Additional skin lesions Flashcards
What is a seborrhoeic wart?
They are benign warty spots. Also known as a basal cell papilloma or seborrhoeic keratosis
Who most commonly get seborrhoeic warts?
Older people
Where do seborrhoeic warts arise ?
Can arise anywhere on the body
What are the clinical features of seborrhoeic warts?
- Have a typical stuck on appearance like a barnacle
- Well-defined flat or raised papule or plaque
- Colour varies - Skin coloured, yellow, grey, light brown, dark brown, black or mixed colours
- Smooth, waxy or warty surface
- May be solitary or grouped in certain areas
What is shown in this pic ?
A very large seborrhoeic wart
How are seborrhoeic warts diagnosed?
- 1st line = clinically
- If in doubt the dermoscopy or biopsy may be done
What is the treatment of seborrhoeic warts?
- 1st line = Cryotherapy
- If large then curretage & local anaesthetic done
What is a lipoma ?
- A benign tumour of adipocytes
- It slowly grows under the skin in the subcutaneous tissue.
What are the clinical features of a lipoma ?
- Smooth, mobile, painless Lump or lumps
- Lump has a rubbery or doughy consistency
- Lump is dome or egg shapped
- Lumps grow and eventually become visible & palpable
What part of the body are lipomas most common on ?
The shoulders, neck, trunk and arms
What is the likely cause in the pic?
How are lipomas diagnosed ?
Clinically
What is the treatment of lipomas ?
- Nothing - observation
- If diagnosis uncertain, or compressing on surrounding structures then may be removed
What is a dermatofibroma ?
A common benign fibrous nodule
What is the development of a dermatofibroma sometimes secondary to ?
An insect bite or rose thorn injury, but not consistently.
What are the clinical features of a dermatofibroma ?
- Very Firm nodules tethered to the skin surface and mobile over subcutaneous tissue.
- The skin dimples on pinching the lesion.
- Colour may be pink to light brown in white skin, and dark brown to black in dark skin; some appear paler in the centre.
- Do not usually cause symptoms, but they are sometimes itchy
How are dermatofibromas diagnosed ?
Clinically
What is the treatment of a dermatofibroma ?
Nothing - just reassurance
What is a cyst ?
A cyst is a benign, round, dome-shaped encapsulated lesion that contains fluid or semi-fluid material.
What is an epidermoid cyst ?
A benign cyst derived from the infundibulum or upper portion of a hair follicle
What are the clinical features of a epidermoid cyst ?
- Commonly affect face & trunk
- A firm, flesh-coloured or yellowish round papule or nodule fixed to the skin
- May have a central punctum (hole in the middle)
- Foul-smelling cheesy debris, which may be expressed from the central punctum.
How are epidermoid cysts diagnosed ?
Clinically
What is the treatment of epidermoid cysts?
- Uncomplicated cysts - no treatment
- Complicated (infection, rupture, inflammation) - surgical excision with an intact cyst capsule
What is a skin tag?
- A common soft harmless lesion that appears to hang off the skin.
- It is also known as an acrochordon
What are the clinical features of a skin tag?
- Skin coloured (or slightly darker)
- Soft lesion which appears to hang off skin
- Most commonly appear in skin folds e.g. neck, armpits, groin
How are skin tags diagnosed ?
Clinically
What is the treatment of skin tags ?
No treatment is best but if needed then:
- Surgical excision - snip or shave
- Very small tags may be removed with cryotherapy
What is a haemangioma ?
Angioma or haemangioma (American spelling ‘hemangioma’) describes a benign vascular skin lesion
What are the 2 main categories of haemangioma ?
- Those that arise in early life (infantile proliferative haemangioma)
- Thse that arise in later in life; most commonly a cherry angioma.
What are the clinical features of a cherry haemangioma?
- A firm red, blue or purple papule (may ressemble melanoma)
- non-blanching
- not found on the mucous membranes
- Most common in elderly
How are cherry haemangiomas diagnosed and how can they be differentiated from a melanoma ?
Clinically - dermoscopy can be used to demonstrate red-clod or lobular pattern to differentiate from melanoma
What is the treament of haemnagiomas ?
None
What is a pyogenic granuloma ?
A relatively common, reactive proliferation of capillary blood vessels.
What causes a pyogenic granuloma ?
- Minor trauma e.g. a pinprick
- Infection
- pregnancy
What are the clinical features of a pyogenic granuloma ?
- It presents as a shiny red lump with a raspberry-like or minced meat-like surface.
- Typically bleeds easily and may ulcerate to form a crusted sore
- Usually a single lesion which develops over days to weeks
- Most frequently found on the head, neck, upper trunk, hands (especially fingers) and feet
How are pyogenic granuloma diagnosed ?
Clinically
What is the treatment of pyogenic granuloma ?
Surgical excision or curettage
What is a merkel cell tumour ?
A rare form of skin cancer. It may be very aggressive and often metastasises to other parts of the body.
What are the clinical features of a merkel cell tumour ?
- A rapidly enlarging, solitary, irregular red nodule.
- It is often similar in appearance to other more common skin cancers such as basal cell carcinoma but grows much more quickly.
How are merkel cell tumours diagnosed ?
Biopsy
What is the treatment of merkel cell tumours ?
MDT assessement (due to poor survival rates) - usually surgery and radiation therapy.
What is kaposi’s sarcoma ?
A disease of the endothelial cells of blood vessels and the lymphatic system
What is the cause of kaposi’s sarcoma ?
- Caused by HHV-8 (human herpes virus 8)
- Has a strong association with AIDS
What are the clinical features of kaposi’s sarcoma ?
- Presents as purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
- Lesions are small & painless
- Skin lesions may later ulcerate
- Respiratory involvement may cause massive haemoptysis and pleural effusion
How is kaposis sarcoma diagnosed?
Skin biopsy
What is the treatment of kaposis sarcoma ?
Radiotherapy + resection
