Approach to Skin Lumps Flashcards
What is molluscum contagiosum and what is the associated skin presentation?
DNA poxvirus skin infection
- smooth, firm pink papules with central umbilication in clusters
- spread by direct skin contact, fomites, sexual transmission, autoinnoculation
- asymptomatic but ± surrounding irritation and pruritus
What is the main causative agent of viral warts?
HPV
What are the typical skin presentations of HPV warts?
Benign skin proliferation
- tiny black or red dots (thrombosed capillaries) within lesion are characteristic
- ±pruritic
- scratching → linear array via autoinoculation
What is Furunculosis and what is the associated skin presentation?
Cutaneous abscesses, tender to palpation
- a/w hair follicles
- #1 Staph Aureus
- common in adolescent and young adults, rare in children
- continuous → carbuncles
What is a pyogenic granuloma and what is the associated skin presentation
Rapidly growing, benign vascular proliferations of skin and mucous membranes
- red papule with meaty erosive surface
- common in children and young adults
- many etiologies (eg. infection, eczema, injury, hormonal fluctuations, retinoid therapy)
What is a fibroepithelial polyp and what is the associated skin presentation?
Common benign cutaneous growths
- small, skin-coloured/brown soft papules
- areas of frequent friction (eg. eyelids, inguinal, neck, axilla)
- pedicle twisting → frank necrosis
What is a seborrheic keratosis and what is the associated skin presentation?
Common benign neoplasm of epidermis
- “stuck-on” appearance papules and plaques with well-defined borders
- ↑age → ↑incidence
- rapid onset of numerous SKs may be a sign of malignancy
What is a epidermal cyst and what is the associated skin presentation?
Semi-solid cyst
- contains: macerated keratin and lipid-rich debris
- etiology (eg. trauama, iatogenic, eccrine duct/pilosebaceous unit occlussion, HPV, Gardner’s syndrome)
What is a lipoma and what is the associated skin presentation?
Slow-growing, mature fat cells
- soft, rubbery, freely-mobile SQ masses without overlying skin change
- often solitary but can be multiple
- usually asymptomatic
What is the 1st and 2nd most common skin cancer?
1) Basal cell carcinoma
2) Squamous cell carcinoma
What is a Basal Cell Carcinoma and what is the associated skin presentation?
Neoplasm of basal keratinocytes
- dark brown to dark blue, rolled edges, slight central induration
- greatest risk factor: sun exposure (intermittent sun > cumulative UV)
What is a Squamous Cell Carcinoma and what is the associated skin presentation?
Neoplasm of squamous epithelial cells
- papulonodule lesion, erosion and ulceration, scaling
- #1 sun-exposed areas of skin
- risk factors: UV, immunosuppression, HIV/AIDS, radiation exposure, smoking, HPV, etc.
What is a Kerathoacanthoma and what is the associated skin presentation?
Rapidly growing, well-differentiated neoplasm of squamous epithelium
- papule → nodule, central crust, painless
- low grade SCC
- appear within few weeks and spontaneously resolve within 6mths → atrophic scar
What is Leukemia cutis and what is the associated skin presentation?
Skin infiltration by malignant proliferation of leukocytes
- polymorphic, haemorrhagic ulcers, pink/red-brown/purple papules/nodules, large tumours, ulcerate and bullous
- 2° to eg. ALL, AML, CML, CLL
What is Dermatofibrosarcoma protuberans and what is the associated skin presentation?
Fibroblast-derived intermediate-grade soft tissue sarcoma (uncommon with low-metastatic potential but locally aggressive)
- slow-growing, red-brown, indurated plaque with irregular nodularity
- #1 trunk, proximal extremities, head and beck
- common in African descents
What is Cherry angioma and what is the associated skin presentation?
Campbell de Morgan spots, senile haemangiomas, acquired benign vascular proliferation
- thin-walled, dilated capillaries
- solitary, well-circumscribed, red papules
What is Xanthelasma and what is the associated skin presentation?
Type of localised plane xanthoma
- yellowish macules/slightly elevated papules/plaques on eyelids
- 3x > in F, 1/2 lipid disorder
- is an independent risk factor for atherosclerosis → IHD
What is a Keloid and what is the associated skin presentation?
Hypertrophic scar tissue
- Dense fibrous tissue nodules that can be painful, pruritic and grow to become very large → chronic discomfort, disfiguring and restrictive
- typically on previously traumatised skin
What is Kaposi sarcoma and what is the associated skin presentation?
Malignant neoplasm of lymphatic endothelial cell origin
- deep red/maroon/purple patches, papules, plaques, tumours, and nodules
- can be AIDS-associated or non-AIDS-associated
- all a/w HHV-8
What is Sarcoidosis and what is the associated skin presentation?
Immune-mediated systemic disorder → granuloma formation
- asymptomatic red-brown dermal papule/plaques
- favor face, neck, upper extremities and upper trunk
What is a Melanoma and what is the associated skin presentation?
Fibroblast-derived intermediate-grade soft tissue sarcoma (uncommon with low-metastatic potential but locally aggressive)
- slow-growing, red-brown, indurated plaque with irregular nodularity
- #1 trunk, proximal extremities, head and beck
- common in African descents
What is a Sebaceous hyperplasia and what is the associated skin presentation?
Localised hypertrophy of the sebaceous glands that occurs on central face (#1 forehead)
- solitary/multiple skin-colour/yellow papules, central dell
- peripheral “crown” of telangiectatic vessels on dermoscopy
What is a Stucco keratosis and what is the associated skin presentation?
Keratosis/Keratoelastoidosis verrucose (benign and asymptomatic)
- white/gray scaly papule on dorsal feet and lower legs
- >40, north europe, 4x > M
What is Tendinous xanthomas and what is the associated skin presentation?
Lipid deposits within tendons
- smooth firm nodules over extensor tendons of elbows, knees, hands or #1 achilles
- #1 cause: familial hypercholesterolemia
What is a Actinic keratosis and what is the associated skin presentation?
Precancerous lesions on chronically sun-exposed skin
- rough, scaly macules/patches
- common in lighter skin individuals
- usually asymptomatic but may be tender
