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10. Year 2: Dermatology > Benign Skin Lesions > Flashcards

Benign Skin Lesions Flashcards

1
Q

What is used to describe a skin lesion?

A

Site

Size

Shape

Colour

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2
Q

When palpating a skin lesion, what are we checking?

A

Mobility

Surface changes

Temperature

Consistency

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3
Q

What are some examples of different kinds of benign skin lesions?

A
  • Seborrhoeic keratosis
    • Causing Sign of Leser-Trelat
  • Viral warts
  • Cysts
  • Dermatofibroma
  • Lipoma
  • Vascular lesions
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4
Q

What does SK stand for?

A

Seborrhoeic keratoses (SK)

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5
Q

What is seborrhoeic keratoses?

A

Warty growths, stuck out appearance

Patients often have multiple

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6
Q

What is the treatment of seborrhoeic keratoses?

A

Causes sign of Leser-Trelat, which is a paraneoplastic phenomenon with abrupt onset of widespread seborrheic keratosis:

  • Particularly in younger person
  • Usually benign but may indicate underlying solid organ malignancy
    • Such as GI adenocarcinoma
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7
Q

What does cyrotherapy utilise?

A

Liquid nitrogen

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8
Q

What are the pros of cyrotherapy?

A
  • Cheap
  • Easy to perform on the day
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9
Q

What are the cons of cyrotherapy?

A
  • Can scar
  • Failure/recurrence
  • No histology
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10
Q

What is cyrotherapy?

A

Use of low temperatures in medical therapy

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11
Q

What causes viral warts?

A

Human papilloma virus

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12
Q

Describe the lesion due to viral warts?

A

Rough hyperkeratotic surface

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13
Q

What is the treatment of viral warts?

A
  • Will clear when immunity developed to virus
  • Cryotherapy or wart paints can stimulate immune system slightly
  • Can curette in severe cases
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14
Q

What are cysts?

A

Encapsulated lesion containing fluid or semi-fluid material

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15
Q

What are some different types of cysts?

A
  • Epidermoid cyst (often wrongly called sebaceous)
  • Pilar cyst
  • Steatocystoma
  • Dermoid cyst
  • Hidrocystoma
  • Ganglion cyst
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16
Q

What can happen if a cyst ruptures?

A

Inflammation of surrounding skin, may become secondary infected

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17
Q

What is the treatment of cysts?

A
  • Excision
  • If inflamed/infected
    • Antibiotics
    • Intralesional steroid
    • Incision and damage
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18
Q

What is dermatofibroma?

A

Benign fibrous nodule, often on limbs:

Proliferation of fibroblasts

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19
Q

What is the aetiology of dermatofibroma?Cause is unknown, sometimes due to area of trauma

A

Cause is unknown, sometimes due to area of trauma

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20
Q

Describe the lesion due to dermatofibroma?

A

Firm nodule, tethered to skin but mobile over fat, pale pink/brown often paler in centre

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21
Q

What is the clinical presentation of dermatofibroma?

A

Firm nodule, tethered to skin but mobile over fat, pale pink/brown often paler in centre

Dimple sign positive

Usually asymptomatic, can be itchy or tender

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22
Q

What is the treatment for dermatofibroma?

A

Excision if concern of symptomatic

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23
Q

What is lipoma?

A

Benign tumour consisting of fat cells

24
Q

Is lipoma common or uncommon?

A

Common

25
Q

Describe the lesion due to lipoma?

A

Smooth and rubbery subcutaneous mass

26
Q

What is the clinical presentation of lipoma?

A

Usually asymptomatic

27
Q

What are 2 types of vascular lesions?

A
  • Angioma
    • Overgrowth of blood vessels in skin due to proliferating endothelial cells
    • Usually asymptomatic, can be unsightly or bleed
    • Occurs in pregnancy and liver disease
    • Excision or laser
  • Pyogenic granuloma
    • Rapidly enlarging red/raw growth, often at site of trauma
    • Bleeds easily
    • Cause is unknown
    • Common on head and hands
    • Removed by curettage and cautery
28
Q

What is angioma?

A
  • Overgrowth of blood vessels in skin due to proliferating endothelial cells
29
Q

What is the clinical presentation of angioma?

