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Dermatology > Benign Skin Tumors > Flashcards

Benign Skin Tumors Flashcards

1
Q

Chrondrodermatitis nodularis helicis population affected

A

40 yo

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2
Q

Chrondrodermatitis nodularis helicis cause

A

unknown, actinic damage, cold exposure, trauma, local ischemia, those who work outside during winter

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3
Q

Chrondrodermatitis nodularis helicis sx

A

Early: central crust at apex
Late: dense rolled edge
Pain with anything touching the ear

well-circumscribed, rounded nodule with raised edges and a crust in its center, often overlying an ulcer which may occasionally have exposed cartilage at the bottom w/ erythema around it
diameter of 4 mm to 6 mm

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4
Q

Chrondrodermatitis nodularis helicis TX

A

Co2 laser
Injectable collagen implants
Intralesional steroid injections
Nitroglycerin gel-2% gel – regeneration of and regrowth
Photodynamic therapy (PDT)
Removal of causative factor/relieving pressure (Doughnut pillow)
Topical steroids
Cartilage excision
Curettage
Wedge excision

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5
Q

Chrondrodermatitis nodularis helicis ddx

A

Squamous cell carcinoma
Basal cell carcinoma
Actinic keratosis

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6
Q
A

Chrondrodermatitis nodularis helicis

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7
Q

Dermatofibroma

A

Area of focal dermal fibrosis, often with overlying epidermal hyperpigmentation and thickening

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8
Q

Dermatofibroma population affected

A

young adults, female

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9
Q

Dermatofibroma sx

A

Small brown papules
Indurated
1-10
Asymptomatic
Purutius
>15 Multiple can be seen with SLE
On trunk or extremities

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10
Q

Dermatofibroma PE

A

Typically about 3-10 mm in size, slightly elevated, scaly lesions
Vary in color from light tan to dark brown
Firm, fibrotic consistency on palpation
Dople sign: central dimpling in the center with lateral compression

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11
Q

Dermatofibroma tx

A

Not needed
Excision

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12
Q

Dermatofibroma ddx

A

Nevi
Malignant melanoma
Dermatofibrosarcoma protuberans

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13
Q
A

Dermatofibroma

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14
Q

Dermatosis Papulosa Nigra population affected

A

Fitzpatrick Skin Type III-VI

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15
Q

Dermatosis Papulosa Nigra sx

A

bumps are about 1-5 millimeters in diameter and 1-3 millimeters high
are harmless and don’t cause any ulcerations (breaks in the skin), scaling, or crusting
Smooth in adolescence, freckle-like bumps and gradually become rougher with time, may grow in size and number with age
On face and neck

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16
Q

Dermatosis Papulosa Nigra tx

A

Cryotherapy
Shave

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17
Q

Dermatosis Papulosa Nigra ddx

A

Sebaceous cyst

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18
Q
A

Dermatosis Papulosa Nigra

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19
Q

Digital mucous cyst population affected

A

middle aged and elderly

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20
Q

Digital mucous cyst sx

A

Over DIP or nail base
usually solitary, rubbery, can be translucent
filled with clear gelatinous viscous fluid

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21
Q

Digital mucous cyst tx

A

Puncture and drainage w/ compression
Excision
Intralesional corticosteroids
Cryotherapy

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22
Q

Epidermal Inclusion Cysts cause

A

traumatic implantation or spontaneous from upper portion of hair follicle of epidermis into dermis.
giant comedones (blackheads or whiteheads)

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23
Q

Epidermal Inclusion Cysts sx

A

Appear as flesh-colored, firm, but often malleable, skin nodules with surface opening appears as a small, round, sometimes imperceptible pore
Range in size from 0.5 - 5 cm
Located anywhere, most commonly on the scalp, neck, and trunk.
Asymptomatic
Oily and foul smelling inside

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24
Q

Epidermal Inclusion Cysts complications

A

Infection: tender and increased discharge

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25
Q

Epidermal Inclusion Cysts tx

A

Don’t need
Excision- make sure to remove entire cyst and lining but not when inflamed
Corticosteroid when inflamed but not infected
Incision and drainage
Take at least 4-6 weeks
Poultice or antibiotics

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26
Q

Epidermal Inclusion Cysts ddx

A

Pilar cyst
Milia
Digital mucous cyst
Ganglion cyst
Lipoma
Nasal gliomas

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27
Q
A

Epidermal Inclusion Cysts

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28
Q

Ganglion cyst

A

cystic swelling surrounded by a fibrous tissue wall occurring in the vicinity of joint capsules and tendon sheaths

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29
Q

Ganglion cyst population

A

female, second and third decade

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30
Q

Ganglion cyst cause

A

degenerative process in the mesoblastic tissues surrounding the joint, herniation of a tendon sheath, trauma

