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36 Cards in this Set
- Front
- Back
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solar lentigo or lentigo senilis
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discrete benign hyperpigmented macule due to chronically exposed skin
-mainly seen in adult males that are balding -most common areas back of the hands and forehead -age spots -liver spots |
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solar lentigo caused by
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increase melanin in the keratinocytes, IT IS NOT INCREASED IN NUMBER OF MELANOCYTES, THE DISEASE NAME IS MISUSED
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what are the disorders of pigmentation
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vitiligo
melasma freckles acanthosis nigricans tattoo |
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what are the symptoms and clinical appearence of vitiligo
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vitiligo is caused by 2 modes
1) partial or complete loss of of pigment producing melanocytes 2)sloughing of the skin -this is seen w/albino ppl and this increases the chance of UV damage -has small maculs of normal pigment w/in the patches -can be un apparent in light individuals -dark individual are effected most profoundly |
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how does vitiligo present and diagnosed histologically
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it presents as a lack or reduced # of melanocytes and diagnosed by staining for melanin proteins like s100 or malan-a
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what is the pathogenesis of vitilgo
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it is usually due to autoimmune disorders, usually antibodies against melanocytes
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what are signs and symtoms associated with melasma
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-hypermelanosis
-seen as , blotchy,demarcated, brown, macules in a symmetrical distribution -mainly on cheeks and forehead -rarely on upperlips and neck |
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what sex is effected most
what are the other names for it |
mainly women, it is associated with pregnancy, and women that take birth control, menopause
-cholasma -mask of pregnancy |
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freckles
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increased production of melanin due to increased exposure to sun
-the freckles get darke -tan-red or brown light macules -they come and a cyclical fashion w/c seperates them from lentigo |
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what happen if you go into the sun
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-the freckles get darke
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what are the signs and symptoms associated with acanthosis nigricans(AN)
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hyperpigmentation in flexure regions like axilla, groin, and anogenital regions
-velvet like texture |
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what %of AN is benign and what are the causes
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80% benign, it is ususally genetic, it appears during childhood, could be due to autosomal dominant disorder w/variable penetrance, or in association with obesity or endocrine abnormalities or due to rare congenital syndromes
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what %of AN is malign and what are the causes
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-20%
-usually older ppl -this is acquired and these ppl usually have GI adenocarcinoma -diagnosis of this can help Id many systemic disorders |
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what are the signs and symptoms associated with Tattoo and why do they fade
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tattoo ink particles are injected inside the dermis, if in epidermis it will fade very quickly and will be sloughed off
-must be inert otherwise they'll be broken down quickly -they fade b/c they are phagocytized by our histocytes (macrophages), since they are inert the phagocyte just releases it and it gets picked up up another histocyte and this continues till the tattoo fades -also they continue to move down to reticular dermis and thats another way they fade |
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what are nevocellular Nevi
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it is a benign neoplasm of melanocytes, occurs on the neck and face of the children and young adults
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nevus
what are different types of nevi |
-mainly known as a birthmark, -start 9-13yrs old
-develop by the age of 30 -ususally go away by adulthood 3 types junctional intradermal compund |
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what are the signs and symptoms associated with junctional nevi
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-beauty spot or mole
-earlier in life it is flat, small, symmetrical -it gets the name b/c it starts at the dermal/epidermal junction -overproduction of melanocytes |
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what are the signs and symptoms associated with compund nevi
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eventually junctional will form into compound
-more raised and dome shaped -symmetry and uniform pigmentation = benign -seen inside dermis as cord of cells |
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1)what are the signs and symptoms associated with intradermal nevus
2) what happens to the size and amount of pigment produced as these cells move deeper into the dermal la |
-these have migrated into papillary dermis and reticular dermis
-usually seen at teen years -these are usually located at the face -these are usually seen with a shaved biopsy and they are older nevi -deeper into the skin they move they get smaller and produce less pigment and grow in chords |
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what is the key thing to remember for nevi and if it is benign or malignant
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it is never malignant inside the nevus, only on the edges
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what are the signs and symptoms associated with congentital nevus
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-present at birth
-usually grow deep around adnexa ,neurvascular bundles, and blood vessel walls |
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what are the signs and symptoms associated with blue nevus
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-fibrosis
-black/blue nodule often confused w/melanoma |
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spitz nevus
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-fasicular growth
-pink/blue cytoplasm -fusiform cells -common in children, red-pink nodule -confused w/hemangioma |
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halo nevus
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-lymphocytic infiltration
-due to host immune response against the nevus |
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dysplastic nevus
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-occurs on trunk
-most common nevus -definitely nor premalignant -cytologic atypia> change in size |
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what are the signs and symptoms associated with MALIGNANT MELANOMA?
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-malignant neoplasm derived from the cells that can make melanin
-can occur on any part of the body however it is rare on the mucous membrane and on anogenital regions -usually denovo as an isolated lesion or next to a melanocytic nevus -they can meatstasize, and are spread to the local lymphnodes,lungs and brain -it uaually presents with asymmetric, color changing, shape changing, irregular bordered, maculopapular lesion |
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what are the sex differnces associated with observation of MALIGNANT MELANOMA?
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females= higher incidence on the back and legs
males= upper back, trunk |
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what is the incidence of the disaese?
2)who is at risk |
the incidence is higher in caucasian males, in general light skinned ppl are more at risk than dark skinned ppl,
incidence fo the disease is directly associated with exposure to the sun 2) redheads or true blondes, that have had 2 peeling sunburns before the age of twenty |
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what cannot be done as far as cytologic preparation of malignant melanoma is concerned?
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you cannot do a shaved biopsy, musty do a excision biopsy, w/c is confirmatory test
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looking at cytological preparation, how do you knw you are looking at the malignant melanoma
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if melanocytes are observed at the epidermal layers, when normal, these cell are not migratory they stay the dermal and epidermal junction
-also an inflammatory immune response will be visible -pagetoid spread, buck shot pattern -also if see melanocytes in the keartohyaline region |
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what is the morbidity/mortality associated with malignant melanoma in type 1 disease vs type 4 disease at 5 year and 10year intervals
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stage1 survival rate = 98%
stage 4 survival rate = 15% for 10 yrs stage 1 = 95% stage 4 = 5% -this finding are b/b stage 4 is metastatic |
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what are the predictions associated with breslow level b/t .76 and 1.5mm
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this signifies a survival rate of 80%
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Fibroeepithelial polyps
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-called many things like skintags, arochrodon, fibroma molle, squamous pappiloma
-occur on neck and groin in old ppl -usually due to excessive rubbing form clothing -usually has raised pedicle -sometimes they look like nevi-if cut at the base, they bleed alot -these become more numerous with hemangiomas and neuromas |
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epithelial inclusion cysts
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-extremely common
-usually occur around the face, mainly around the eye -due to blockage of a sebaceous duct where a hair follicle would be growing -this fills up keartin, lipid and sebaceous debris -if ruptured it provokes an intense inflammatory response -these can be heritable |
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hemangiomas
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red
-thick vessel walled -usually reactive and not neoplastic -capillary hemangioma is the most common |
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xanthoma
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yellow
-eruptive -central nuclei |
