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33 Cards in this Set

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what is vitiligo?
depigmentation of skin
usually due to loss of melanocytes
describe skin lesions in vitiligo
asx, flat, well-demarcated macules or patches of depigmentation
usually on hand, wrist, perioral, periorbital, axilla, anogenital regions
how does vitiligo differ from albinism?
albinism- melanocytes present but not prod melanin
vitiligo-no melanocytes present
why do ppl of diff races have varying shades of skin?
differences in amt of melanosomes produced; NOT a diff in number of melanocytes
what is melasma
HYPERmelanosis
"mask of pregnancy"
"chloasma"
exclusively in women: pregnant, oral contraceptives, menopause
describe skin lesions in melasma
sharply demarcated, blotchy brown macules
symmetrically distributed
cheeks, forehead (upper lip, neck)
freckles
what distinguishes them from lentigo?
small macules due to incr melanin prod
intensify with sun (v. lentigo)
acanthosis nigricans
hyperpigmentation
flexural folds (axilla, groin, neck)
NO melanocytic hyperpasia
important cutaneous marker for assoc conditions (pineal, pituitary tumors)
2 types of acanthosis nigricans; what is each type associated with?
benign (80%) childhood to puberty; AD, variable penetrance; obesity, endocrine disorders

malignant (20%); acquired in middle aged to older; often assoc with GI adenocarcinoma
where are tattoo particles deposited?
papillary dermis
why do tattoos fade?
taken up by histiocytes
when histiocytes die, rel particles which are taken by new histiocytes--> less concentrated
nevocellular nevi; types
benign neoplasms of melanocytes (nevus= any congenital skin lesion)
occur in children to young adults, go away with age

tan to brown, uniform pigmentation, small, solid, macule or papule, well-defined borders

junctional, compound, intradermal
junctional nevocellular nevus
"mole"
melanocytes transformed to round cells growing in aggregates along dermoepidermal jxn
early developmental stage
compound nevocellular nevus
more raised and dome-shaped
still symmetrical with uniform pigmentation
formed when junctional nevi grow into underlying papillary dermis
intradermal nevocellular nevus
epidermal aggregates lost completely to dermis
often removed for cosmetic reasons
mature, deep, small, prod little pigment, grow in cords
why is the maturation process of nevi important diagnostically?
distinguishes benign nevi from melanomas which have little to no maturation
dysplastic nevus
most common nevus
occurs on trunks
small, macular
occur throughout life
sims- NOT premalignant
malignant melanoma
neoplasm of melanocytes
skin, eye, mucous mbrs(rare)
primarily adults
80-90% de novo; 10-20% next to melanocytic nevus
what is malignant lentigo?
melanoma in situ
radial growth, no metastasis
with time, usually has vertical, metastatic component
where do malignant melanomas freq metastasize? and how?
widely
regional lymph nodes
liver
lungs brain
hematogenous spread
where is the highest incidence of malignant melanoma in males and females? what does this suggest? which ethnic group?
males: trunk
females: leg
suggests assoc with sun exposure
caucasians
what does it mean if the prevalence of a disease is equal to the incidence?
incidence= new cases in pop/yr
prevalence= new cases in pop

if equal means that ppl who get disease in a yr are dying because prevalence is staying the same
what are the 4 cardinal signs of malignant melanoma?
1. asymmetrical
2. irregular borders
3. uneven pigmentation
4. maculopapular
clinical warning signs of malignant melanoma?
enlargement of pre-existing mole; itching/pain in pre-existing mole; dev new pigmented lesion in adulthood; irregular borders; varied pigmentation
how is a malignant melanoma lesion removed? how does this compare to a nevus?
mal mel: excised (diagnostic)
then biopsied to confirm

nevus: shaved off
what is pagetoid spread? what is this a feature of?
when melanocytes are found in the stratum corneum with the keratin
malignant melanoma
what factors are of prognostic significance in malignant melanoma?
clinical stage (IV is distant metastasis; 5 yr survival rate drops from 98% at stage 1 to 15% in stage 4)
also, tumor thickness (breslow level?) and presence of ulceration
what are fibroepithelial polyps?
skin tags
(acrochrodon
fibroma molle
squamous papilloma)
neck and groin in older ppl (areas of rubbing)
many have pedicles
composed of fibrovascular cores covered by squamous epithelium
where do epithelial inclusion cysts occur and what causes them?
obstruction of hair follicle
seen on face and upper extremity
what are epithelial cysts filled with and what is a consequence of trauma?
filled with keratin
trauma can lead to chronic inflamm reaction, granuloma formation to keratin released
what are all cysts lined with? why do they grow?
epithelium; cyst grows b/c epithelium grows...eventually attenuated
hemangioma
red
thick vessel walls, clustered
freq due to exaggerated reaction and not neoplastic
most common benign tumor in kids
xanthomas
yellow
central nucleus