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Year 2 - Dermatology > Benign + premalignant skin lesions > Flashcards

Benign + premalignant skin lesions Flashcards

(48 cards)

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1
Q

Name 3 premalignant skin lesions

A

Bowens disease
Actinic Keratoses
Melanoma in situ

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2
Q

Name 6 benign skin lesions

A 
Viral warts 
Epidermoid and pilar cysts 
Seborrhoeic keratoses 
Dermatofibroma 
Lipoma 
Vascular lesions
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3
Q

When describing a skin lesion, what characteristics of it should be included

A 
Site
Size
Shape
Colour
Mobility
Texture
Temperate
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4
Q

Clinical features of seborrhoeic keratoses

  • number
  • appearance
  • where
  • colour
A

MULTIPLE well-circumscribed ‘stuck-on’ GREASY plaques/papules that look like warts

usually on trunk

yellow/brown

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5
Q

Seborrhoeic keratoses typically affects what age group

A

40s-50s

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6
Q

What benign vascular lesion is associated with seborrhoeic keratoses

A

cherry angiomas - bright red spots

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7
Q

Seborrhoeic keratoses generally left untreated because not troublesome but if irritated, itching, and displeasing, then can be treated with (2)

A

cryotherapy

curettage (scraping them off)

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8
Q

Cryotherapy involves the use of what substance

A

liquid nitrogen

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9
Q

What is the leser-trelat sign

A

Abrupt onset of widespread seborrhoeic keratosis, particularly in a younger individual associated with an underlying malignancy; not direct result but paraneoplastic effect

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10
Q

Leser-trelat sign may indicate what underlying malignancy

A

GI cancer

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11
Q

What differentiates a cyst from an abscess

A

Cyst contains non-infected fluid while abscess contains infected fluid

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12
Q

Most common type of cyst

A

Epidermoid - i.e. epidermis like cells lining the wall of the cyst

affects young/middle aged

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13
Q

Pilar cysts are seen where

A

Scalp

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14
Q

Epidermoid cysts are often confused with what cyst

A

sebaceous cyst

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15
Q

Clinical features of an epidermoid cyst - face, neck, chest (2)

A

firm, elastic, dome-shaped lesion

central keratin-filled punctum may be present

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16
Q

Cysts may get infected and consequently enlarge, becoming red and tender and discharge pus

Treatment of acutely infected cysts (3)

A

Antibiotics
Intralesional steroid - calms inflammation
Incision & Drainage - removing whole sac as sac can refill again if you only drain the fluid

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17
Q

Clinical features of a dermatofibroma

  • firm or soft
  • mobility
  • colour
  • what do you see when you squeeze it
A

Firm nodule,

tethered to skin but mobile over fat (moves with skin)

Pale pink/brown

Dimple sign

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18
Q

Dermatofibromas commonly seen where

A

Lower legs

Upper arms

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19
Q

Treatment if dermatofibroma becomes symptomatic/concerning

A

Excision

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20
Q

What is a lipoma

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A

Benign tumour of adipose tissue

21
Q

Clinical features of a lipoma

  • texture
  • mobility
  • superficial/deep
  • size
Study These Flashcards
A

soft,
mobile
superficial

quite big and lumpy <5cm

22
Q

Lipomas could be confused with

Study These Flashcards
A

liposarcomas which have potential to be malignant unlike lipomas

23
Q

Benign vascular lesions include (2)

Study These Flashcards
A

angioma

pyogenic granuloma

24
Q

What is an angioma

Study These Flashcards
A

Overgrowth of blood vessels in the skin due to endothelial hyperplasia (i.e. dilated vessel)

25
Clinical features of angiomas - soft or hard - colour - distribution
Soft papules/nodules Red/ blue/ purple usually on trunk
26
Angiomas aren't usually treated but if they start catching on things or bleeding then can be removed by (2)
Curettage Laser
27
What form of angioma is associated with liver disease
Spider naevi
28
What is a pyogenic granuloma + initiating factor
Sudden onset rapidly growing vascular lesion (rapid overgrowth of tiny blood vessels), often resulting from trauma
29
Clinical feature of a pyogenic granuloma - colour - texture usually asymptomatic but vulnerable to what
Starts as a small deep red lesion but quickly enlarges into a nodule Initially smooth and shiny, but often becomes eroded and crusty after they've bled bleeds significantly on mild contact
30
Treatment of pyogenic granuloma
Curettage + cautery of area left behind
31
Risk factors of premalignant skin lesions
UV radiation
32
How does UV radiation predispose to premalignancy
Causes DNA damage + immunosuppression
33
Describe the spectrum normal/benign cells proceed through to become a malignancy (5)
Benign --> hyperplasia -- dysplasia --> in situ disease --> invasive malignancy
34
What happens to cells in dysplasia (3)
Nuclei change, DNA damage, shape change
35
What is wrong with cells in situ disease
cells look cancerous under microscope, but not cancer because haven’t invaded anywhere, cell is still where it should be, e.g. epidermal cell is still in epidermis
36
Clinical features of actinic keratoses - type of lesion - shape - texture - scaling? - colour
Irregularly shaped rough hyperkeratotic scaly macules/plaques yellow/brown
37
Biggest risk factor of actinic keratoses
Chronic sun exposure/ sun damage
38
Actinic keratoses (premalignant lesion) may progress to what skin cancer type
Squamous cell carcinoma
39
Treatment of actinic keratoses - destructive methods (2) - topical methods (3)
Destructive - Cryotherapy - Curettage Topical - fluorouracil - interferes with DNA/RNA synthesis - imiquimod, - diclofenac gel
40
What is Bowen's disease
Squamous cell carcinoma in situ entirely contained within epidermis
41
Clinical feature of Bowen's disease (premalignant disease)
Irregular scaly erythematous plaque
42
Risk of Bowen's disease (premalignant lesion) becoming malignant
Low
43
Bowen's disease is often confused with what skin conditions
Eczema or psoriasis because it's an red scaly plaque
44
Treatment of Bowen's disease (4)
Cryotherapy Curettage + electrocautery (to seal vessel and destroy residual cells) Photodynamic therapy Topical imiquimod
45
How does photodynamic therapy work in treating Bowen's disease
Photochemical reaction to selectively destroy cancer cells - topical photosensitising agent applied to cancerous cells - then red light applied to trigger photodynamic reaction of the photosensitive agent absorbed into the cancerous cells and destroys the cells
46
Topical imiquimod can be used for the premalignant lesions (actinic keratinosis and Bowen's disease), viral warts and superficial basal cell carcinomas - what does it do/mechanism of action
Is an immunotherapy cream, i.e. modifies immune response -activates the immune system to recognise abnormal cells by flagging the abnormal cells which stimulates cytokine release --> causes inflammation and destruction of lesion
47
Melanoma in situ (a premalignant lesion) aka stage 0 melanoma is confined to which layer of skin + since it is in situ, it has no ... potential
epidermis metastatic
48
Melanoma in situ treatment
Excision with 5mm margin

Year 2 - Dermatology (10 decks)

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