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31
Q

Ganglion cyst sx

A

Dorsum of the wrist, flexor aspect of the wrist adjacent to the radial artery, elbow, ankle, foot, and back of knee
Usually smooth and rounded; at other times multilocular, hard/firm, crystal clear, very thick gelatinous content occasionally tinged with blood, cystic and fluctuant.
increases in size after excessive movement or use and size decreases with rest
Pain dull and constant or painless or sharp pain
Weakness

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32
Q

Ganglion cyst complications

A

Infection risk with aspiration
Sclerosing agent can cause damage to surrounding structures

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33
Q

Ganglion cyst tx

A

Intentional rupture: smack the cyst
Aspiration
Injection of sclerosing solution- Sodium morrhuate
Excision
Compression early
Acupuncture
Corticosteroid injections

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34
Q
A

Ganglion cyst

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35
Q

Gardner’s syndrome cause

A

autosomal dominant, heritable disorde

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36
Q

Gardner’s syndrome sx

A

multiple epidermal cysts
fibromas
osteomas
and intestinal polyps, which often undergo malignant degeneration.

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37
Q
A

Gardner’s syndrome

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38
Q

Hypertrophic scar

A

Enlargement of the sar within the boundary of the original scar

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39
Q

Hypertrophic scar cause

A

Genetics
Body site
Quality of the surgery
Skin tension
Skin type
The patients health status at the time

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40
Q

Hypertrophic scar RF

A

young age, female gender, dark skin, neck or upper limb burns, multiple surgical procedures, greater than 3 weeks to healing, meshed skin graft use, and burn severity

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41
Q

Hypertrophic scar sx

A

1 to 2 months after injury
Irritation
pruritus
neuropathic pain
increased induration and often dyspigmentation over the site of a wound

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42
Q

Hypertrophic scar Tx

A

Surgery
Corticosteroid
Cryotherapy
Laser

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43
Q

Hypertrophic scar ddx

A

Keloid scarring
Sarcoma
dermatofibrosarcoma protuberans
Dermatofibroma
nodular scleroderma
Lobomycosis

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44
Q

Keloid scarring

A

Enlargement of the scar beyond the original scar boundary

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45
Q

Keloid scarring cause

A

Genetics
Body site
Quality of the surgery
Skin tension
Skin type
The patients health status at the time
Response to trauma
* Acne
* Body piercing
* Tattoos
* Insect bites
* Vaccination
* Surgery

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46
Q

Keloid scarring population

A

darker skin types, 10-30 years

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47
Q

Keloid scarring RF

A

darker skin type

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48
Q

Keloid scarring Tx

A

Silicone-based therapy (gel, sheets, spray)- week or 2 after surgery
Intralesional corticosteroids
Acupuncture
Topical steroids
Laser therapy
Radiation therapy
Cryotherapy
Pressure therapy(local hypoxia)
Surgery–last option d/t recurrence

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49
Q
A

Hypertrophic scar

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50
Q
A

Keloid scarring

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51
Q
A

Lipoma

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52
Q

Lipoma

A

Deeper than an epidermal inclusion cyst

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53
Q

Lipoma population

A

middle life

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54
Q

Lipoma cause

A

genetics, trauma, fat metabolism problems

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55
Q

Lipoma sx

A

Feel rubbery but is usually not malleable
Move freely
only slightly elevated above the skin’s surface, but easily palpable deep to the skin
Asymptomatic and slow growing
trunk, neck, and upper extremities
Flesh-colored
Range in size from 1 - 10 cm
May be solitary or multiple

56
Q

Lipoma diagnosis

A

Slightly malleable
If the skin moves over top of the lesion, the lesion is sub-dermal in origin and probably is a lipoma
Biopsy
MRI
US

57
Q

Lipoma complications

A

Gardner’s syndrome
Multiple symmetrical lipomatosis
Dercum’s disease

58
Q

Lipoma tx

A

Not required
Incision and blunt dissection
Liposuction
Injection with low dose deoxycholate

59
Q

Meibomian cyst cause

A

blockage of meibomian gland of eye

60
Q

Meibomian cyst sx

A

Painless
Initial lid edema and irritation
firm nodule on eyelid

61
Q

Meibomian cyst tx

A

Hot compress 10-15 min qid/ 2-3 weeks
Steroid injection after 6 weeks
Incision and curettage w/ or w/o antibiotics

62
Q
A

Meibomian cyst

63
Q

Milia

A

Small epidermoid cysts

64
Q

Milia cuase

A

trauma

65
Q

Milia sx

A

Face
1-2 mm white to yellow
Single or multiple

66
Q

Milia Tx

A

Lidocaine, scalpel, express it
Retinoid therapy

67
Q

Nasal Gliomas population

A

children at birth

68
Q

Nasal Gliomas cause

A

genetics

69
Q
A

Nasal Gliomas

70
Q

Neurofibromas/Von Recklinghausen’s disease

A

Focal proliferation of neural tissue within the dermis

71
Q

Neurofibromas/Von Recklinghausen’s disease types

A

Neurofibromatosis type 1: most common
Neurofibromatosis type 2
Schwannomatosis: enlargement of nerve bundles

