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46 Cards in this Set
- Front
- Back
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Skin Phototypes
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I - Pure white - tender sunburn, no tan
II - Pure white - tender sunburn, light tan III - White - non-tender sunburn, dark tan IV - Beige - No sunburn, dark tan V - Brown - no sunburn, dark tan VI - Black - no sunburn, dark tan |
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Common Melanocytic Nevus
AKA, when appears |
AKA - Mole
Appear - early childhood, disappear by age 60 |
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Junctional Common Melanocytic Nevus
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macular, brown, pigment is in epidermis
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Compound Common Melanocytic Nevus
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elevated, tan to brown color, pigment is epidermal & dermal
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Dermal nevus
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flesh-colored as pigment is in the dermis, elevated
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Congenital Nevus
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pigmented lesion present at birth, rare varieties become apparent within first 12 months of life
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Congenital Nevus
Management (Small CN <1.5 cm) |
Should be excised as soon as possible
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Congenital Nevus
Management (Large CN >1.5 cm) |
Excise before age 12 even if not obviously dysplastic
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Congenital Nevus
Management (Giant) Prognosis |
remove as soon as possible
Prognosis: poor if melanoma develops |
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ABCDE of Moles
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A - Asymmetry - in shape
B - Borders - are irregular C - Color - is mottled, shades of brown, black, gray, red & white D - Diameter - usually large (>6 mm) E - Enlargement - |
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Dysplastic Nevus Syndrome
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-arise in childhood, before puberty
-increased number of moles in sun-exposed areas -moles also present in non sun-exposed areas |
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Dysplastic Nevus Syndrome
Incidence |
-Almost all patients with familial cutaneous melanoma
-30-50% of patients with sporadic primary melanoma 5% of general white population |
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Familial Atypical Mole & Malignant Melanoma
(FAMMM) |
Essentially dysplastic nevus syndrome with 2 blood relatives with melanoma
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Benign pigmented nevi
Treatment |
monitoring, excision if cosmetically undesired, laser
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Dysplastic nevi
Treatment |
-Surgical excision (do not laser or freeze)
-Monitoring by patient monthly and provider annually |
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Predisposing Factors for Melanoma
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-Prescence of precursor lesions
-Family history -Phenotype (Blonde or red hair, blue or green eyes, lighter skin type, freckling tendency( -hx of blistering sunburns -increased sun exposure |
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Halo nevi
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synonymous with Sutton's nevus or Leukoderma acquisitum centrifugum
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Halo nevi
Etiology |
due to circulating cytotoxic antibodies
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Superficial Spreading Melanoma
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-Account for 70% of all melanomas
-Evolves over a period of 1-5 years -2% occur in phototypes V & VI |
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Nodular Melanoma
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-Accounts for 16% of all melanomas
-Age - Median 50 years -Prognosis -- worse than superficial spreading melanoma |
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Nodular Melanoma
Evolves when |
Evolves over 6-18 months
Rarely associated with nevus remnant |
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Lentigo Maligna
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Flat, macular, intraepidermal neoplasm and the precursor or evolving lesion of Lentigo Maligna Melanoma (LMM)
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Lentigo Maligna
AKA |
Hutchinson's nevus,
Hutchinson's freckle, Melanoma in situ |
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Lentigo Maligna
Age affected, who affected |
-Median age is 65
- = in males & females -older population with increased sun exposure |
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Lentigo Maligna Melanoma
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-5% of all melanomas
-Age = 7th decade -Occur on head and neck -May take 20 years to evolve from Lentigo maligna |
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Acral Lentiginous Melanoma
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-2-8% of all melanomas
-Age - 65 years old -Males > Females |
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Acral Lentiginous Melanoma
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very common in American & African blacks & Japanese
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Acral Lentiginous Melanoma
Evolution & Prognosis |
Evolves over 2-5 years
Prognosis - survival rates for volar type are less than 50% -Subungual (nail) type has 5 year survival rate of 80% |
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Stages of Melanoma
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Stage 1 - localized dz with no clinically palpable nodes
Stage 2 - palpable regional lymph nodes Stage 3 - presence of distant metastasis |
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Metastatis Melanoma
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Local - within 5 cm of primary site
Intransit metastases - >5cm from primary site |
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Metastaic Melanoma
Melanogenuria |
generalized blue-gray cutaneous discoloration, may be accentuated in sun-exposed areas of skin
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Oral Leukoplakia
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sharply defined, white, macular, slightly raised area, cannot be rubbed off, remains after irritant removed
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Oral Leukoplakia
Predisposing Factors |
-tobacco
-alcohol -HPV Types 11 & 16 |
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Oral Leukoplakia
Prognosis |
-10% progress to malignancy
-on the floor of mouth, more likely to progress to squamous cell carcinoma |
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Actinic Keratosis
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single or multiple, discrete, dry, rough, adherent, scaly lesions on habitually sun-exposed skin
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Actinic Keratosis
Common in.... |
-middle age men
-skin types I, II, III -outdoor workers, sportspersons |
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Basal Cell Carcinoma
Predisposing Factors |
-Most common type of skin cancer
Predisposing Factors -Phototypes I & II -Prolonged sun exposure |
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Basal Cell Carcinoma
Treatment |
-Excision with primary closure, skin flaps or grafts
-Cryosurgery, curettage, electrosurgery -Imipuimod |
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Squamous Cell Carcinoma
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Malignant tumor of skin & mucous membranes
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Squamous Cell Carcinoma
Predisposing factors |
HPV
Immunosuppression PUVA Scars Chronic ulcers Discoid Lupus |
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Bowen's Disease
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Usually a solitary lesion on exposed skin
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Bowen's Disease
Description |
Slowly enlarging, erythematous macule, sharp border, little or no infiltration, slight scaling
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Bowen's Disease
Treatment |
-Excision
-Moh's surgery in difficult sites -Cryotherapy -Efudex -Imiquimod |
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Erythoplasia of Queyart
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Clinically & histologically resembles Bowen's disease but occurs on penis
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Invasive Squamous Cell Carcinoma
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Fleshy, granulating, friable, crusted nodules
-Has capacity to metastasize |
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Invasive Squamous Cell Carcinoma
Treatment & Prognosis |
Excision
Accutane Prognosis -- SCC has remission rate after therapy of 90% |
