Pigmented Lesions

Front 1

What is albinism?

Back 1

1. Genetic disorder where melanocytes are present

2. Melanin is decreased or absent

Front 2

What is vitiligo?

Back 2

1. Acquired autoimmune process

2. Melanocytes are destroyed

Front 3

What stimulus increases the number of nevi found on skin?

Back 3

1. Sun exposure

Front 4

What are the characteristics of benign nevi?

Back 4

1. <6mm

2. Uniform pigmentation

3. Smooth border

4. Unchanging size/color

Front 5

What is the histology of benign nevi?

Back 5

1. No melanocytes above DE junction

2. Cell maturation through dermis

Front 6

What are the characteristics of a junctional nevus?

Back 6

1. Smooth brown macules

2. 1-6 mm

3. Can become compound or intradermal

4. Small, well-nested on histo

Front 7

Back 7

Junctional nevus: nests of bland melanocytes at DEJ

Front 8

What are the characteristics of a compound nevus?

Back 8

1. Slightly elevated or dome shaped

2. Flesh colored or brown

3. Less prominent pigment in melanocytes

Front 9

Back 9

Compound nevus: nests of nevus cells in the epidermis overlying a dermal component of orderly nevus cells

Front 10

What are the characteristics of an intradermal nevus?

Back 10

1. Junctional activity has ceased

2. All nevus cells in dermis

3. Flesh-colored or pigmented, dome-shaped

4. Usually symmetrical

Front 11

Back 11

Intradermal nevus: melanocytic cells resemble neuronal structures

Front 12

What is the malignant potential of nevi?

Back 12

1. 1/2 of melanomas occur in pre-existing nevi

Front 13

When should you bx a nevus?

Back 13

1. Violate ABCDEs

2. New in 4th decade

3. Present in difficult-to-observe places

Front 14

When should you bx nails?

Back 14

1. Hutchinson's sign

2. Solitary expanding longitudinal pigmented band

Front 15

What is this? Tx?

Back 15

1. Halo nevus

2. No tx indicated

3. 20% of individuals with halo nevi have association with malignant melanoma

Front 16

What is the histology of a halo nevus?

Back 16

1. Lymphocytic infiltrated with dermal nevus cells

Front 17

What is this? Tx?

Back 17

1. Common blue nevus

2. MC occur on dorsal hands, feet, scalp, and face

3. Tx: excision, q-switched ruby laser

Front 18

What is the histology of blue nevi?

Back 18

1. Dendritic dermal melanocytes and melanophages

2. Sclerotic stroma

Front 19

What are the ssx of a malignant blue nevus?

Back 19

1. Sudden increase in size and ulceration

Front 20

What is this?

Back 20

1. Nevus spilus--- speckled

2. Size is varied

3. Rarely evolves to melanoma

Front 21

What is this?

Back 21

1. Becker's nevus

2. Hyperpigmented, hypertrichotic

3. Begins before puberty

4. Rarely malignant

Front 22

What is this? Tx?

Back 22

1. Spitz nevus

2. Starburst pattern on dermoscopy

3. Tx: complete excision

Front 23

What is the histology of a spitz nevus?

Back 23

1. Oval nests that rain down the adjacent rete ridges

2. Kamino bodies in epidermis

Front 24

What is this? With what is it associated?

Back 24

1. Cafe-au-lait macule

2. NFT-1

Front 25

What is this?

Back 25

1. Lentigo simplex

2. No predisposition to neoplastic change

Front 26

What is this?

Back 26

1. Penile/vulvar melanosis

Front 27

What is this?

Back 27

1. Solar lentigines

2. In area of sun exposure

Front 28

What is the histology of solar lentigines?

Back 28

1. Hyperpigmented, club-shaped rete ridges

Front 29

What is this?

Back 29

1. Ink spot/sunburn lentigo

2. On shoulders and upper back

Front 30

What is the inheritance of ephelides?

Back 30

1. AD

Front 31

What is this?

Back 31

1. Seborrheic keratosis

2. Sign of Leser-Trelat

3. "Stuck on" appearance

Front 32

What is the sign of Leser Treat?

Back 32

1. Seborrheic keratosis---- points to adenocarcinoma of stomach, lymphoma, breast CA, and lung SCC

Front 33

What is this?

Back 33

1. Mongolian spot

2. Sacral area of newborn

3. Melanocytes failed to migrate to epidermis from neural crest

Front 34

What is this? With what is it associated?

Back 34

1. Nevus of ota

2. Associated with glaucoma or ipsilateral sensorineural hypoacusia

Front 35

How do you tx nevi of Ota?

Back 35

1. Q-switched lasers

Front 36

What is this? Tx?

Back 36

1. Nevus of Ito

2. Posterior supraclavicular and lateral cutaneous brachial nerves

3. Tx: Q-switched laser

Front 37

What are the size classifications of congenital nevi?

Back 37

1. Small <1.5 cm

2. Intermediate 1.5-20 cm

3. Giant >20 cm

Front 38

With what disorders are congenital melanocytic nevi associated?

Back 38

1. Scoliosis

2. Spina bifida

3. Atrophy

4. Asymmetry

5. Clubfoot

Front 39

How do you tx congenital melanocytic nevi?

Back 39

1. Excise suspect lesions

Front 40

What are the ssx of giant pigmented nevi?

Back 40

1. Large, darkly pigmented hairy patches

2. Present at birth, grow proportionally

Front 41

With what are giant pigmented nevi associated?

Back 41

1. Neurocutaneous melanocytosis

Front 42

How do you tx giant hairy nevi?

Back 42

1. Surgical excision

2. Resurfacing autografts

Front 43

What are the ssx of dysplastic nevi?

Back 43

1. 5-12 mm with irregular borders

2. Brown, tan, pink

Front 44

What are the ssx of dysplastic nevus syndrome?

Back 44

1. AD inheritance

2. Melanoma in 1/2 degree relative

3. >50 dysplastic nevi

4. Dysplastic nevi on histology

Front 45

What mutations predispose to dysplastic nevus syndrome?

Back 45

1. CDKN2A (p16)

2. CDK4

Front 46

How do you tx dysplastic nevi?

Back 46

1. Remove any suspect lesion

2. Excisional bx