Term
|
Definition
| no organelles and no nuclei, topmost level of skin |
|
|
Term
|
Definition
| 1-3 cells thick, keratohyaline granules contribute to permeability barrier, top middle level of skin |
|
|
Term
|
Definition
| Contains keratinocytes; 4-10 cells thick, acquire keratin intermediate filaments (tonofibrils) and desmosomes, bottom middle level of skin |
|
|
Term
|
Definition
| 1 cell layer, 17% undergo apoptosis or terminal differentiation, bottom most level of skin |
|
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Term
|
Definition
| only present in thick skin (palms and soles = volar skin). |
|
|
Term
| Normal total epidermal renewal time |
|
Definition
| 2 months:26-42 days from basal layer to granular layer; 14 days through stratum corneum |
|
|
Term
| Melanocytes: what do they do? Where are they mostly found? Is there a difference between melanocytes in dark/light skin? |
|
Definition
| Produce melanin in melanosomes from tyrosine via tyrosinase. Melanin helps protect DNA from harmful UV rays. Highest density of melanocytes on face and male genitalia, lowest density on trunk. No significant difference in density and distribution b/w dark and lightly pigmented skin. |
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Term
|
Definition
| bone marrow derived antigen presenting cells in the skin (2% of cells in epidermis). |
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Term
|
Definition
| most important adhesion molecules of the skin. |
|
|
Term
| Basement membrane zone: where is it and what does it do? What is it made of? |
|
Definition
| Found at the dermoepidermal junction. It separates the epithelium and endothelium from the underlying connective tissue. It consists of the basal cell plasma membrane, lamina lucida, lamina densa (contains type IV collagen), and sublamina densa. |
|
|
Term
| What does the Sublamina Densa contais? |
|
Definition
| anchoring fibrils (type VII collagen) and dermal collagens (types I and II). |
|
|
Term
| What is Epidermolysis bullosa? |
|
Definition
| deficiency in type VII collagen. |
|
|
Term
| What is the Papillary dermis made of? |
|
Definition
| consists of fine collagen and reticulin |
|
|
Term
| What is the Reticular dermis made of? |
|
Definition
| consists of coarse collagen and reticulin and is located below the papillary dermis |
|
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Term
|
Definition
| bypass the capillary network; richly innervated; responsible for temperature regulation |
|
|
Term
| Where is the Superficial horizontal plexus? |
|
Definition
| at the dermal-epidermal junction |
|
|
Term
| Where is the Deep horizontal plexus? |
|
Definition
| at the dermal-SQ junction. |
|
|
Term
| What does Subcuntaneous tissue contain and how are the contents arranged? |
|
Definition
| adipocytes which are separated into lobules by fibrous septae that are continuous with the dermis |
|
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Term
|
Definition
| results from arterial interference |
|
|
Term
|
Definition
| occurs due to venous disorders |
|
|
Term
| What does the Skin contain? |
|
Definition
| Meissner corpuscles (touch) and Pacinian corpuscles (pressure – looks like onion) |
|
|
Term
| Where do Terminal hairs come from and where are they? |
|
Definition
| come from heavily pigmented thick hair shafts with follicles deep in the dermis. Present on scalp |
|
|
Term
| Where do Vellus hairs come from and where are they? |
|
Definition
| short, fine, lightly pigmented hair shaft with follicles extending only into upper reticular dermis. Present on face |
|
|
Term
| Where is Smooth muscle found in the skin? |
|
Definition
| 3 places: arrector pili of hair follicles, walls of blood vessels, and specialized muscle of genital skin or nipple. |
|
|
Term
| Sebaceous glands: what are they like at birth, just after birth, and through puberty and adulthood? What type of glands are they? |
|
Definition
| Well-developed at birth, atrophy a few months after born and enlarge again at puberty. One to many lobules lead to a common excretory duct. They are holocrine glands, which secrete by cellular decomposition. |
|
|
Term
