Question | Answer |
Lentigo | in sun damaged skin with increased number of melanocytes |
Peutz Jeghers syndrome | lentigo accumulate in the perioral distribution and hands and feet |
Ephelis | like lentigo only they darken in the sun and have the same number JUST more melanin production |
Cafe Au Lait | Look like freckles but larger |
Neurofibromatosis | if more than six cafe au laits that is diagnostic |
Three Types of NEVI (moles) | Junctional (dermal-epidermal layer) Compound (junction and dermis) and Intradermal (confined in the dermis) |
Spitz Nevus aka | spindle and epitheliod cell Nevus seen mostly in children |
Blue Nevus | Collection of pigmented dendritic melanocytes in the dermis common on butt, face, feet and dorsa of the hand |
Cong. Nevus | Small to Giant in Size can involve large areas of the body and are at risk for developing Malignant melanoma risk |
Where do malignant melanomas occur | anywhere |
Median age for dev. a malignant melanoma | 50 |
who gets malignant melanomas | light skinned people with incidental exposure |
what is the 5 year with malignant melanoma | 80% |
where is the highest incidence of malignant melanoma | australia |
how do almost all Malignant melanomas begin | as an abnormal proliferation of malanocytes within the epidermis (in situ) |
what are the two growth patterns of malignant melanoma | vertical and Radial |
Radial Growth | confined within the epidermis if they drop into the papillary dermis they are eliminated at once |
cellular appearance of malignant melanocytes | irregular and atypical |
Clark system of measurment | Level 1- intraepidermal 2-papillary dermis 3-fills papillary dermis 4-subcutis invasion |
Breslow's thickness Measurement | 90-95% prognostic Less than .75 mm never and more than 4mm 60% mets |
besides clark and breslow what are some other indicators for survival | women > men and extremities> other sites |
what are the classifications of malignant melanomas | Superficial, Lentico, Acral, Nodular |
Superficial spreading Malignant melanom | 70% of malignants are superficial Legs of women and backs of men LONG radial phase until vertical phase starts signified by a nodule |
Lentigo Malig. melanoma | in sun exposed, usually on the face, Long Radial Phase (10-40 yrs) |
Nodular malignant Melanoma | 10-15% VERY short undetectable radial growth phase, evolves as a nodule from the start |
Acral Lentiginous Melanoma | Most common in African, Asian, Hispanics, Native Amer on palms and soles, or mucus membranes irregular borders adn varying colors with some radial before vertical BY FAR THE RAREST |
how are melanocytes identified | S-100 proteins and Malanosomes |