Benign Lesions

Question 1

How are seborrheic keratoses treated?

Answer 1

Generally left untreated

If troublesome - cryotherapy or curettage

Question 2

How are cysts treated?

Answer 2

Excision

If troublesome: antibiotics, intralesional steroids, incision/drainage

Question 3

What may seborrheic keratoses indicate?

Answer 3

Abrupt onset could be Leser-Trelat

Indicating underlying malignancy

Question 4

What is a dermatofibroma? How is treated?

Answer 4

Benign fibrous nodule, often on limbs - proliferation of fibroblasts
Firm nodule, tethered to skin but mobile over fat
Excision if concern/symptomatic

Question 5

What are some examples of benign vascular lesions?

Answer 5

Angioma - excision or laser

Pyogenic granuloma - curettage and cautery

Question 6

What are some pre-malignant skin lesions?

Answer 6

Actinic keratoses - cryotherapy, curettage, diclofenac gel, imiquimod
Bowen’s disease aka intraepidermal SCC - cryotherapy, curettage, photodynamic therapy, imiquimod
Melanoma in situ - excision

Question 7

How does imiquimod work?

Answer 7

Immune response modifier

• stimulates cytokine release
• inflammation and destruction of lesions

Question 8

What sunscreen advice should be given?

Answer 8

Cover-up
Avoid peak hours 10am-4pm
Don't burn, avoid tanning
Avoid sunbeds
Sunscreen with UVA and UVB protection
- at least SPF30/4 star
Apply 2tbsp every 2 hours