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Advanced Ocular Disease > Epithelial Eyelid Growths > Flashcards

Epithelial Eyelid Growths Flashcards

1
Q

The majority of eyelid growths originate from what layer of the skin?

A

Epidermis

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2
Q

What eyelid lesion shows Pseudo-horn cysts on histology?

A

Seborrheic Keratosis

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3
Q

Tell me everything you know about the presentation of Seborrheic Keratosis (6)

A
  1. “stuck on” like a button
  2. waxy texture due to increased keratin
  3. raspberry / verrucous texture due to exaggerated surface topography
  4. pseudo-horn cysts revealed on histology due to small accumulations of keratin
  5. pigmented due to melanin deposition
  6. sits on a broad base
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4
Q

What is the Leser-Trelat sign?

A

Sudden explosion of Seborrheic Keratosis lesions indicating an underlying malignancy such as stomach, colon, or breast cancer

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5
Q

What causes Seborrheic Keratosis

A

Only god knows

But definitely NOT the sun

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6
Q

Seorrheic keratosis is a proliferation of what type of cells in the epidermis?

A

Basal cells

Also presents with varying degrees of acanthosis due to squamous cell proliferation

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7
Q

What is going on histologically in Keratoacanthoma?

A

Hyperplasia of squamous cells with a keratin core

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8
Q

Why are we not concerned about Keratoacanthoma in terms of malignancy?

A

Very little cellular atypia

Inflammation and WBC’s at the base of the lesion prevents invasion into neighboring tissue

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9
Q

Tell me everything you know about the presentation of Keratoacanthoma (6)

A
  1. Cup-shaped / nodular
  2. Pedunculated
  3. Keratin core / ulceration
  4. Inflammation at base
  5. Rapid growth for 6-8 weeks follow by involution
  6. Rolled borders
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10
Q

What causes Keratoacanthoma?

A

UV light

HPV

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11
Q

What eyelid lesion is associated with the term Pseudoepitheliomatous hyperplasia?

A

Keratoacanthoma

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12
Q

Inactive HPV resides in the ________ and does not become active until it migrates up to the ________ Cell replication takes place in the highly differentiated ________

A

Inactive HPV resides in the basal epithelium and does not become active until it migrates up to the squamous cells Cell replication takes place in the highly differentiated keratinocytes

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13
Q

Verruca lesions and benign squamous papillomas are difficult to distinguish clinically. How could you differentiate the two histologically?

A

Verruca lesions show viral inclusions and koilocytes while BSP lesions do not

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14
Q

What is Verruca planar?

A

Broad based warts

do not show overlapping borders which is characteristic of Seborrheic Keratosis

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15
Q

What are alternative topical methods of treating non-facial verruca warts? (5)

A 
Canthadrin
Retin-A
Podophyllin
Topical Vitamin A
Cidofovir
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16
Q

Tell me everything you know about the presentation of Molluscum Contagiosum (2)

A
  1. Flesh-colored

2. Cheesy core

17
Q

Molluscum Contagiosum can shed viral particles into the eye resulting in a _____ conjunctivitis while verruca infiltration results in a ______ conjunctivitis

A

Molluscum - Follicular conjunctivitis

Verruca - Papillary conjunctivitis

18
Q

You can use treatments such as Australiain lemon myrtle oil, tea tree oil, duct tape, SilverCure device, and Zymaderm (OTC-naturopathic) to treat what condition?

A

Molluscum Contagiosum

19
Q

5% of actinic keratosis lesions turn into _______

A

Squamous cell carcinoma

20
Q

Tell me everything you know about the presentation of Actinic Keratosism (3)

A
  1. Inflammation at base
  2. Surf and Scale
  3. Varying degrees of keratosis and pigmentation
21
Q

How does MOHs surgery work?

A

Surgeon scrapes off layers of the lesion and the pathologist inspects each layer for cancer. Surgery stops when there is no cancer found

22
Q

What are the classic features of Squamous Cell Carcinoma?

A

THERE ARE NONE

23
Q

What is the biggest histological indication that the lesion is squamous cell carcinoma?

A

Keratin pearls

24
Q

True/Flase. Squamous cell carcinoma is more aggressive than basal cell carcinoma

A

TRUE

25
Q

The presence of keratin is an indication of which condition: SCC or BCC?

A

SCC

26
Q

What are the 3 histological types of Basal Cell Carcinoma? Which is the most common?

A

Nodular - most common
Superficial
Sclerosing

27
Q

What is a classic histological feature of basal cell carcinoma?

A

Palisading nuclei

28
Q

What are the classic characteristics of nodular basal cell carcinoma? (5)

A
  1. Ulcerative or non-ulcerative
  2. Pearly borders
  3. Slow growth
  4. Locally invasive
  5. Telangiectatic vessel
29
Q

Does SCC and BCC typically occur on the upper or lower lid? Why?

A

Lower lid because it is exposed to the sun more

30
Q

Superficial BCC resemble what condition? What is a characteristic feature?

A

Resembles eczema psoriasis

Characteristic thread-like borders

31
Q

The sclerosing-morpheoform of BCC is characterized by __________ which makes it the most difficult to remove surgically

A

Cordlike infiltration

32
Q

Pigmented BCC could be mistaken for what condition?

A

Melanoma

33
Q

What is Gorlin Syndrome

A

“Basal Cell Nevus Syndrome” but don’t call it that because the “nevi” are really just BCC lesions
Autosomal Dominant cancer that affects several organs with patients typically developing mutliple neoplasms such as BCC lesions and medulloblastoma. Extremely sensitive to ionizing radiation such as sunlight

34
Q

What is Inverted Follicular Keratosis?

A

Considered to be an irritated variant of seborrheic keratosis. Acantholysis just above the basilar layer with whorls of benign squamous cells (squamous eddies) just above this zone. Many authors prefer the term basosquamous cell epithelioma because it is more true to the pathophysiology of the condition.

35
Q

What is radiation dermatosis?

A

Result of cancer therapy. The skin is usually pretty resistant to radiation damage but the face is particularly predisposed due to the thinness of the tissue. Over 800 rads may predispose BCC and SCC and melanoma.

Advanced Ocular Disease (8 decks)

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