Benign skin conditions Flashcards
(30 cards)
1
Q
Features of seborrhoeic keratoses
A
- large variation in colour from flesh to light-brown to black
- have a ‘stuck-on’ appearance
- keratotic plugs may be seen on the surface
- very common, related to skin aging
- an occur anywhere other than palms and soles and mucous membranes
2
Q
Management of seborrhoeic keratoses
A
- reassurance about the benign nature of the lesion is an option
- options for removal include curettage, cryosurgery and shave biopsy
3
Q
Spot diagnosis
A
seborrhoeic keratosis
4
Q
Spot diagnosis
A
Seborrhoeic keratosis
5
Q
Spot diagnosis
A
Seborrhoeic keratoses
6
Q
Another name for cherry hemangiomas
A
Cherry haemangiomas (Campbell de Morgan spots)
7
Q
What are cherry haemangiomas?
A
Cherry haemangiomas (Campbell de Morgan spots)
- benign skin lesions which contain an abnormal proliferation of capillaries
- unknown cause
8
Q
Features of cherry haemangiomas
A
aka Campell De Morgan spots
- They are more common with advancing age and affect men and women equally
- May develop on any part of the body but they appear most often around the mid trunk
- Increase in number from about the age of 40
- erythematous, papular lesions
- typically 1-3 mm in size
- non-blanching
- not found on the mucous membranes
9
Q
Management of Cherry Haemangiomas
A
As they are benign no treatment is usually required
10
Q
Spot diagnosis
A
Cherry haemangioma (Campbell De Morgan)
11
Q
Spot diagnosis
A
Pyogenic granuloma
12
Q
What’s Pyogenic Granuloma
A
Pyogenic granuloma
- a relatively common benign skin lesion
- name is confusing as they are neither true granulomas nor pyogenic in nature
- multiple alternative names e.g. ‘eruptive haemangioma’
13
Q
Features of pyogenic granuloma
A
- most common sites are head/neck, upper trunk and hands
- Lesions in the oral mucosa are common in pregnancy
- initially small red/brown spot → rapidly progress within days to weeks forming raised, red/brown lesions which are often spherical in shape
- the lesions may bleed profusely or ulcerate
14
Q
Management of pyogenic granuloma
A
- lesions associated with pregnancy often resolve spontaneously post-partum
- other lesions usually persist
- Removal methods include curettage and cauterisation, cryotherapy, excision
15
Q
Spot diagnosis
A
Pyogenic granuloma
16
Q
What’s dermatofibroma?
A
- Solitary dermal nodules
- Usually affect extremities of young adults
- Lesions feel larger than they appear visually
- Histologically they consist of proliferating fibroblasts merging with sparsely cellular dermal tissues
-No treatment required if diagnosis is confident
17
Q
Dermatofibroma O/E
A
- Site of minor trauma – insect bite
- Brownish/red dermal lesion
- Feels firm
- Pinching the tumour between fingers leads to dimpling / sinking down into the dermis
18
Q
Dimple / buttonhole / pinch sign = ?
A
Dimple / buttonhole / pinch sign = dermatofibroma
19
Q
What’s Congenital Melanocytic Naevi
A
- Typically appear at, or soon after, birth
- Usually greater than 1cm diameter
- Increased risk of malignant transformation (increased risk greatest for large lesions)
20
Q
What’s atypical naevus syndrome?
A
- Atypical melanocytic naevi that may be autosomally dominantly inherited
- Some individuals are at increased risk of melanoma (usually have mutations of CDKN2A gene
- Many people with atypical naevus syndrome AND a parent sibling with melanoma will develop melanoma
21
Q
Actinic keratosis O/E
A
- Flaky / keratotic patches
- Bald scalps, foreheads, ears, dorsum of hands and forearms
- Feel crusty
22
Q
What’s an epidermoid cyst?
A
- Common and affect face and trunk
- They have a central punctum, they may contain small quantities of sebum
- The cyst lining is either normal epidermis (epidermoid cyst) or outer root sheath of hair follicle (pilar cyst)
23
Q
What’s actinic keratoses?
A
Actinic, or solar, keratoses (AK)
- a common premalignant skin lesion
- develops as a consequence of chronic sun exposure
24
Q
Features of actinic keratoses
A
- small, crusty or scaly, lesions
- may be pink, red, brown or the same colour as the skin
- typically on sun-exposed areas e.g. temples of head
- multiple lesions may be present
25
Management of actinic keratoses
* prevention of further risk: e.g. sun avoidance, sun cream
* fluorouracil cream: typically a 2 to 3 week course. The skin will become red and inflamed - sometimes topical hydrocortisone is given following fluorouracil to help settle the inflammation
* topical diclofenac: may be used for mild AKs. Moderate efficacy but much fewer side-effects
* topical imiquimod: trials have shown good efficacy
* cryotherapy
* curettage and cautery
26
What's Bowen's disease?
***Bowen's disease***
* a type of intraepidermal squamous cell carcinoma
* more common in elderly females
* around a 3% chance of developing invasive skin cancer
27
Features of Bowen's disease
* red, scaly patches
* often occur on sun-exposed areas such as the lower limbs
* Well defined scaly plaque
* No raised edge
28
Management of Bowen's disease
* topical 5-fluorouracil or imiquimod
* cryotherapy
* excision
29
Advice on sun protection
* How to recognise sunburn
* Avoid the strong sun – (11am – 3pm)
* Cover up – hats, t-shirts, sun glasses
* Use Factor 50
* Know your skin type
* UV index
* Avoid sunbeds
* Vitamin D
30
Skin types
Skin type is an important risk factor for skin cancer. Skin types may be classified according to Fitzpatrick classification:
* I: Never tans, always burns (often red hair, freckles, and blue eyes)
* II: Usually tans, always burns
* III: Always tans, sometimes burns (usually dark hair and brown eyes)
* IV: Always tans, rarely burns (olive skin)
* V: Sunburn and tanning after extreme UV exposure (brown skin, e.g. Indian)
* VI: Black skin (e.g. Afro-Caribbean), never tans, never burns
