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38 Cards in this Set

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Ephelids
• “Freckles”
• Lighten in Winter and darken in Summer.
• Increased pigment at basal layer.
• “Freckles”
• Lighten in Winter and darken in Summer.
• Increased pigment at basal layer.
Melasma
• “Mask of pregnancy”
• Diffuse patchy pigment on face.
• Pigment in epidermis and/or dermis.
• “Mask of pregnancy”
• Diffuse patchy pigment on face.
• Pigment in epidermis and/or dermis.
Vitiligo
• White patches
• Complete loss of pigment.
• Loss of melanocytes and pigment.
• White patches
• Complete loss of pigment.
• Loss of melanocytes and pigment.
Albinism
• Absence of pigment in skin, hair, and nails.
• Autosomal recessive
• Loss of pigment with normal appearing
melanocytes.
• Absence of pigment in skin, hair, and nails.
• Autosomal recessive
• Loss of pigment with normal appearing
melanocytes.
Mongolian Spot
• Bluish-gray lumbosacral patch in newborns.
• More common in pigmented races.
• Resolves in early childhood.
• Sparse deep dendritic melanocytes.
• Bluish-gray lumbosacral patch in newborns.
• More common in pigmented races.
• Resolves in early childhood.
• Sparse deep dendritic melanocytes.
Café au lait
• Light brown patches.
• 6 or more 0.5 cm in child  Neurofibromatosis.
• 6 or more 1.5 cm in adolescence 
Neurofibromatosis.
• Increased pigment in basal layer.
• Light brown patches.
• 6 or more 0.5 cm in child  Neurofibromatosis.
• 6 or more 1.5 cm in adolescence 
Neurofibromatosis.
• Increased pigment in basal layer.
Lentigo
• Macular pigmented lesions on
sun exposed skin
• Indication of photodamage
• Increased melanocytes at
Dermal-Epidermal (DE) junction
without nest formation.
• Macular pigmented lesions on
sun exposed skin
• Indication of photodamage
• Increased melanocytes at
Dermal-Epidermal (DE) junction
without nest formation.
Junctional Nevus
• Macular pigmented lesion
• Nests of melanocytes along the
DE junction
• Macular pigmented lesion
• Nests of melanocytes along the
DE junction
Compound Nevus
• Slightly raised pigmented
plaque
• Nests of melanocytes at DE
junction and within the dermis
• Slightly raised pigmented
plaque
• Nests of melanocytes at DE
junction and within the dermis
Intradermal Nevus
• Papular lesions
• Light or dark
• Nests of melanocytes within
the dermis
• Papular lesions
• Light or dark
• Nests of melanocytes within
the dermis
Spitz's Nevus
• Papular lesions of children
• Historically “benign juvenile
melanoma” – avoid this term!
• Epithelioid and spindle cell
melanocytes can look atypical
• Nests often vertically oriented
• Papular lesions of children
• Historically “benign juvenile
melanoma” – avoid this term!
• Epithelioid and spindle cell
melanocytes can look atypical
• Nests often vertically oriented
Blue Nevus
• Bluish papule or macule
• Deeper melanin appears blue
due to Rayleigh scattering
• Heavily melanized dendritic
melanocytes within the mid to
deep dermis
• Bluish papule or macule
• Deeper melanin appears blue
due to Rayleigh scattering
• Heavily melanized dendritic
melanocytes within the mid to
deep dermis
Halo Nevus
• Depigmented zone around a nevus
• Common in children – worrisome in
elderly
• Lymphocytes surround benign
nests of melanocytes
• Depigmented zone around a nevus
• Common in children – worrisome in
elderly
• Lymphocytes surround benign
nests of melanocytes
Congenital Nevus
• Large “bathing trunk nevus”
has increased risk of melanoma
• Small form not strongly
associated with melanoma
• Benign melanocytes extend more
deeply into dermis and even
subcutaneous tissues.
