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Melanocyte
Melanocyte
MITF immunostain
Melanocytic lesions
Potentially malignant: Atypical melanocytic hyperplasia Malignant: Melanoma in-situ Invasive melanoma
Lentigo: From Latin word for lentil. A dark spot on skin that looks like a lentil bean and does not fade in the winter.
Freckle: Small brownish spot turning darker or increasing in number upon exposure to the sun and fading in winter. (Freckle=Speckle)
Lentigo simplex
Solar lentigo
Elongated rete ridges Basal melanosis No junctional nest Dermal solar elastosis
Nevus = Mole
Life of a nevus
Congenital nevus
Common nevi
Nevus: Junctional
Nevus: Compound
Raised or flat (older person) lesion Junctional clefted nests and dermal nests
Dysplastic nevus
Nevus: Blue
70% occurs in pts < 20 yrs Raised, junctional or compound nevus Epithelioid clefted nests oriented vertically Cytologic and nuclear pleomorphism
Melanoma
Types Melanoma in-situ Melanoma (Invasive melanoma)
Melanoma
Lentigo maligna & lentigo maligna melanoma
Superficial spreading ( Pagetoid): In-situ & invasive Acral-lentiginous: In-situ & invasive
Nodular: Invasive Desmoplastic: Invasive
Neoplastic melanocytes spread from the junction upwards and along the adnexa. No dermal invasion.
Epidermal atrophy, solar elastosis Confluent and nested proliferation of pleomorphic melanocytes
Nodular melanoma
Desmoplastic melanoma
Epidermal atrophy, dermal actinic change, mononuclear cell and spindle cell infiltration
S-100: Positive
Risk factors
Uncontrollable: Skin type (race) History of melanoma Moles and atypical moles Age: 70 + Gender: M > F Controllable: UV radiation ( sunlight, tanning booths and lamps).
Skin types
I II III
IV
VI
History of melanoma
First-degree relatives: Father, mother, brother, sister, child Personal history of melanoma Melanoma pt.: Family history in 10%
Male: Female: 1. Prostate (25%) 1. Breast (31%) 2. Lung (15%) 2. Lung (14%) 3. Colorectum (10%) 3. Colorectum (10%) 4. Bladder (7%) 4. Uterus (5%) 5. NH Lymphoma (5%) 5. NH Lymphoma (4%) 6. Melanoma (5%) 6. Thyroid (4%) 7. Kidney (4%) 7. Melanoma (4%)
Melanoma sites
Editorials 1985-2008
April;144: 533-534. Ackerman AB. No one should die of malignant melanoma. J Am Acad Dermatol. 1985 Jan; 12: 115-6. Kittler H. Early recognition at last. Arch Dermatol. 2008