Benign and Premalignant Skin Lesions Flashcards
Describe seborrhoeic keratoses
Benign but commonly referred
Warty growths - stuck on appearance
Can be variable appearance
Can have multiple cherry angiomas
Generally left untreated
What is the treatment for seborrhoeic keratoses if troublesome?
Cryotherapy
Curettage - scraping off
What is crytotherapy?
Liquid nitrogen
Pros - cheap and easy to perform
Cons - can scar, failure/ recurrence and no pathology result
What is the sign of Leser-Trelat?
Paraneoplastic phenomenon
Abrupt onset of widespread seborrhoeic keratosis, particularly in younger individual
SKs remain benign but may indicate underlying solid organ malignancy
Describe viral warts
Due to human papilloma virus
Rough hyperkeratotic surface
Difficult to treat
Will clear when immunity developed to virus
What is the treatment for viral warts?
Cryotherapy or wart paints can stimulate immune system slightly
Can curette in severe cases
Describe cysts
Encapsulated lesion containing fluid or semi-fluid material
Usually firm and fluctuant
Common and affect around 20% of people
What are the multiple types of cysts?
Epidermoid cysts - puncture
Pilar cyst - hair root sheath
Steatocystoma - sebaceous cyst
Dermoid cyst
Hidrocystoma - around eye
Ganglion cyst - degeneration of mucosal tissue of joint
What is the treatment for cysts?
Excision
If inflamed or infected - antibiotics, intralesional steroid and incision + drainage
What is the risks of cysts?
Can rupture and cause inflammation of surrounding skin
May become secondary infected
Describe dermatofibroma
Benign fibrous nodule and often on limbs - proliferation of fibroblasts
Cause is unknown but sometimes on an area of trauma
Excision if concerned or symptomatic
What are the symptoms of dermatofibroma
Form nodule, tethered to skin but mobile over fat
Pale pink/ brown and often paler in the centre
Dimple sign positive
Usually asymptomatic but can be itchy or tender
Describe a lipoma
Benign tumour of fat cells
Common and cause unknown
Smooth and rubbery subcutaneous mass which is usually asymptomatic
What are the possible diagnosis if the lipoma is tender?
Angiolipoma
Liposacrcoma - rare malignancy
What are some vascular lesions?
Angioma
Pyogenic granuloma
Describe an angioma
Overgrowth of blood vessels in skin due to proliferating endothelial cells
Generally asymptomatic but can slightly bleed
Excision or laser
What groups are at risk of angiomas?
Occurs in all age groups and both sexes
Pregnancy and liver disease
What are some types of angiomas?
Cherry angiomas
Spider naevi
Venous lakes - dilated venules
Describe pyogenic granulomas
Rapidly enlarging red/ raw growth, often at site of trauma
Bleed easily
Cause is unknown
Common on head and hands
How are pyogenic granulomas removed?
Curettage and cautery
What is a risk factors for pre-malignant lesions?
UV radiation - DNA damage and immunosuppression
UVB and UVA can penetrate down into subcutaneous layer
What is Bowman’s disease?
Intraepidermal squamous cell carcinoma
Is full thickness dysplasia, contained in epidermis with no metastatic potential
5% chance of becoming malignant
What is the appearance of Bowman’s disease?
Irregular, scaly erythematous plaque
What is the treatment for Bowman’s disease?
Cryotherapy and curettage - lesion scraped off and heat applies to seal vessels and destroy residual cancer cells
Photodynamic therapy
Imiquimod
