benign and premalignant lesions Flashcards

1
Q

What is seborrheic keratoses

A

benign warty growths

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2
Q

How does seborrhoeic keratoses present

A

Usually there are multiple on a patient

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3
Q

What is the management of seborrhoeic keratoses

A

Usually left untreated unless it is causing issues

Cryotherapy (freezing the warts off) or curettage (scraping warts off) can be done

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4
Q

What is used in cryotherapy

A

liquid nitrogen

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5
Q

What are the negatives of cryotherapy

A

they can scar and can reoccur

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6
Q

What is the sign of Leser-Trelat

A

Abrupt onset of widespread seborrhoeic keratosis

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7
Q

What can the sign of Leser-Trelat indicate

A

Underlying solid organ malignancy - usually GI carcinoma

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8
Q

What causes viral warts

A

human papilloma virus

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9
Q

How does the treatment of viral warts work

A

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

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10
Q

What are cysts

A

Encapsulated lesion containing fluid or semi-fluid material

Usually firm and fluctulant

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11
Q

What is the risk with cysts

A

They can rupture and cause inflammation of the surrounding skin which can become infected

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12
Q

What is the treatment of cysts

A

Excision

If inflamed/infected - antibiotics
intralesional steroid
incsion and drainage

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13
Q

What is dermatofibroma

A

benign fibrous nodule which is often on the limbs

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14
Q

What causes the firm nodule in dermatofibroma

A

Proliferation of fibroblasts

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15
Q

What is the nodule of the dermatofibroma like

A

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

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16
Q

What is a lipoma

A

Benign tumour made up of fat

17
Q

How do lipomas present

A

Smooth and rubbery and usually are asymptomatic

18
Q

When should lipomas be removed

A

If they are tender

19
Q

What is an angioma

A

Overgrowth of blood vessels due to over proliferating endothelial cells

20
Q

What is a pyogenic granuloma

A

rapidly enlarging red growth which is usually a site of trauma

21
Q

What is the common site of pyogenic granuloma

A

Hands and head

22
Q

What is the treatment of pyogenic granuloma

A

They are treated readily since they bleed readily

They are removed by curettage and then the bottom is burnt by cautery

23
Q

Which UV radiations can cause damage to the skin and increase malignancy risk

A

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

24
Q

What is bowen’s disease

A

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

25
What is the treatment of Bowens
cryotherapy curettage photodynamic therapy imiquimod
26
What can curettage be used for
Superficial lesions as it does not penetrate the dermis
27
What is photo-dynamic therapy
Photochemical reaction to selectively destroy cancer cells
28
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
29
What is imiquimod
An immune response modifier which stimulates release of cytokines to cause inflammation and destruction of the lesion
30
What is the cons of imiquimod
6x a week significant inflammation recurrence is a chance
31
What is actinic keratoses
Areas of squamous dysplasia on the surface of the skin Low risk of transformation into squamous cell carcinoma
32
What is the presentation of actinic keratoses
roughly scaly patches on sun damaged skin
33
What is melanoma in situ
Melanoma cells entirely confined to the epidermis with no metastatic potential and can be treated by excision
34
What is lentigo maligna
type of melanoma in situ which usually occurs in the face
35
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