| Eccrine glands: where are they most commonly found? |
|
Definition
| Most numerous on the sole of the foot. A glandular portion (secretory coil) leads into a coiled proximal duct, which leads to a straight duct that eventually passes through the epidermis. |
|
|
Term
| Apocrine glands: where are they located? What do they secrete? |
|
Definition
| Located in the axilla, anogenital region, areola of the nipple in females, eyelids (Moll’s gland), and external auditory canal. They are sometimes in the skin of the scalp and face. The secretory portion is located in the deep dermis or subcutaneous tissue. The short duct enters the infundibulum of the hair follicle above the entry of the sebaceous duct. Secrete a milky, viscous, odorless fluid via decapitation secretion, in which the apical portion of the secretory cell pinches off and enters the lumen of the gland. |
|
|
Term
| What immune cells are found most commonly in normal skin? |
|
Definition
| contains only a few lymphocytes, and T cells predominate over B cells |
|
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Term
|
Definition
| a flat, pigmented circumscribed lesion up to 5 mm in diameter |
|
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Term
|
Definition
| an elevated dome-shaped or flat-topped lesion 5 mm or less in diameter |
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|
Term
|
Definition
| an elevated lesion > 5 mm in diameter that is spherical |
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|
Term
|
Definition
| an elevated flat-topped lesion > 5 mm in diameter |
|
|
Term
|
Definition
| a raised, fluid-filled lesion < 5 mm in diameter |
|
|
Term
|
Definition
| a raised, fluid-filled lesion > 5 mm in diameter |
|
|
Term
|
Definition
| a common term for vesicle or bulla. |
|
|
Term
|
Definition
| a pus-filled, raised lesion |
|
|
Term
|
Definition
| a dry, plate-like excrescence that is usually a result of imperfect cornification |
|
|
Term
|
Definition
| thickened and rough skin, characterized by prominent skin markings. Results from repeated rubbing in susceptible individuals (ex. Lichen simplex chronicus) |
|
|
Term
|
Definition
| a traumatic lesion characterized by the breakage of the epidermis, resulting in raw, linear areas. It usually results from scratching |
|
|
Term
|
Definition
| hyperplasia of the stratum corneum, often associated with abnormality of keratin |
|
|
Term
|
Definition
| retention of nuclei in the stratum corneum due to abnormal keratinization. This is normally the case on mucous membranes |
|
|
Term
|
Definition
| epidermal hyperplasia preferentially involving the stratum spinosum |
|
|
Term
|
Definition
| loss of intercellular connections resulting in loss of cohesion between keratinocytes |
|
|
Term
|
Definition
| intercellular edema of the epidermis |
|
|
Term
|
Definition
| abnormal keratinization that occurs prematurely below the stratum granulosum |
|
|
Term
|
Definition
| hyperplasia of the papillary dermis with elongation and/or widening of the dermal papillae |
|
|
Term
|
Definition
| Refers to linear proliferation of melanocytes within the epidermal basal cell layer. It may occur as a reactive change or in neoplasia. |
|
|
Term
|
Definition
| thickening of the stratum granulosum. It is often due to chronic rubbing |
|
|
Term
|
Definition
| Formation of vacuoles within or adjacent to cells. It occurs in the basal keratinocyte-basement membrane zone area and is seen primarily in lichenoid dermatitis. |
|
|
Term
| Contact dermatitis: involves what type of immune reaction? |
|
Definition
| Involves initial environmental contact, in which Langerhans cells process the agent and migrate to lymph nodes, where they present to CD4 T cells. The CD4 T cells become memory cells, and second exposure to the agent results in a delayed-type hypersensitivity reaction in which the CD4 T cells activate CD 8 T lymphocytes. |
|
|
Term
|
Definition
| Refers to the accumulation of edema fluid in the epidermis. It is another term for acute eczematous dermatitis. |
|
|
Term
| Acute eczematous dermatitis: what causes them, what different types, how do they resolve? |
|
Definition
