinum, lead, silver, mercury

Question 48

gingival line associated with lead and bismuth

Answer 48

Burtons line

Question 49

chronic silver intoxication

Answer 49

argyria

Question 50

amalgam tattoo appearance

Answer 50

macular and gray with soft moderately defined lines

Question 51

sturge-weber syndrome signature color

Answer 51

port wine

Question 52

t/f. melanoacanthoma often demonstrates slow growth

Answer 52

false. rapid