Benign Skin Lesions Flashcards Preview

Dermatology (Year 2 GM) > Benign Skin Lesions > Flashcards

Flashcards in Benign Skin Lesions Deck (37):
1

What is the appearance of seoborrhoeic keratoses?

Warty growths

Stuck on appearance

Variable appearance

 

Patients may or may not have several cherry angiomas

2

What is the treatment for seborrhoeic keratoses?

Generally left untreated but if troublesome - cryotherapy / curettage

3

What is cryotherapy?

Liquid nitrogen

4

What are the pros and cons of cryotherapy?

•Pros 

–Cheap

–Easy to perform “on the day”

 

•Cons

–Can scar

–Failure/Recurrence

–No pathology result

5

What condition does a rapid onset of seborrhoeic keratoses indicate? (particularly in a younger individual)

Leser - Trelat

 

SK's remain benign but may indicate underlying solid organ malignancy

 

GI adenocarcinoma

6

What are these?

 

They have a rough hyperkeratotic surface

They are viral warts (due to the human papilloma virus)

7

What is the treatmet of viral warts?

Tend to be difficualt to treat

 

•Will clear when immunity developed to virus

•Cryotherapy or wart paints can stimulate immune system slightly

•Can curette in severe cases

8

What is this?

 

(encapsulated lesion containing fluid or semi-fluid material)

 

Firm and fluctulant

Cysts

9

What are different types of cyst?

Epidermoid

Pilar

Steatocystoma - genetic predisposition - may be treated with isotretinoin

10

What risks are associated with cysts?

Can rupture and cause inflammation of surrounding skin

May become secondary infected

11

What are the treatments of cysts?

Treated with excision

If inflamed / infected:

- Antibiotics

 - Intralesional steroid

- Incision and drainage

12

What is this?

 

(described as a benign fibrous nodule - often on limbs)

Dermatofibroma

13

The proliferation of what type of cell causes dermatofibroma?

Fibroblasts

 

The cause is unknown, they are sometimes attributed to an area of trauma

14

What are the features of dermatofibroma?

Firm nodule, tethered to skin but mobile over fat

 

Pale/pink brown 

 

Often paler centre

 

Dimple sign positive

 

Usually asymptomatic - can be itch or tender

 

Excision if concern or symptomatic

15

What is a lipoma?

It is a benign tumour consisting of fat cells

 

 

 

16

What are the features of lipomas?

Common

Smooth and rubbery subcutaneous mass

Usually asymptomatic

 

17

If the lipoma is tender what might that indicate?

Angiolipoma

Liposarcoma - rare malignancy

18

What is an angioma?

Overgrowth of blood vessels in the skin due to proliferating endothelial cells

19

What are the features of angiomas?

Generally asymptomatic but they may bleed and can be described as unsightly

 

 

They occur in liver disease or pregancy

20

What is the treatment for angiomas?

Excsion or laser

21

What is this?

Pyogenic granuloma

22

What are the features of pyogenic granuloma?

Rapidly enlarging

Bleed easily

Occur in 5% of pregnancies

Common on the head and the hands

23

What is the treatment for pyogenic granuloma?

Curettage and cautery

24

So what were the vascular lesions?

Pyogenic granuloma

Angioma

25

What are some pre-malignant skin conditions?

Actinitic keratoses

Bowen's disease

Melanoma in situ

26

What does actinitc keratoses progress to?

SCC

 

Common in the elderly population

 

Described as a crusty scaly patch - sign of partial thickness epidermal dysplasia

27

If actinitic keratoses is partial thickness epidermal dysplasia - what is full thickness epidermal dysplasia known as?

Bowen's disease

 

It is entirely contained within the epidermis so there is no metastatic potential 

 

Potential to become malignant is around 5%

 

It is described as irregular, scaly, erythematous plaque

 

28

What is the treatment if bowens?

Cryotherapy

Curettage - Lesion scraped off and heat applied to seal vessels and destroy residual cancer cells

Photodynamic therapy

 

Imiquimod

29

How does photodynamic therapy work?

A topical photosensitising agent causes cancer cells to become sensitised to a specific colour of light - the agent conecntratres in cancer cells 

 

A photodynamic reaction occurs between light photosensitiser and oxygen causing inflamation and destruction of cells

30

Pros and cons of photodynamic therapy

•Pros

–Done for the patient by hospital staff

–Can treat multiple areas, including those which would be hard to reach by patient

–1 or 2 treatments

•Cons

–Requires hospital appointments

–Can be painful and scar

31

How does imiquimod work?

Stimulates cytokine release - inflammation and destruction of lesion

32

Pros and cons for imiquimod

•Pros

–Useful where surgery is undesirable

–Usually good cosmetic result

–Large surface area

•Cons

–Treatment time is 6 weeks

–Significant inflammation

–Failure/recurrence

33

What is treatment of actinitic keratoses?

–Cryotherapy

–Curettage

–Diclofenac Gel

–Imiquimod

34

What is meant by melanoma in situ?

Melanoma cells are entirely confined to the epidermis

 

No metastatic potential

 

Treated with excision

35

Give an example of a melanoma in situ

Lentigo maligna

 

Usually facial

36

What are ways to avoid the sun?

 

Actinitic keratoses is described as rough scaly patches on sun damaged skin

•Cover up

•Avoid sun at peak hours

–10am-4pm

•Don’t burn and try not to tan

•Avoid sunbeds

•Sunscreen

–UVA & UVB protection

–At least SPF 30 / 4 Star

–Need to apply 2 tablespoons every 2 hours

37