| Describes multiple conditions and etiologies. All are characterized by red, papulovesicular, oozing, and crusted lesions at an early stage. Different types include allergic contact, atopic, drug-related eczema, photoeczema, and primary irritant forms. Most resolve completely after the stimulus is removed. |
|
|
Term
| What happens with persistent Ag stimulation in acute eczematous dermatitis? |
|
Definition
| Lesions become more scaly (hyperkeratotic) as the epidermis thickens (acanthosis) and becomes chronic, resulting in chronic spongiotic dermatitis. |
|
|
Term
| Psoriasis: what is it? Affects what? Characterized by? |
|
Definition
| Proliferative skin disease marked by persistent epidermal hyperplasia (acanthosis). It most frequently affects the elbows, knees, scalp, and lumbosacral areas, intergluteal cleft, and glans penis. It is characterized by a well-demarcated, pink plaque covered by loosely adherent white scales. |
|
|
Term
|
Definition
| Occurs when the scale is removed and there are multiple foci of bleeding due to dilated, tortuous capillaries. |
|
|
Term
| What is Koebner phenomenon? |
|
Definition
| When psoriatic lesions may be induced in some people by local trauma |
|
|
Term
| What are Pustules of Kogoj? |
|
Definition
| Neutrophilic aggregates in the superficial epidermis |
|
|
Term
|
Definition
| Neutrophilic aggregates in the stratum corneum |
|
|
Term
| What may psoriasis look like? |
|
Definition
| May look like fungal infections, need to stain to check that it is not a fungal infection to Dx |
|
|
Term
| What does the epidermis look like in psoriasis? |
|
Definition
| The epidermis is thickened (acanthosis) with hyperkeratosis and parakeratosis. There is loss of the stratum granulosum. |
|
|
Term
| Urticaria: A disease of what? Mediated by? What type of hypersensitivity? |
|
Definition
| Disease of the superficial and deep vascular beds mediated by mast cell degranulation, which causes dermal microvascular hyperpermeability. Leads to erythematous, edematous, pruritic papules or plaques called wheals. It is type I hypersensitivity (Immediate type - IgE mediated). |
|
|
Term
| What does skin look like in urticaria? |
|
Definition
| Skin may look normal at low power. At high power, you can see edema, sparse perivenular infiltrate of mononuclear cells, neutrophils, and eosinophils. The blood vessels are dilated. |
|
|
Term
| What happens in Hereditary angioneurotic edema ? |
|
Definition
| Due to C1 inhibitor deficiency, resulting in uncontrolled activation of early complement components. It results in complement mediated urticaria that affects the lips, throat, eyelids, genitals, and distal extremities. |
|
|
Term
| Leukocytoclastic vasculitis: What is it and what causes it? |
|
Definition
| An immune reaction featuring neutrophilic inflammation of the vessels (fibrinoid necrosis). The cause is unknown in half of cases, but it may be caused by infection, chronic disease states (RA, SLE, ulcerative colitis), underlying malignancy (Iymphoma), a drug, or an allergen. |
|
|
Term
| What are other terms for leukocytoclastic vasculitis? |
|
Definition
| Cutaneous necrotizing vasculitis, allergic cutaneous vasculitis, and hypersensitivity angiitis |
|
|
Term
| Where are immune complexes deposited in leukocytoclastic vascultis? |
|
Definition
| Circulating immune complexes are depositied in vessel walls, attracts neutrophils which do damage. |
|
|
Term
| What is leukocytoclastic vasculitis associated with? |
|
Definition
| Associated with hepatitis B or C. |
|
|
Term
| What are the lesions like in leukocytoclastic vasculitis? |
|
Definition
| Lesions are 2-4 mm palpable, red purpuric papules that do not blanch under pressure. Lesions appear on lower extremities or at sites of pressure. Lesions persist up to a month and then resolve leaving hyperpigmentation or atrophic scars. |
|
|
Term
| What might you see in leukocytoclastic vasculitis? |
|
Definition
| “Nuclear dust” remnants (leukocytoclasia) may be seen, as well as extravasated erythrocytes, resulting in the characteristic palpable purpura. |
|
|
Term
| SLE: what are cutaneous lesions due to? Are ANAs elevated? What is the relationship between skin lesions and systemic pathology? |
|
Definition
