3 - premalignant lesions

Question 1

what is actinic keratosis? presents?

Answer 1

partial thickness dysplasia of epidermal keratinocytes
= from sun damage

PRESENTS
- scaly, erythematous papules or patches, gritty & rough
- occur on scalp, face, hands (sun exposed areas)

Question 2

what is management options for actinic keratosis?

Answer 2

lesion based treatment = cryotherapy (freeze off), curettage (scrape away), cautery (burn off)

field based treatment = topical fluorouracil, imiquimod, photodynamic therapy

Question 3

what is bowen’s disease? typical presentation?

Answer 3

= squamous cell carcinoma in situ - full thickness dysplasia of epidermal keratinocytes

PRESENTS
- typical for fair skinned women or torso in men
- slowly enlarging, well demarcated, scaly red patch w irregular border

Question 4

what is associated with genital mucosa in bowen’s disease?

Answer 4

there’s variant of bowen’s disease which affects genital mucosa = this has strong link with HPV-16

Question 5

what is management of bowen’s disease?

Answer 5

• cryotherapy
• 5-fluorouracil cream
• imiquimod
• photodynamic therapy

Question 6

what is keratoacanthoma? presentation?

Answer 6

= rapidly growing epidermal tumours

PRESENTS
- red papule with central crater like crusty keratinous plug
- sun exposure related

Question 7

what is management of keratoacanthoma?

Answer 7

= if leave alone then will regress spontaneously after 3 months ish leaving pitted scar but often really hard to tell difference between SCC so usually excised