72
Q

Neurofibromas/Von Recklinghausen’s disease population

A

20-40 yo, childhood (NF1), 16-20 (NF2)

73
Q

Neurofibromas/Von Recklinghausen’s disease
cause

A

inherited disorder or no known cause

74
Q

Neurofibromas Type 1 sx

A

Cafe au lait spots: Flat, light brown spots on the skin birth-1 year
Freckling in the armpits or groin area 3-5
Bone defects: bowed legs or Scoliosis
Lisch nodules: tiny bumps on the iris of the eye
Optic glioma: at age
Soft, pea-sized bumps on or under the skin
Learning difficulties
Larger than average head size
Short stature

75
Q

Neurofibromatosis type 2 sx

A

Hearing loss
Tumors in both ears
Ringing in the ears
Poor balance
Headaches
Soft, pea-sized bumps on or under the skin

76
Q

Schwannomatosis sx

A

Numbness and weakness in the arms or legs
Pain
Balance difficulties
Facial drop
Vision problems or the development of cataracts
Soft, pea-sized bumps on or under the skin

77
Q

Neurofibromas PE

A

on compression, invaginate into a slit-like defect in the skin = “buttonhole” sign

78
Q

Neurofibromas diagnosis

A

Crowe’s Criteria for Diagnosis of Neurofibroma
Six or more café-au-lait spots, each greater than 1.5 cm in diameter, are diagnostic.
Axillary freckling
Biopsy

79
Q

Neurofibromas tx

A

Don’t need to remove
Lift and snip
Shave
Hyfrecator
Radiosurgery

80
Q

nevi

A

A nevus (mole) is a benign neoplasm derived from the pigment-forming (melanocyte) nevus cell.

81
Q

nevi population

A

white, middle-aged adult,

82
Q

nevi cause

A

congenital or acquired

83
Q

Junctional Nevi

A

Initial pinpoint (1-2 mm)
Expands to 4-6 mm
Flat, slightly elevated
Smooth or slightly elevated
Sharply circumscribed
Uniformly pigmented (brown, tan, black)
Nevus cells at dermo-epidermal junction
Round or oval and symmetrical border
Hairless
0.1-0.6 cm
Develop after age 2 years
Palms, soles, and genitalia
Very rare to melanoma
Can change into compound
25-40 moles is normal
Appear singularly and rarely in crops

84
Q

Compound Nevi signs

A

Slightly elevated dome shaped, papule, Smooth or warty, Flesh, brown, halo nevus (white halo at the periphery) , Uniformly, round, oval, and symmetric
Hair may be present
Appear singularly and rarely in crops

85
Q
A

milia

86
Q
A

Neurofibroma

87
Q
A

Junctional nevi

88
Q
A

compound nevi

89
Q

Intradermal/dermal nevi

A

Dome shaped
Verrucoid (warty)
Pedunculated
Sessile
Brown or black, but may become lighter or flesh-colored with age
Vary in size from a few millimeters to a centimeter
Variety of shapes

90
Q
A

intradermal/dermal nevi

91
Q

Atypical nevi sx and signs

A

Slow growing
3-15mm
Irregular, ill defined
Asymmetrical
Tan, brown, dark brown, black, pink
Central papule surrounded by macular ring
Asymptomatic
Risk of melanoma
Back, upper, lower limbs, female breasts, scalp, buttock, groin

92
Q
A

atypical nevi

93
Q

Nevi diagnosis

A

When to work up
* Symptomatic should be worked up
* Blue nevus
* Asymmetric
* Changing

94
Q

Pilar or Trichilemmal Cyst population

A

women with family history

95
Q

Pilar or Trichilemmal Cyst sx

A

Scalp
5-5 cm nodule/tumor - smooth, firm, dome
Pain free

96
Q

Pilar or Trichilemmal Cyst Tx

A

Excision

97
Q
A

Pilar or Trichilemmal Cyst

98
Q

Sebaceous cyst cause

A

poor hygiene

99
Q

Sebaceous cyst sx

A

flesh-colored, dome-shaped nodules that feel firm (not hard)
Range in size from 0.5 to 5 cm

100
Q

Sebaceous cyst dx

A

an oily substance rather than macerated keratin.
Biopsy is usually not necessary

101
Q

Sebaceous cyst tx

A

Don’t need
Excision- make sure to remove entire cyst and lining but not when inflamed
Corticosteroid when inflamed but not infected
Incision and drainage
Take at least 4-6 weeks
Poultice or antibiotics