| cutaneous lesions are due to epidermal injury initiated by exogenous agents, such as UV light, and perpetuated by cell-mediated immunoreactions to DNA and other nuclear/cytoplasmic Ags. There is an inverse relationship b/w prominence of skin lesions and extent of systemic pathology. ANAs are elevated in over 90% of patients. Malar/butterfly rash. |
|
|
Term
| Subacute cutaneous lupus features |
|
Definition
| Prominent edema of the papillary dermis with vacuolar alteration of the dermal-epidermal junction. There is a more sparse lymphocytic infiltrate than in DLE. |
|
|
Term
| Discoid lupus erythematosus: limited to? What do lesions look like? Are ANAs elevated? |
|
Definition
| usually limited to the skin, and lesions occur above the neck on the face, scalp, and ears. The lesions have a disk shape with hyperkeratotic margins and depigmented center when viewed grossly. There is superficial and deep perivascular and periadnexal infiltrate of lymphocytes. Elevation of ANAs is rarely seen (<10%). |
|
|
Term
| What is the “Lupus Band Test?” |
|
Definition
| Direct immunofluorescence detecting a granular band of Igs and complement along the dermal-epidermal junction. |
|
|
Term
| When is Lupus Band test positive? |
|
Definition
| Lesional skin of DLE; lesional and non-lesional skin in SLE |
|
|
Term
| Lichen planus: Characterized by? Pathogenesis? How long does it take to resolve? What type of infiltrate and where does it occur? What are the lesions like/where are they? |
|
Definition
| Characterized by pruritic, purple, polygonal, planar papules and plaques. Pathogenesis is unknown, and it usually resolves 1 to 2 years after onset. It is the prototypic interface dermatitis, with a dense lymphocytic infiltrate present along the dermoepidermal junction. The lesions are symmetrically distributed on the extremities (often wrists and elbows) and glans penis. Oral lesions are often present (70%). |
|
|
Term
| What type of dermatitis is lichen planus? |
|
Definition
|
|
Term
| What Wickham’s striae (in lichen planus? |
|
Definition
| White dots or lines overlying the purple papules. |
|
|
Term
| How does lichen planus differ from lupus? |
|
Definition
| Differs from lupus in that there is epidermal hyperplasia, and the dermis in lupus contains mucin. |
|
|
Term
| Erythema multiforme: Common or uncommon? Self-limiting? Hypersensitivity response? If so, to what? What type of lesions? |
|
Definition
| An uncommon, usually self-limited disorder that seems to be a hypersensitivity response to certain infections (particularly HSV) and drugs (sulfonamides, penicillin, NSAIDs, salicylates, hydantoins, and antimalarials). It presents with an array of lesions, including macules, papules, vesicles, and bullae, as well as characteristic targetoid lesions. |
|
|
Term
|
Definition
| consists of a red macule or papule with a pale vesicular or eroded center. |
|
|
Term
| Pathogenesis of erythema multiforme? |
|
Definition
| Involves cytotoxic T cells directed against a drug or microbe that is believed to cross react with Ags in the basal layer of skin and mucosa. |
|
|
Term
| Is erythema multiforme related to/interact with lichenoid dermatitis? |
|
Definition
| Erythema multiforme is an interface of lichenoid dermatitis. |
|
|
Term
| “Erythema multiforme minor” |
|
Definition
| Usually associated with infection and has a less severe presentation. |
|
|
Term
| “Erythema multiforme major” |
|
Definition
| (Stevens-Johnson syndrome, toxic epidermal necrolysis) may be life threatening due to sloughing of large portions of the epidermis (lose moisture and infectious barrier). Most often see in reactions to drugs. |
|
|
Term
| Pemphigus vulgaris: common or uncommon? What type of hypersensitivity? |
|
Definition
| Rare autoimmune disorder in which the skin blisters due to antibodies against keratinocytes (type II hypersensitivity). There is loss of cellular attachments (acantholysis) within the epidermis and mucosal epithelium. |
|
|
Term
| Is pemphigus vulgaris fatal? |
|
Definition
| Fatal without Tx, but Tx of corticosteroids is very effective. |
|
|
Term
| What do Abs form against in pemphigus vulgaris? |
|
Definition
| IgG Abs against desmoglein 3, a desmosomal protein |
