benign and premalignant lesions Flashcards
What is seborrheic keratoses
benign warty growths
How does seborrhoeic keratoses present
Usually there are multiple on a patient
What is the management of seborrhoeic keratoses
Usually left untreated unless it is causing issues
Cryotherapy (freezing the warts off) or curettage (scraping warts off) can be done
What is used in cryotherapy
liquid nitrogen
What are the negatives of cryotherapy
they can scar and can reoccur
What is the sign of Leser-Trelat
Abrupt onset of widespread seborrhoeic keratosis
What can the sign of Leser-Trelat indicate
Underlying solid organ malignancy - usually GI carcinoma
What causes viral warts
human papilloma virus
How does the treatment of viral warts work
The warts are so superficial, the immune does not realise there is a virus - the treatments cause inflammation (cryotherapy or wart paints) which stimulates the immune system so that they can find the virus causing the warts
What are cysts
Encapsulated lesion containing fluid or semi-fluid material
Usually firm and fluctulant
What is the risk with cysts
They can rupture and cause inflammation of the surrounding skin which can become infected
What is the treatment of cysts
Excision
If inflamed/infected - antibiotics
intralesional steroid
incsion and drainage
What is dermatofibroma
benign fibrous nodule which is often on the limbs
What causes the firm nodule in dermatofibroma
Proliferation of fibroblasts
What is the nodule of the dermatofibroma like
firm and tethered to the skin but can move over fat
It is pin/brown and paler in the centre
Dimple positive - if you squeeze on either side it di,ples
What is a lipoma
Benign tumour made up of fat
How do lipomas present
Smooth and rubbery and usually are asymptomatic
When should lipomas be removed
If they are tender
What is an angioma
Overgrowth of blood vessels due to over proliferating endothelial cells
What is a pyogenic granuloma
rapidly enlarging red growth which is usually a site of trauma
What is the common site of pyogenic granuloma
Hands and head
What is the treatment of pyogenic granuloma
They are treated readily since they bleed readily
They are removed by curettage and then the bottom is burnt by cautery
Which UV radiations can cause damage to the skin and increase malignancy risk
UV is immunosuppresive
UVC - filtered by the atmosphere and penetrates the epidermis
UVB - weakened by clouds and penetrates the dermis - causes burning
UVA - not weakened by clouds or glass - can penetrate down to the subcutaneous fat - causes tanning
What is bowen’s disease
intradermal squamos cell carcinoma - full thickness dysplasia which entirely contained within the epidermis
Has the potential to become malignant
It is irregular and scaly erythematous plaque
What is the treatment of Bowens
cryotherapy
curettage
photodynamic therapy
imiquimod
What can curettage be used for
Superficial lesions as it does not penetrate the dermis
What is photo-dynamic therapy
Photochemical reaction to selectively destroy cancer cells
What are the pros and cons of photodynamic therapy
can treat multiple areas and is done by hospital staff
Cons are that it can be painful and scar
What is imiquimod
An immune response modifier which stimulates release of cytokines to cause inflammation and destruction of the lesion
What is the cons of imiquimod
6x a week
significant inflammation
recurrence is a chance
What is actinic keratoses
Areas of squamous dysplasia on the surface of the skin
Low risk of transformation into squamous cell carcinoma
What is the presentation of actinic keratoses
roughly scaly patches on sun damaged skin
What is melanoma in situ
Melanoma cells entirely confined to the epidermis with no metastatic potential and can be treated by excision
What is lentigo maligna
type of melanoma in situ which usually occurs in the face
What is the difference between epidermoid and pillar cysts
epidermoid cysts - young and middle aged adults - common in acne
Pillar cyst - women more than men and in middle age
