pigmented lesions

Question 1

are melanin-producing cells that have their embryologic origin in the neural crest that migrate to epithelial
surfaces where they reside among basal epithelial cells.

Answer 1

melanocytes

Question 2

in what epithelial surface does melanocytes reside?

Answer 2

basal epithelial cells

Question 3

granules of pigment that melanocytes produces

Answer 3

melanosomes

Question 4

ABCDE of mole or melanoma

Answer 4

A - asymmetry
B - Border
C - Color
D - Diameter
E - evolving

Question 5

one half of a mole does not match the other

Answer 5

asymmetry

Question 6

the edges are irregular, ragged, notched, or blurred. Normal moles are round or oval

Answer 6

border

Question 7

the mole is not evenly colored. it may include shades of brown or black, or patches of pink, red, white or blue

Answer 7

color

Question 8

the spot is larger than 6 mm across

less than .25in - benign

greater than .25in - malignant

Answer 8

diameter

Question 9

the mole is changing in size, shape or color

Answer 9

evolving

Question 10

what part of the melanocyte-keratinocyte unit transfers the melanin of melanocytes into the keratinocytes

Answer 10

dendritic processes

Question 11

melanocytic lesion are physiologic or pathologic lesions?

Answer 11

physiologic lesions

Question 12

linked to cigarette smoking, “smoker’s melanosis”

stimulation of melanocytes to produce more melanin

time and dose related

Answer 12

smoking-associated melanosis

Question 13

most typically affected location of smoking associated melanosis

Answer 13

anterior labial gingiva

palate and buccal in pipe smoking

Question 14

location of affected area in pipe smoking

Answer 14

palate and buccal mucosa

Question 15

DD of smoking associated melanosis

Answer 15

diffuse melanoacanthoma

peutz-jeghers syndrome

addison’s disease

Question 16

treatment of smoking-associated melanosis

Answer 16

smoking cessation

Question 17

prognosis of SAM

Answer 17

biopsy if pigmentation shows irregularity or intense color

Question 18

common oral pigmentation

Answer 18

melanotic macule

Question 19

melanocytic nevi aka as

Answer 19

moles

Question 20

presents as:
1. intraoral freckle
2. postinflammatory pigmentation
3. macules associated with systemic disease (peutz jeghers, bandler or addisons’s disease)

Answer 20

oral melanotic macule

Question 21

systemic disease that needs to be considered if melanotic macules are seen in excess in oral and perioral distribution

Answer 21

1. peutz-jeghers syndrome
2. addison’s disease

Question 22

systemic condition associated with OMM

peutz-jeghers syndrome

Answer 22

intestinal polyposis

autosomal-dominant inheritance

risk of cancer specifically intestinal cancer

Question 23

systemic condition associated with OMM

addison’s disease

Answer 23

macules and diffuse bronzing

adrenal cortical insufficiency - weakness, hypotension, nausea, weight loss

Question 24

systemic condition associated with OMM

laugier-hunziker syndrome

Answer 24

Oral, subungual, and skin macules

Question 25

systemic condition associated with OMM Bandler syndrome

Answer 25

Small intestine hemangiomas and mucocutaneous macules

Question 26

gene mutation of peutz-jeghers syndrome

Answer 26

STK11/LKB1 located on chromosome 19

Question 27

gene mutation in peutz jeghers is usually found in ___ organ

Answer 27

small intestine (jejenum)

Question 28

adrenal cortical insufficiency

Answer 28

addison's disease

Question 29

characterized by melanin accumulation in basal keratinocytes and normal numbers of melanocytes

Answer 29

melanotic macule

Question 30

discrete melanin-pigmented patches of skin that have irregular margins and a uniform brown coloration.

Answer 30

Cafe-au-Lait Macules

Question 31

Individuals with six or more large café-au-lait macules should be suspected of having?