|
|
Term
| What is acantholysis and what does it involve? |
|
Definition
| Loss of cellular attachments within epidermis and mucosal epithelium. Acantholysis selectively involves the cells immediately above the basal cell layer, resulting in a suprabasal acantholytic blister. |
|
|
Term
| What does direct immunofluorescence reveals in pemphigus vulgaris? . |
|
Definition
| Characteristic net-like pattern of IgG deposits |
|
|
Term
| Is pemphigus vulgaris the most common type of pemphigus? |
|
Definition
| Most common type of pemphigus. |
|
|
Term
| What does pemphigus vulgaris involve? |
|
Definition
| Involves mucosa and skin, particularly the face, scalp, axillae, groin, trunk, and points of pressure. |
|
|
Term
|
Definition
| An autoimmune blistering disorder caused by IgG antibodies to desmoglein 1. |
|
|
Term
| When does acantholysis occur in pemphigus foliaceus? |
|
Definition
| in the superficial epidermis at the level of the stratum granulosum |
|
|
Term
| Is pemphigus foliaceus more or less benign than vulgaris? |
|
Definition
| More benign, confined to skin (no mucous membranes). |
|
|
Term
|
Definition
| A blistering disease caused by IgG antibodies against basement membrane proteins (hemidesmosomes, which contain bullous pemphigoid antigen or BPAG). |
|
|
Term
| What characterizes bullous pemphigoid? |
|
Definition
| Characterized by a subepidermal nonacantholytic blister. |
|
|
Term
| What are the lesions like in bullous pemphigoid? |
|
Definition
| Lesions are tense bullae filled with clear fluid on a normal or erythematous base. |
|
|
Term
| Do bulla in bullous pemphigoid rupture? |
|
Definition
| Bullae do not rupture as easily as in pemphigus vulgaris. |
|
|
Term
| In whom and where are bullous pemphigoid lesions most commonly found? |
|
Definition
| Elderly individuals, lesions on skin and mucosa, most commonly inner thighs, flexor surfaces of forearms, axillae, grown, and lower abdomen. Oral involvement in 1/3 of patients. |
|
|
Term
| What does bullous pemphigoid cause? |
|
Definition
| Causes dermal-epidermal separation in the lamina lucida. |
|
|
Term
| Dermatitis herpetiformis: characterized by? Mostly affects? Associated with (in some cases)? What Ig is involved and how? |
|
Definition
| Characterized by urticaria and grouped vesicles. Predominantlhy affects males in third/fourth decades. Some cases associated to celiac disease and respond to gluten-free diet. IgA Abs to gluten cross-react with reticulin, a component of anchoring fibrils (sublamina densa) that attach epidermal basement membrane to superficial dermis. |
|
|
Term
| What does dermatitis herpetiformis result in? |
|
Definition
| Results in a subepidermal blister. |
|
|
Term
| What Is found in the tips of dermal papillae in dermatitis herpetiformis? |
|
Definition
| Granular deposits of IgA are seen at the tips of dermal papillae, as are neutrophils (present in papillary dermal microabscesses). |
|
|
Term
| What are dermatitis herpetiformis lesions like? |
|
Definition
| Lesions are bilateral, symmetric, and involve the extensor surfaces, elbows, knees, upper back, and buttocks. |
|
|
Term
| Verrucae are caused by ____ and are most common where? What do they look like? |
|
Definition
| HPV ; most common on dorsal and periungual (around nail) parts of the hand. They are small (< 1 cm) papules with a rough surface consisting of symmetric, circumscribed epidermal proliferations. |
|
|
Term
| What does dermatitis herpetiformis display on biopsy? |
|
Definition
| displays hyperkeratosis and epidermal hyperplasia. |
|
|
Term
|
Definition
| Enlarged keratinocytes with a pyknotic nucleus surrounded by a halo-like area. They are seen in the superficial levels of the epidermis. |
|
|
Term
|
Definition
| HPV types 2 and 4; common |
|
|
Term
|
Definition
|
|
Term
|
Definition
| small flat papules on the face, caused by HPV 3 and 10 |
|
|
Term
|
Definition
| STDs caused by HPV 6 and 11. Usually associated with HPV 16 and 18, which may cause squamous cell carcinoma |
|
|
Term
|
Definition
| Caused by HPV 16 and 18. Seen as multiple hyperpigmented papules on the genitalia (histologically identical to squamous cell carcinoma in situ) |