• Large “bathing trunk nevus”
has increased risk of melanoma
• Small form not strongly
associated with melanoma
• Benign melanocytes extend more
deeply into dermis and even
subcutaneous tissues.
Dysplastic Nevus
• Larger irregular morphology
• Heritable Melanoma Syndrome
• Controversial Diagnosis
• Atypical melanocytes
• Nests stream horizontally
• Severely atypical treated as
melanoma in situ
• Larger irregular morphology
• Heritable Melanoma Syndrome
• Controversial Diagnosis
• Atypical melanocytes
• Nests stream horizontally
• Severely atypical treated as
melanoma in situ
Nevus
• Slight irregularity of border and color
• Dermoscopy reveals a fine reticular
pigment network without atypical
features.
Actinic Keratosis
• Scaly/hyperkeratotic lesions on
sun exposed skin.
• Considered pre-cancerous, but
only about 1% evolve to SCC
• Atypical keratinocytes in lower
epidermis
• Underlying solar elastosis
(bluish dermis)
• Overlying parakeratosis
(...
• Scaly/hyperkeratotic lesions on
sun exposed skin.
• Considered pre-cancerous, but
only about 1% evolve to SCC
• Atypical keratinocytes in lower
epidermis
• Underlying solar elastosis
(bluish dermis)
• Overlying parakeratosis
(retained nuclei)
Seborrheic Keratosis
• Appear as one gets older – most
common in elderly.
• “Stuck on” lesions – keratotic with
varying shades of brown, but can be
skin colored or even erythematous.
• Can have rough or smooth surface
and be large or small.
• Ma...
• Appear as one gets older – most
common in elderly.
• “Stuck on” lesions – keratotic with
varying shades of brown, but can be
skin colored or even erythematous.
• Can have rough or smooth surface
and be large or small.
• May have keratotic pores or
pseudocysts.
• Sometimes inflamed or bleeding from
picking.
• Not limited to sun exposed surfaces.
Acanthosis Nigricans
• Most common in obesity but rarely
associated with internal tumors.
• Clinically velvety brown plaques –
usually in the axillae
• Most common in obesity but rarely
associated with internal tumors.
• Clinically velvety brown plaques –
usually in the axillae
Fibroepithelial Polyps
• AKA Acrochordons.
• Commonly known as skin tags.
• More common in obesity involving
neck, axillae, and groin areas.
• Can be associated with Acanthosis
Nigricans.
• AKA Acrochordons.
• Commonly known as skin tags.
• More common in obesity involving
neck, axillae, and groin areas.
• Can be associated with Acanthosis
Nigricans.
Epidermoid Cysts
• Sometimes referred to as “sebaceous
cysts”, but they aren’t.
• Expansion of hair follicle forms epithelial
lining. Also form as EIC’s from trauma.
• Pilar cyst has trichilemmal keratinization.
• Acne cyst results from follic...
• Sometimes referred to as “sebaceous
cysts”, but they aren’t.
• Expansion of hair follicle forms epithelial
lining. Also form as EIC’s from trauma.
• Pilar cyst has trichilemmal keratinization.
• Acne cyst results from follicular rupture.
Sebaceous Hyperplasia
• Very common in middle aged and
elderly men.
• Umbilicated pale yellowish papules.
• Benign tumor of sebaceous glands.
• Very common in middle aged and
elderly men.
• Umbilicated pale yellowish papules.
• Benign tumor of sebaceous glands.
Syringoma
• Seen under the eyes of women.
• Small skin colored papules.
• Benign tumor of eccrine sweat glands.
• Seen under the eyes of women.
• Small skin colored papules.
• Benign tumor of eccrine sweat glands.
Nevus Sebaceous
• Birthmark lacking hair when on scalp.
• Prepubertal may appear smooth yellow/orange.
• Adolescent has cobblestone surface.
• Adult form is prone to basal cell carcinoma.
• Birthmark lacking hair when on scalp.