Answer 31

neurofibromatosis (NF)

Question 32

oral lesions associated with cutaneous pigmented macuels

Answer 32

neurofibromatosis neurofibromatosis of skin, oral mucosa, jaws Cafe-au-Lait macules of skin McCune-Albright syndrome Polyostotic fibrous dysplasia endocrine abnormalities

Question 33

collections of nevus cells that are round or polygonal and are typically seen in a nested pattern

Answer 33

melanocytic nevus

Question 34

common acquired papular lesions that usually appear shortly after birth and throughout childhood.

Answer 34

melanocytic nevus

Question 35

most common location of melanocytic nevus

Answer 35

palate

Question 36

types of melanocytic nevus

Answer 36

1. intramucosal nevus 2. blue nevus 3. compound nevus 4. junctional nevus

Question 37

a subtype of melanocytic nevus that when cells are located in the epithelium–connective tissue junction, it is called?

Answer 37

junctional nevus

Question 38

a subtype of melanocytic nevus when cells are located in connective tissue,

Answer 38

intramucosal nevus

Question 39

a subtype of melanocytic nevus when cells are located in a combination of these zones

Answer 39

compound nevus

Question 40

a subtype of melanocytic nevus when cells are spindle shaped and are found deep in the connective tissue

Answer 40

blue nevus

Question 41

most commonly seen subtype of melanocytic nevus

Answer 41

intramucosal nevi

Question 42

second most commonly seen subtype of melanocytic nevus

Answer 42

blue nevus

Question 43

rarely seen subtyope of melanocytic nevus

Answer 43

compound and junctional nevi

Question 44

treatment of melanocytic nevus

Answer 44

needs to be differentiated from melanoma suspected nevi should be biopsied all suspected oral nevi should be excised.

Question 45

a lesion that ot has a high incidence in japan

Answer 45

oral melanoma

Question 46

high risk sites of oral melanoma

Answer 46

palate and gingiva, more than 70% of case

Question 47

subtype of melanoma connective tissue invasion without junctional phase poor prognosis

Answer 47

invasive melanoma

Question 48

subtype of melanoma prolonged preinvasive junctional phase poor prognosis due to delayed diagnosis and undertreatment

Answer 48

melanoma in situ

Question 49

exhibit abnormal expression of adhesion molecules, a phenotype that would contribute to the process of invasion

Answer 49

melanoma

Question 50

in amelanotic melanoma, Three reliable antibodies that react with proteins expressed by melanoma are

Answer 50

HMB45 melan-A (MART-1) anti-S-100 protein

Question 51

treatment for melanoma

Answer 51

chemotheraphy, surgical excision

Question 52

prognosis of melanoma

Answer 52

depends on histological subtype depth of invasion metastasis

Question 53

survival rate of melanoma

Answer 53

20% after 5 years

Question 54

gene mutation of melanoma if familial

Answer 54

p16 p14 CDK4 MC1R

Question 55

gene mutation of melanoma if sporatic

Answer 55

BRAF or N-RAS

Question 56

BRAF gene may also be found in ___ lesion

Answer 56

ameloblastoma

Question 57

Melanin found within surrounding basal keratinocytes and sub adjacent connective tissue macrophages is termed as?

Answer 57

Melanophages

Question 58

In addisons disease, overproduction of __ and __ results in stimulation of melanocytes, leading to diffuse pigmentation of the skin

Answer 58

ACTH and MSH Adenocorticotropic hormone Y-melanocyte-stimulating hormone

Question 59

(melanin present within connective tissue macrophages) is typically seen within the lamina propria.

Answer 59

Melanophagocytosis

Question 60

Characterized by melanin accumulation in basal keratinocytes and normal numbers of melanocytes

Answer 60

Melanotic macules

Question 61

embryologic origin of melanin

Answer 61

neural crest cells

Question 62

Predominantly in any mucosal surface and vermillion of the lips

Answer 62

Melanotic macule

Question 63

Common location of melanocytic nevus

Answer 63

Palate