|
|
Term
| Epidermodysplasia verruciformis |
|
Definition
| Rare AR disease with impaired cell-mediated immunity and increased susceptibility to HPV. HPV 5,8,9, 47 most common |
|
|
Term
| Seborrheic keratosis: common? Benign? Look like? Characterized by? Seen in? |
|
Definition
| Common benign lesions that are round, flat plaques of varying diameter and different shades of brown depending on the melanin pigmentation. They are characterized by keratin-filled cysts (horn cysts) and down-growths of keratin into the main tumor mass (pseudo-horn cysts). Seen in middle aged and elderly. |
|
|
Term
| What are sebhorrheic keratosis associated with? |
|
Definition
| Many are associated with mutations of FGF receptor III. |
|
|
Term
| What does explosive onset of subherorreic keratosis lesions indicate? |
|
Definition
| A paraneoplastic phenomenon (sign of Lesseler-Trelat) indicative of internal malignancies. |
|
|
Term
| Actinic keratosis is: what is it? What is it due to? What is it associated with? Common in? what do they look like? Do they become malignant? |
|
Definition
| Skin dysplasia due to chronic sunlight exposure and is associated with hyperkeratosis. They are common on fair-skinned people and are < 1 cm. They may be tan-brown, red, or skin colored and have a rough, sand paper-like consistency. Some remain stable, but some develop into squamous cell carcinoma, and should therefore be treated |
|
|
Term
| Where is cytologic atypia seen? |
|
Definition
| in the lower portions of the epidermis with hyperplasia of basal cells or atrophy |
|
|
Term
|
Definition
| blue-gray elastic fibers from chronic sun damage. Parakeratosis is also seen. |
|
|
Term
| Keratoacanthoma: fast or low? What do they look like? |
|
Definition
| rapidly growing keratotic papules on sun-exposed skin that develop over 3-6 weeks into crater-like nodules. Have a maximum diameter of 2-3 cm. They spontaneously regress in 6-12 months, leaving an atrophic scar. Some consider it a variant of squamous cell carcinoma. |
|
|
Term
| Squamous cell carcinoma: common in? arise from? |
|
Definition
| Common on sun-exposed skin in elderly. They may arise from actinic keratoses (less aggressive) or in non-sun exposed sites (more aggressive). |
|
|
Term
| Describe the cells in squamous cell carcinoma |
|
Definition
| Highly atypical cells at all levels of the epidermis (in situ) |
|
|
Term
|
Definition
| means it has not broken through basement membrane |
|
|
Term
|
Definition
| broken through basement membrane |
|
|
Term
| Do squamous cell carcinomas always have keratinization? |
|
Definition
|
|
Term
| Basal cell carcinoma: level of commonality? Slow or fast growing? What type of people/skin get it? What does it look like? |
|
Definition
| The most common human skin cancer. It is a slow growing tumor that rarely metastasizes. Arises on sun-exposed skin of people with fair skin. Characterized by pearly papules with prominent, dilated subepidermal vessels (telangiectasia). May ulcerate. |
|
|
Term
| What mutations do you find in basal cell carcinoma? |
|
Definition
| Mutations in PTCH (sonic hedgehog). |
|
|
Term
|
Definition
|
|
Term
|
Definition
| grows deeper (than superficial BCC) into the dermis |
|
|
Term
|
Definition
| shows angulated nests and cords of basaloid cells infiltrating a cellular fibroblastic stroma |
|
|
Term
|
Definition
| well-demarcated zones of pigment loss due to partial or complete loss of melanocytes |
|
|
Term
|
Definition
| Consists of small (5-10 mm) oval, tan-brown patches that do not darken with sun exposure (unlike freckles). There is basal keratinocyte pigmentation with localized melanocyte proliferation. |
|
|
Term
|
Definition
| any congenital lesion of the skin (birthmark) |
|
|
Term
|
Definition
| Benign congenital or acquired localized proliferation (neoplasm) of melanocytes in the epidermis and/or dermis. Most have mutations in BRAF. They are potential precursors for melanoma. |
|
|
Term
| When do melanocytic nevi begin to appear? |
|
Definition
| first two years of life and continue to appear during 1st two decade |
|
|
Term
| What do melanocytic nevi do over time? |
|
Definition
