Pigmented Lesions Flashcards

(30 cards)

1
Q

Definition: nevus cells migrate from neural crest to skin and occasionally mucous membranes?

A

nevi (common mole)

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2
Q

Present at birth in about 1% of newborns, larger “garment nevus”

A

congenital nevus

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3
Q

Genetic influence and the average person has about 15?

A

acquired nevus

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4
Q

Definition: flat macule, nevus cell in basal epithelium at “junction” of epithelium and connective tissue

A

junctional nevus

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5
Q

Definition: Nodule +/- hair, nevus cells in dermis or lamina propria?

A

intradermal nevus

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6
Q

Definition: Nodule, combination of junctional and intradermal?

A

compound nevus

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7
Q

Definition: dendritic nevus cells deep within connective tissue?

A

blue nevus

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8
Q

Your patient is black with a mole on his cheek that is reactive, but resolves upon irritant removal. It appears as a reactive proliferation of intraepithelial dendritic melanocytes. What is it?

A

Melanoacanthoma

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9
Q

Your patient recently did a lot of activity in the sun and came back to your office with multiple flat, tan macule on head and neck skin. What is it?

A

Ephelis (freckles)

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10
Q

What causes freckles from sun exposure?

A

localized overproduction of melanin, not an increase in the number of cells

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11
Q

Your patient is over 40 and/or elderly and has multiple flat evenly discolored macule from chronic UV damage. What are they?

A

actinic or senile lentigo AKA age spots or liver spots

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12
Q

Your female age 43, has multiple 6.8mm tan to brown flat macule like a big freckle in the lower lip, palate, or gingiva. What are they?

A

melanotic macule

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13
Q

What is the 3rd most common skin cancer?

A

malignant melanoma

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14
Q

How do individuals get melanoma?

A

Acute sun damage
Fair complexion
multiple moles, freckles
family history

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15
Q

What do the clinical features ABCD stand for for melanoma?

A

Assymetry - elevated surface as well
Borders - irregular
Color - variation
Diameter - growth, change, >6mm

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16
Q

Melanoma has 2 growth phases. What are they?

A

Radial (75-85%)

Vertical (grown down into tumor)

17
Q

Most common clinical melanoma?

A

superficial (70%) in the trunk

18
Q

Second most common clinical melanoma?

A

nodular melanoma in Head and Neck

19
Q

Third most common melanoma?

A

lentigo maligna melanoma (old age) and on face

20
Q

Where does aural lentiginous melanoma grow?

A

palms, soles, subungual (toenail), mucous membranes

21
Q

Where does oral melanoma occur and how does it grow?

A

palate
Maxillary gingiva
radial growth

22
Q

Melanoma Tx?

A

excision with 1mm margin
lymph node dissection
chemo, radiation, immunotherapy

23
Q

Most important factor influencing survival of melanoma?

A

depth of invation

metastasis decreases survival

24
Q

What type of melanoma has a worse survival prognosis?

25
What drugs cause multifocal pigmentation?
antimalarials antiarrythmics (quinidine) Tranquilizers (thorazine) cis-platinum
26
Patient walks in with a bronze coloration all over his body. What caused it and how?
adrenocortical insufficiency triggers hypothalamus to stimulate anterior pituitary to produce ACTH and MSH (melanin stimulating hormone)
27
Patient walks in with oral and perioral freckles, especially on the lips and cheek and is complaining of intestinal polyps. What is it?
autosomal dominant | Peutz-Jeghers Syndrome
28
A person walks in with cafe au laits spots. Name the generic condition and the syndrome?
Neurofibromatosis | McCune Albright syndrome
29
A patient walks in with melanin pigmentation on his palate especially and possibly on the gingiva. What caused this?
smoker's melanosis
30
Name the last 4 multifocal pigmentations not covered
Physiologic Satellite lesions Kaposi's sarcoma Petechiae, ecchymosis, purpura