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