Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
oval tan-brown macules or patches
|
lentigo
|
|
|
arises in childhood
assoc w/ peutz-jeughers and LEOPARD |
lentigo simplex
|
|
|
caucasian > 70yo
sun exposed areas |
actinic or solar lentigo
liver spots |
|
|
linear melanocytic hyperplasia
no nests above BM hyperpigmented basal cell layer elongated, thinning rete ridges |
lentigo
|
|
|
patchy macular hyperpigmentation of face
incr melanin production women, darkly pigmented more prone worse w/ UV, pregnancy, OCPs |
melasma
|
|
|
oral lentigines
GI polyps visceral tumors (pancreas, gonads) |
peutz jeughers sd
|
|
|
congenital skin lesion
benign melanocytic neoplasm (mole) |
nevus
|
|
|
what are the types of melanocytic nevi?
|
junctional
compound intradermal [this is the maturation sequence] |
|
|
derived from neural crest cells
dendritic cells in basal layer of epidermis |
melanocytes
|
|
|
type of melanocyte
no dendritic processes in nests in basal layer in epidermis and dermis |
nevus cell
|
|
|
how do nevus cells differ in appearance in the epidermis, middle and lower dermis?
|
epidermis: epithelioid, cuboidal or oval, indistinct cytoplasm, pigmented, oval nucleus
middle: smaller, lymphoid, no pigment lower: spindle cells like fibroblasts |
|
|
how is congenital melanocytic nevus treated?
|
nothing, UNLESS it's >20cm or covers 5% of body area, then needs excised
|
|
|
nests of melanocytes
invade erector pili mm extend along sweat ducts |
congenital melanocytic nevus
|
|
|
what is a spitz nevus?
|
spindle and epithelioid cell nevus
looks like hemangioma |
|
|
where is a blue nevus most commonly located?
|
dorsa of hands & feet
|
|
|
elongated wavy melanocytes
long branching dendrites in dermis incr collagen long axis parallel to epidermis in bundles |
common blue nevus
|
|
|
nests and fasciles of spindle shaped cells w/ abundant pale cytoplasm
little or no melanin |
cellular blue nevus
|
|
|
where is a cellular blue nevus usually located?
|
buttocks or sacrococcygeal
|
|
|
what is a mongolian spot?
|
congenital, benign blue or gray hyperpigmentation
due to excess melanocytes MC in Asian & African; will fade |
|
|
host immune response vs. nevus cells, melanocytes
depigmented zone surrounds melanocytic nevus |
halo nevus
|
|
|
acquired
larger than most nevi irregular border variegated |
dysplastic nevus
*melanoma risk is incr* still low though |
|
|
nevus cell nexts in epidermis enlarged
lentiginous hyperplasia eosinophilic fibrosis around elongated rete ridges melanocyte nests discohesion of cells in nests |
dysplastic nevus
|
|
|
what genetic markers are assoc w/ melanoma?
|
CDKN2A - familial
sporadic: BRAF, NRAS (also CDKN2A) |
|
|
atypical melanocytes - enlarged nuclei, prominent red nucleoli
haphazard arrangement asymmetry dermal mitoses deep, atypical |
melanoma
|
|
|
which growth phase is mets assoc w/?
|
vertical growth phase
|
|
|
what is the stain used specifically for melanoma?
|
HMB45
|
|
|
what are the subtypes of melanoma?
|
- superficial spread - MC, initally radial then fast vertical
- nodular -- no radial phase, more invasive - lentigo - slow radial, 5% go vertical - acral lentiginous - blacks & Asians MC, hands & feet |
|
|
which type of melanoma displays spindle shaped cells?
|
lentigo
|
|
|
which type of melanoma will reach 5-7cm diameter before invading?
|
lentigo
|
|
|
which type of melanoma might ulcerate & lacks surrounding macular hyperpigmentation?
|
nodular
|
|
|
which type of melanoma has pagetoid spread of large melanocytes?
|
superficial
|
|
|
which type of melanoma has a different sexual distribution?
|
superficial - trunk for men, legs for women
|
|
|
which type of melanoma displays hutchinson's sign (pigmentation on the nail fold)?
|
acral lentiginous
|
|
|
which type of melanoma nests at the dermal-epidermal junction?
|
acral lentiginous
|
|
|
spindle cells that are S-100 (+) and HMB-45 (-)
********* |
desmoplastic melanoma
|
|
|
what is the primary prognostic indicator in melanoma?
|
breslow thickness - measured from granular layer of epidermis to greatest depth
*** > 3.0mm *** |
|
|
what are the Clark levels?
|
1 - in situ (epidermis only)
2 - papillary dermis 3 - papillary/reticular dermal interface 4 - reticular dermis 5 - SQ fat |