| They undergo maturation, in which deeper nevus cells are smaller and more mature than superficial ones. Note melanomas do not have maturation. |
|
|
Term
|
Definition
| nests of melanocytes in the dermoepidermal junction and are believed to be an early developmental stage |
|
|
Term
|
Definition
| nests and cords of melanocytes in the dermis (most junctional nevi become this) |
|
|
Term
|
Definition
| Occur if the epidermal nests are lost and only the dermal melanocytes remain. They are a later stage of development. |
|
|
Term
|
Definition
| May be sporadic or familial (AD inheritance). |
|
|
Term
| What happens if dysplastic nevi are sporadic? |
|
Definition
| In sporadic, risk of malignant transformation is no higher than in common melanocytic nevi. Transition to melanoma occurs but is not very common, as most melanomas arise de novo. These lesions should be viewed as markers of melanoma risk. These also have mutations in BRAF. |
|
|
Term
| When does lentiginous hyperplasia.occur? |
|
Definition
| The result of single melanocytes beginning to replace the normal basal layer |
|
|
Term
| Describe the nests of melanocytes in the epidermis. |
|
Definition
| There may be fusion of nests of melanocytes in the epidermis (bridging). It also shows linear fibrosis around epidermal nests of melanocytes. |
|
|
Term
| Is melanoma more or less common than squamous or basal cell carcinoma? |
|
Definition
| less common but more deadly than squamous or basal cell carcinoma |
|
|
Term
| How do you cure most melanoma? |
|
Definition
| most cured surgically due to public awareness |
|
|
Term
| What is the most important clinical sign of melanoma? |
|
Definition
| change in color or size of a pigmented lesion |
|
|
Term
| What are melanoma associated with? |
|
Definition
| intense, intermittent sun exposure at an early age; also preexisting nevi and hereditary predisposition; prominent eosinophilic "cherry red" nucleoli |
|
|
Term
| What is the ABCDE you should look at with melanoma? |
|
Definition
| asymmetry, border irregularity, color variation, diameter, evolution |
|
|
Term
| What is the prognosis once melanoma metastasize? |
|
Definition
|
|
Term
| What mutations are typical in melanoma? |
|
Definition
|
|
Term
| Do melanoma mature with progressive dermal descent? |
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Definition
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Term
| Do most melanoma arise de novo? |
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Definition
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Term
| Radial growth phase (of melanoma) |
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Definition
| Initial tendency of melanoma to grow horizontally in the epidermis and superficial dermis (in situ). Cells do not have the capacity to metastasize in this stage. |
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Term
| Vertical growth phase (of melanoma) |
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Definition
| Occurs when melanoma grows downward into deep dermal layers (lower half of reticular dermis). Cells contain little or no pigment anymore. Eventually a clone of cells with metastatic ability arises. Thickness of tumor predicts likely hood of metastasis (strongest predictor). |
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Term
| Other predictors of melanoma prognosis (besides thickness) include: |
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Definition
| mitotic rate, lymphocytic response (good), location (extremities better than head/neck/trunk), sex (women better than men), regression (bad), and ulceration (bad) |
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Term
| The stage of the melanoma disease is |
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Definition
| the most important single factor influencing a patient’s survival, based on TNM system (qualities of tumor, number of lymph nodes, metastasis). |
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Term
| Describe the hematogenous spread of melanoma |
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Definition
| common to lymph nodes, liver, lungs, brain, etc |
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