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Skin > Norton Part 1 > Flashcards

Norton Part 1 Flashcards

1
Q

what causes vitiligo

A

autoimmune disorder
chronic depigmenting condition from complete loss of epidermal melanocytes
may find autoantibody against melanin-concentrating hormone receptor 1 in serum

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2
Q

vitiligo peaks when and is more common in what people

A

2nd and 3rd decades

higher incidence in african americans

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3
Q

where is vitiligo mainly found

A

acral areas (fingers, limbs, ears) and orificies (mouth, eyes, nose, anus)

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4
Q

what does vitiligo present as

A

asymptomatic white macules with sharp borders that gradually enlarge
hair will also loose pigment

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5
Q

what can one use to see vitiligo lesions better

A

Wood’s lamp

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6
Q

what is another name for a freckle

A

ephelis

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7
Q

what is an ephelis (freckle)

A

hyper pigmentation of the basal layer from increased melanosomes

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8
Q

freckles appear when

A

after sun exposure in lightly pigmented kids

darken with sun exposure

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9
Q

what does lentigo present as

A

small (less than 1 cm) circumscribed brown macular lesions

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10
Q

lentigo is what?

A

hyper pigmentation of cells just above the basement membrane

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11
Q

what happens to lentigo with sun exposure

A

they do not darken

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12
Q

what histological features are seen in lentigo

A

rete ridges are elongated and appear club shaped or tortuous
melanocytes are increased in basal layer
malanophages appear in upper dermis

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13
Q

what is the main difference between freckle and lentigo

A

lentigo has increased melanocytes

freckle has increased melanosomes but not melanocytes and gets darker w/ sun exposure

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14
Q

what are the gross features of a melanocytic nevi

A

tan to brown
uniformly pigmented
small (usually less than 6mm)

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15
Q

what are the histological features of a melanocytic nevi

A

sharply defined
well nested at the dermal-epidermal junction
melanocytes mature as they descend in dermis
no deep mitoses
no deep pigment in the melanocytic nest

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16
Q

what is a junctional nevi

A

melanocytic nests at the dermal-epidermal junction which are restricted to the tips and sides of the rete

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17
Q

what happens to the cells of a compound nevi and what does it appear as

A

they invade the dermis and mature and become smaller

more raised and dome shaped than junctional nevus

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18
Q

what is seen histologically on an intradermal nevi

A

melanocytic nests are lost completely

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19
Q

what is a spitz nevus composed of

A

spindle and/or epithelioid cells

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20
Q

what is a Kamino body and where is it found

A

eosinophilic bodies of dyskeratotic melanocytes along dermal-epidermal junction
spitz nevi

21
Q

spitz nevi are common in whom and what do they look like

A

children

deep red color

22
Q

what are the histological features of a compound nevi

A

similar to junctional nevus but also has nests and cords of nevus cells in underlying dermis

23
Q

what are the histological feature of a spitz nevus

A

sharply defined laterally
line symmetry from left to right
nests of melanocytes in epidermis
clefts separating nests from keratinocytes

24
Q

what does a dysplastic (atypical) melanocytic nevus commonly look like

A

large, oval, and multiple (dysplastic nevus syndrome, AD)

irregular pigment is common

25
Q

a fading border or fried-egg appearance (central papule, surrounding macule) is commonly associated with what?

A

dysplastic (atypical) melanocytic nevus

26
Q

dysplastic (atypical) melanocytic nevus may be precursor of what

A

melanoma

27
Q

what is a malignancy of pigment-producing cells

A

melanoma

28
Q

melanocytes are derived from where?

A

neural crest

29
Q

what is the number one cause of skin cancer deaths worldwide

A

melanoma

30
Q

where is melanoma normally found

A

skin, eyes, GI tract, leptomeninges, oral and genital mucosa

31
Q

the incidence of what neoplasm is increasing the most

A

melanoma

32
Q

what is the most frequent cancer in white/caucasian/apigmentd women aged 25-29

A

melanoma

33
Q

what are the subtypes of melanoma?

A 
superficial spreading
lentigo maligna
nodular
acral
amelanotic
34
Q

what are the growth phases of melanoma

A

vertical and radial

35
Q

what does the vertical growth phase of melanoma determine

A

tumor stage

36
Q

what stage of melanoma can lead to metastasis

A

vertical growth phase

37
Q

where does melanoma normally metastasis to?

A

lymph nodes, brain, GI tract, bone, liver and lungs

38
Q

what is the third most common metastatic tumor to the brain after lung and breast cancer

A

melanoma

39
Q

what is the number one risk factor for melanoma

A

a changing mole

40
Q

what are some common risk factors for melanoma

A

atypical/dysplastic nevi
numerous common nevi
large (giant) congenital nevi (>20cm diameter)
previous melanoma or prior skin cancer (non melanoma)
fair skin and history of blistering in sun
xeroderma pigmentosa

41
Q

what is the ABCDE rule of skin lesions

A 
Asymmetry
Border irregularity
Color variation
Diameter > 6mm
Evolving
42
Q

how does one manage melanoma

A

ABCDE rule of skin lesions
avoid superficial skin biopsy by shaving, scissors excision, or curettage
full-thickness skin extending to the subcutaneous fat with 2mm lateral margins
excision, punch, or incisional if lesion is large

43
Q

what margins does one need when biopying melanoma

A

2mm lateral margins

44
Q

what growth phase of melanoma do the tumor cells lack the ability to metastasize

A

radial growth phase

45
Q

during the radial growth phase where does the melanoma spread

A

horizontal spread within the epidermis and superficial dermis

46
Q

in the vertical growth phase where does the melanoma spread

A

downward into deeper dermal layers as a mass

47
Q

in the vertical growth phase of melanoma what happens to the cells

A

they have metastatic potential

the invading cells do not mature like in a melanocytic nevi

48
Q

when does a grossly visible nodule appear in melanoma

A

vertical growth phase

Skin (12 decks)

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