102
Q
A

Sebaceous cyst

103
Q

Sebaceous hyperplasia

A

Small tumors of enlarged sebaceous glands

104
Q

Sebaceous hyperplasia population

A

> 30 yo

105
Q

Sebaceous hyperplasia cause

A

sun exposure, trauma

106
Q

Sebaceous hyperplasia sx

A

On Forehead, cheek, lower lid, and nose
1-3 mm
Telangiectasia
Central umbilication
Soft
Blood vessels occur in the valleys between lobules

107
Q

Sebaceous hyperplasia dx

A

Biopsy

108
Q

Sebaceous hyperplasia tx

A

Carbon dioxide laser ablation
Shave excision
Electrodessication with curettage
Trichloroacetic acid
Photodynamic therapy
Cryotherapy
Not required

109
Q
A

Sebaceous hyperplasia

110
Q

Seborrheic keratosis population

A

middle age

111
Q

Seborrheic keratosis cause

A

autosomal dominant, benign proliferation of immature keratinocytes,

112
Q

Seborrheic keratosis sx

A

Vary in size from 2 mm to more than 3 cm
Slightly to markedly elevated

Rough
verrucous or crumbly, dry and cracked with accentuation of the hair follicles, papule or plaque

Smooth
smooth dome- shaped surface with tiny, round, 1 mm in diameter white or black horny cysts/pearls embedded in the surface, papule or plaque

113
Q

Seborrheic keratosis types

A

Rough
* verrucous or crumbly, dry and cracked with accentuation of the hair follicles.
Smooth
* smooth dome- shaped surface with tiny, round, 1 mm in diameter white or black horny cysts/pearls embedded in the surface

114
Q

Seborrheic keratosis dx

A

Excisional or shave biopsy

115
Q

Seborrheic keratosis TX

A

No treatment
Liquid nitrogen cryotherapy
Light electrocautery
Dermabrasion
Laser treatment
* Only for darker lesions
Trichloroacetic acid
Topical tretinoin
Local anesthesia by shaving/curetting along with hyfrecation or radiosurgery

116
Q
A

Seborrheic keratosis

117
Q
A

Seborrheic keratosis

118
Q

Skin Tag (acrochordon) population

A

adulthood

119
Q

Skin Tag (acrochordon) cause

A

obesity, diabetes, metabolic syndrome, aging

120
Q

Skin Tag (acrochordon) sx

A

Increase with age
soft, skin-colored to slightly pigmented
pedunculated papule-neck, axilla, groin, eye, mouth
Multiple in one spot
May appear necrotic
Hyperpigmentation

121
Q

Skin Tag (acrochordon) PE

A

tan to flesh-colored, 1 -10 mm., soft, fleshy, pedunculated, papules

122
Q

Skin Tag (acrochordon) TX

A

Cosmetic or irritation but not pathological
Scissor excision
Cryotherapy
Radiosurgery
Electrodesiccation
Lift-and-snip
Shave procedure
Dental floss

123
Q

Skin Tag (acrochordon) ddx

A

Intradermal nevi
Neurofibromata

124
Q

Seborrheic keratosis ddx

A

Warts
Actinic keratosis
Nevi
Pigmented basal cell carcinomas
Dermatofibroma
Malignant melanomas

125
Q

Sebaceous hyperplasia ddx

A

Basal Cell Carcinoma
Small keratoacanthoma
Molluscum contagiosum
Syringoma

126
Q

Sty or external hordeolum Tx

A

Hot and cold compress

127
Q
A

Sty or external hordeolum

128
Q

Syringoma

A

Most common tumor of the intraepidermal eccrine sweat glands

129
Q

Syringoma population

A

women, any age, >30

130
Q

Syringoma cause

A

autosomal dominant

131
Q

Syringoma sx

A

Symmetrical
Small, firm, multiple, flesh-colored papules
Occur on lower lids, and less commonly on forehead, chest, abdomen and vulva
No malignant potential

132
Q

syringoma dx

A

Shave biopsy

133
Q

syringoma Tx

A

Electrodessication and curettage
Cryotherapy
Laser
trichloroacetic acid
Glycolic acid at 10%-20% concentration
May cause scarring

134
Q

Venous ulcers

A

Location: Medial lower leg

Irregular margins
Superficial
Ruddy granular tissue
Painless-moderate pain
Exudative
Periwound is weepy or dry and thin
Firm edema/woody
Lipodermatosclerosis
Hemosiderin staining

135
Q
A

syringoma

136
Q
A

venous ulcers

137
Q

Arterial ulcers

A

Location: lateral malleolus, between toes, phalangeal heads
Even wound margins
Pale deep wound bed
Pale dry granulation
Painful
Minimal exudate-dry
Thin, shiny dry skin
Pallor elevation/dependent rubor
Cool
Diminished/absent pulses

Dermatology (11 decks)

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