• Prepubertal may appear smooth yellow/orange.
• Adolescent has cobblestone surface.
• Adult form is prone to basal cell carcinoma.
Adenoma Sebaceum
• Central facial papules.
• One manifestation of Tuberous
Sclerosis.
• Angiofibromas, histologically.
• Central facial papules.
• One manifestation of Tuberous
Sclerosis.
• Angiofibromas, histologically.
Neurofibroma
• Neurofibromatosis / Von Recklinghausen’s.
• Solitary lesion more commonly.
• Spindle cell tumor of Schwann cells and fibroblasts.
• Neurofibromatosis / Von Recklinghausen’s.
• Solitary lesion more commonly.
• Spindle cell tumor of Schwann cells and fibroblasts.
Xanthelasma
• Yellowish plaques on eyelids.
• Not strongly associated with increased
lipids – other xanthomas associated with
increased lipids.
• Foamy histiocytes contain the lipid.
• Yellowish plaques on eyelids.
• Not strongly associated with increased
lipids – other xanthomas associated with
increased lipids.
• Foamy histiocytes contain the lipid.
Diseases associated with Trichilemmoma
Cowden Syndrome/ Breast carcinoma
Diseases associated with Sebaceous Adenoma
Muir-Torre Syndrome/Mult CA
Diseases associated with Angiofibromas
Tuberous Sclerosis
Diseases associated with Neurofibromas
When multiple - Von Recklinghausen's
Diseases associated with Xanthomas
When multiple, associated with lipid disorders
Dermatofibroma
• Common on the legs of women.
• Brownish papule with “dimple sign”.
• Benign fibrohistiocytic tumor.
• Common on the legs of women.
• Brownish papule with “dimple sign”.
• Benign fibrohistiocytic tumor.
Keratoacanthoma
• Rapidly growing “volcanoe-like” lesion with
keratin center.
• Can resolve spontaneously.
• Rare metastasis has prompted many to
consider this a form of Squamous Cell
Carcinoma which it resembles histologically.
• Rapidly growing “volcanoe-like” lesion with
keratin center.
• Can resolve spontaneously.
• Rare metastasis has prompted many to
consider this a form of Squamous Cell
Carcinoma which it resembles histologically.
Angiomas
• Cherry angiomas most common
• Strawberry angiomas in children often
resolve spontaneously
• Pyogenic granuloma is a traumatic variant.
• Port wine stains are very common in the
form of a “stork bite” on posterior neck.
• Veno...
• Cherry angiomas most common
• Strawberry angiomas in children often
resolve spontaneously
• Pyogenic granuloma is a traumatic variant.
• Port wine stains are very common in the
form of a “stork bite” on posterior neck.
• Venous Lakes occur on lips and ears.
• Telangiectasia of face is more commonly due
to sun damage than rosacea.
Keloid
• Hypertrophic scars that extend beyond
initial injury.
• More common in African-Americans
• Hypertrophic scars that extend beyond
initial injury.
• More common in African-Americans
Lipoma
• Soft mobile subcutaneous mass.
• Solitary or multiple.
• Stable size.
• When tender = angiolipoma.
• Soft mobile subcutaneous mass.
• Solitary or multiple.
• Stable size.
• When tender = angiolipoma.
Verruca
Warts

• Verruca vulgaris – common wart
(seeds = microhemorrhage).
• Plantar warts – common warts
“pounded inward”.
• Verruca plana – flat warts.
• Condyloma accuminatum – genital,
STD, HPV 6,11 most common.
• Mollus...
Warts

• Verruca vulgaris – common wart
(seeds = microhemorrhage).
• Plantar warts – common warts
“pounded inward”.
• Verruca plana – flat warts.
• Condyloma accuminatum – genital,
STD, HPV 6,11 most common.
• Molluscum Contagiosum – pox virus,
not HPV – children and STD in adults.
• Mosaic warts – extensive plantar
involvement.