Benign Lesions Flashcards
Includes:
Seborrhoeic Keratoses Viral warts # Cysts Dermatofibromas Lipomas Angiomas Pyogenic Granulomas
Patient presents with an encapsulated lesion on the skin, it contains fluid and is firm but mobile on the skin. What is it? [2]
A cyst. Most likely an epidermoid cyst
How would you treat a sebaceous cyst in the skin? [4]
Excision with complete removal of cyst wall to prevent recurrence
If they’re infected you’ll need:
- Antibiotics
- Intralesional steroids
- Incision & Drainage
Patient presents with rough hyperkeratotic surfaces containing black spots of blood vessels. Mainly around the fingers. Whats the most likely diagnosis? [2]
Viral Wart. Brought on by the HPV virus
How do we treat viral warts? [2]
- Chemical paints and cryotherapy to stimulate immune system
- Currete if severe or painful ones.
Patient comes in with multiple “warty” growths with a stuck on appearance. They have nearby cherry angiomas?
Seborrhoeic Keratoses are dark brown and appear to be stuck on. Can be greasy (look like rough moles)
How would you treat seborrhoeic keratoses? [2]
Mostly you leave them, they may even fall off themselves.
If they’re troublesome you can currette them or use cryotherapy
What do you think if seborrhoeic keratoses appear suddenly? (multiple warty “stuck on” growths)? [2]
Leser-Trelat Syndrome
Its a paraneoplasic syndrome resulting from GI adenocarcinomas
Most people have firm fibrous nodules that are pale pink/brown and may be itchy/tender. What are they? [2]
Proliferations of fibroblasts at the site of minor trauma e.g. insect bites known as dermatofibromas
They dimple when you pinch them
Dermatofibromas
Define [2]
Appearance [4]
Management [2]
Benign neoplasm of dermal fibroblasts containing histiocytes, blood vessels and fibrotic changes
App: brown pigmented nodule, firm and woody, intradermal ie can be moved over subcutaneous tissue, dimples when pinched
Leave it unless its causing itching or tenderness, or if its potentially developing malignancy. Then you must excise it
Patient presents with a smooth rubbery subcutaneous mass thats quite mobile. its completely asymptomatic. Give 2 differentials
Probably a lipoma (benign adipose tumour)
If its tender that might indicate an angiolipoma
A patient comes in with a number of red nodules with spider naevi, upon dermatoscopy you see venous lakes in the nodule. What is it? [1]
An angioma.
Due to proliferation of blood vessels
Often found during pregnancy or liver disease
How do treat an angioma [2]
Excision or laser ablation
Patient with a red raw growth on hand that bleeds?
RF [2]
Appearance [3]
Mx
Pyogenic Granuloma
RF: previous trauma, pregnancy
Sy/Si:
- bright red hemi-spherical nodule on hands, face, gums and lips
- that may have purulent discharge
- soft and bleed very easily (may mimic amelanotic melanoma)
Mx: cutterage and diathermy at base
What is a complication of lipoma
Sarcomatous transformation
Lipomas: when to intervene
Surgical excision if causing pressure symptoms or features indicative of sarcomatous change
Sebaceous cyst
Types - differentiate between the 2
Epithelial lined cyst containing keratin
- Epidermoid cyst: proliferation of epidermal cells in dermis
- Pilar cyst: arise from outer root sheath of hair follicle
Sebaceous cyst
Presentation [2]
Sites: hair growth areas eg scalp, face, neck, chest, back, never on soles, palms
App: typically have punctum and are firm, smooth, intradermal
Neurofibroma [2]
Appearance [3]
Mx [1]
Benign nerve sheath tumour arising from Schwann cells, can be associated with neurofibromatosis type I
Appearance:
- Solitary/multiple pedunculate nodules
- Fleshy consistency
- Pressure can cause paresthesia
Mx: surgical excision if malignant growth suspected
Papilloma [1]
Associated with [2]
Appearance [2]
Mx [2]
Overgrowth of all skin layers with a central vascular core; assoc. w/ HPV 6 and 11
Appearance: skin tag or fibre-epithelial polyp, pedunculate, flesh colored
Mx: excision, diathermy if trauma to control bleeding
Pyogenic granuloma [1]
Risk factors [2]
Presentation [3]
Mx [1]
Rapidly growing capillary haemangioma (neither actually pyogenic or a granuloma)
RF: previous trauma, pregnancy
Sxs: bright red hemi-spherical nodule on hands, face, gums and lips that may have purulent discharge; soft and bleed very easily (may mimic amelanotic melanoma)
Mx: cutterage and diathermy at base
Dermoid cyst 2 types [4] (causal) Appearance [3] Ix [1] Mx [1]
- Congenital (inclusion): inclusion of epidermis along sides of skin fusion; usually occur in midline of neck or nose and at medial and lateral ends of eyebrows
- Acquired (implantation): implantation of epidermis into dermis, often secondary to trauma e.g. piercing
- Smooth spherical swelling at sites of embryological fusion,
- may scar at recurrence
- soft, tender and subcutaneous
Ix: CT if congenital
Mx: surgical excision
Keratocanthoma Define Appearance [3] Prognosis Mx [2]
Define: benign overgrowth of hair follicle cells
App: fast growing intradermal dome shaped lesion with a keratin plug
Prog: usually regress in 6w
Mx: excision and histology to reduce scarring and excl. well differentiated SCC
Granuloma Annulare Epidemiology Aetiology Appearance [4] Mx
Ep: skin of teenagers and young adults
Ax: delayed hypersensitivity to part of dermis
Sy/Si: papular lesions that are often slightly hyper pigmented and depressed centrally, typically occur on dorsal surfaces of hands and feet and extensor aspects of arms and legs
Mx: not rqd
