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YEAR 4 DERM > Pigmented lesions > Flashcards

Pigmented lesions Flashcards

1
Q

What are seborrhoeic warts/ seborrhoeic keratosis?

A

Harmless warty spot that appears during adult life as a common sign of skin ageing.

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2
Q

Presentation of seborrhoeic warts/ seborrhoeic keratosis?

A

Middle aged - elderly
Multiple and asymptomatic
- Flat or raised papule or plaque
- 1 mm to several cm in diameter
- Varied colours: Skin coloured, yellow, grey, light brown, dark brown, black or mixed colours
- Smooth, waxy or warty surface
- Solitary or grouped in certain areas, such as within the scalp, under the breasts, over the spine or in the groin

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3
Q

Common sites for seborrhoeic warts/ seborrhoeic keratosis?

A

Face
Trunk

Never really on palms or soles

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4
Q

How are seborrhoeic warts/ seborrhoeic keratosis diagnosed?

A

Many of them seen
Have a ‘stuck on’ appearance, with well defined edges

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5
Q

Management of seborrhoeic warts/ seborrhoeic keratosis?

A

Only If symptomatic
Curette and cautery
Cryotherapy

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6
Q

What is a melanocytic naevi?

A

A melanocytic naevus (American spelling ‘nevus’), or mole, is a common benign skin lesion due to a local proliferation of pigment cells (melanocytes).

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7
Q

Common features in presentation of melanocytic naevus?

A

Not present at birth
Developed during infancy, childhood or adolescence
Asymptomatic

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8
Q

Types of melanocytic naevi?

A

Congenital naevi
Junctional naevi
Intradermal naevi
Compound naevi

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9
Q

Management of melanocytic naevi?

A

Only manage if symptomatic
Shave or complete excision

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10
Q

What is melasma?

A

Aquired chronic skin disorder, where there is increased pigmentation in the skin

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11
Q

Cause of melasma?

A

Genetic predisposition
Triggered by factors - sun exposure, hormonal changes e.g. pregame’s, COCP

Pigmentation is caused by overproduction of melanin by melanocytes

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12
Q

Presentation of melasma?

A

Brown macules (freckle-like spots)
Can have larger patches
Irregular border
Symmetrical distribution

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13
Q

Common sites for melasma to present?

A

Forehead
Cutaneous upper lips or cheeks

Rare = neck, shoulder, upper arms

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14
Q

Management of melasma?

A

Lifelong sun protection
Discontinue COCP/POP
Cosmetic camouflage
Topical treatment to inhibit formation of new melanin = hydroquinone, azelaic acid, kojic acid, vitamin C
Laser treatment (use w/ caution as can cause hyperpigmentation)

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15
Q

What is this?

A

Seborrhoic keratosis

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16
Q

What is this?

A

Vitiligo

17
Q

What is this?

A

Melanocytic naevus

18
Q

What is this?

A

Melasma

19
Q

What is vitiligo?

A

Acquired depigmenting disorder - where you lose melanocytes

20
Q

Cause of vitiligo?

A

AI disorder - innate immune system destroys melanocytes, so lose pigment formation in skin

21
Q

Presentation of vitiligo?

A

Any age
Single patch or multiple patches of depigmentation
Sites of previous injury are favoured
Affects face, hands, feet, body folds, genitalia

22
Q

Management of vitiligo?

A

Minimise skin injury - can trigger new patch!
Topical treatments - topical steroids, calcineurin inhibitors
Phototherapy - UVB therapy
Oral immunosuppression - methotrexate, ciclosporin, mycophenolate mofetil

23
Q

What is this?

A

Senile purpura

24
Q

Presentation of senile purpura?

A

Elderly population with sun-damaged skin
Present on extensor surfaces of hands and forearms
Non-palpable purpura
Surrounding skin is atrophic and thin
Pt is systemically wel

25
Q

Investigations for senile purpura?

A

Bloods
Urine analysis
Skin biopsy

26
Q

What is present in Hx of pt with vasculitis?

(clue: to do with the lesions they have)

A

Painful lesions which are palpable !

27
Q

Common sites for vasculitis?

A

Legs, buttocks, flanks (dependent areas i.e. influenced by gravity)

28
Q

What is this?

A

Vasculitis

29
Q

Investigations for vasculitis?

A

Skin biopsy
Bloods
Urinalysis

30
Q

Management of vasculitis?

A

Treat underlying cause
Steroids and immunosuppressants needed if systemic involvement

31
Q

What is this?

A

Kaposi’s sarcoma

32
Q

How does Kaposi’s sarcoma present?

A

Purple papules or plaques on skin or mucosa
Lesions can ulcerate
Respiratory system involvement = haemoptysis, pleural effusion

33
Q

Who may Kaposi’s sarcoma develop in?

A
  • Descents from Mediterranean and Middle European backgrounds and in men in Sub-Saharan Africa.
  • Pts with HIV associated KS
  • Pt from certain parts of Africa, where it is common in children/ young adults
  • Pts on drug treatment causing immune suppression.
34
Q

Causes of Kaposi’s sarcoma?

A

Human Herpes Virus 8
Low CD4 count - in AIDS

35
Q

Management of Kaposi’s sarcoma?

A

If HIV related = HAART anti-retrovirals
If localised lesion = Radiotherapy + resection

YEAR 4 DERM (17 decks)

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