A

Usually asymptomatic, can be unsightly or bleed

30
Q

In who does angioma usually occur?

A

Pregnancy and liver disease

31
Q

What is the treatment of angioma?

A

Excision or laser

32
Q

What is pyogenic granuloma?

A
  • Rapidly enlarging red/raw growth, often at site of trauma
33
Q

What is the aetiology of pyogenic granuloma?

A

Unknown

34
Q

What is the treatment of pyogenic granuloma?

A

Removed by curettage and cautery

35
Q

Where on the body is pyogenic granuloma most common?

A

Head and hands

36
Q

What is the main risk factor for pre-malignant lesions?

A
  • UV radiation
    • Causes DNA damage and immunosuppression
    • Ultraviolet radiation is split into vacuum UV, UVC, UVB and UVA (in order of decreasing frequency)
37
Q

What are the different kinds of ultraviolet radiation in order of decreasing frequency?

A

Vacuum UV

UVC

UVB

UVA

38
Q

What are some examples of pre-malignant tumours?

A
  • Actinic keratoses
  • Bowen’s disease
  • Melanoma in situ
39
Q

Describe the spectrum of damaged cells?

A

1) Normal/benign
2) Hyperplasia
3) Dysplasia
4) In-situ disease
5) Invasive malignancy

40
Q

What is actinic keratoses?

A

Rough scaly patches on sun damaged skin

41
Q

How high is the risk of actinic keratoses transforming to SCC?

A

Low risk

42
Q

What is the treatment for actinic keratoses?

A
  • Cryotherapy
  • Curettage
  • Diclofenac gel
  • Imiquimod
43
Q

What is Bowen’s disease?

A

Squamous cell carcinoma in situ:

  • Full thickness dysplasia, entirely contained within the epidermis
  • No metastatic potential
  • Potential to become malignant (around 5%)
44
Q

Describe the lesion due to Bowen’s disease?

A

Irregular, scaly erythematous plaque

45
Q

What is the treatment of Bowen’s disease?

A
  • Cryotherapy
  • Curette
    • Lesion scrapped off and heat applied to seal vessels and destroy residual cancer cells
  • Photodynamic therapy
    • Photochemical reaction to selectively destroy cancer cells
    • Topical photosensitising agent applied
      • Concentrates in cancerous cells
    • Red light applied and photodynamic reaction occurs
  • Imiquimod
    • Called Aldara and is topical cream
    • Immune response modifier
      • Stimulates cytokine response, causing inflammation and destruction of lesion
    • Pros
      • Useful where surgery undesirable
      • Good cosmetic result
    • Cons
      • Treatment time is 6 weeks
      • Signifianct inflammation
      • Failure/recurrence
46
Q

Describe a curette procedure?

A
  • Lesion scrapped off and heat applied to seal vessels and destroy residual cancer cells
47
Q

What is photodynamic therapy?

A
  • Photochemical reaction to selectively destroy cancer cells
  • Topical photosensitising agent applied
    • Concentrates in cancerous cells
  • Red light applied and photodynamic reaction occurs
48
Q

How is imiquimob administered?

A

Topical cream

49
Q

What is the mechanism of action of imiquimod?

A
  • Immune response modifier
    • Stimulates cytokine response, causing inflammation and destruction of lesion
50
Q

What are the pros of imiquimob?

A
  • Useful where surgery undesirable
  • Good cosmetic result
51
Q

What are the cons of imiquimob?

A
  • Treatment time is 6 weeks
  • Significant inflammation
  • Failure/recurrence
52
Q

What is melanoma in situ?

A

Melanoma cells entirely confined to epidermis

No metastatic potential

53
Q

Does melanoma in situ have any metastatic potential?

A

No

54
Q

What is the treatment for melanoma in situ?

A

Excision

55
Q

What are some ways to protect yourself from the sun?

A

Cover up

Avoid sun at peak hours

Don’t burn and try not to tan

Avoid sunbeds

Suncreen:

  • UVA and UVB protected
  • At least SPF 30/4 star
  • Need to apply 2 tablespoons every 2 hours
56
Q

How much sunscreen should be applied to be effective?

A
  • UVA and UVB protected
  • At least SPF 30/4 star
  • Need to apply 2 tablespoons every 2 hours

10. Year 2: Dermatology (11 decks)

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