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Year 2 - Dermatology > Benign + premalignant skin lesions > Flashcards

Benign + premalignant skin lesions Flashcards

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Dermatology Board Prep flashcards
1
Q

Name 3 premalignant skin lesions

A

Bowens disease
Actinic Keratoses
Melanoma in situ

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2
Q

Name 6 benign skin lesions

A 
Viral warts 
Epidermoid and pilar cysts 
Seborrhoeic keratoses 
Dermatofibroma 
Lipoma 
Vascular lesions
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3
Q

When describing a skin lesion, what characteristics of it should be included

A 
Site
Size
Shape
Colour
Mobility
Texture
Temperate
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4
Q

Clinical features of seborrhoeic keratoses

  • number
  • appearance
  • where
  • colour
A

MULTIPLE well-circumscribed ‘stuck-on’ GREASY plaques/papules that look like warts

usually on trunk

yellow/brown

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5
Q

Seborrhoeic keratoses typically affects what age group

A

40s-50s

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6
Q

What benign vascular lesion is associated with seborrhoeic keratoses

A

cherry angiomas - bright red spots

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7
Q

Seborrhoeic keratoses generally left untreated because not troublesome but if irritated, itching, and displeasing, then can be treated with (2)

A

cryotherapy

curettage (scraping them off)

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8
Q

Cryotherapy involves the use of what substance

A

liquid nitrogen

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9
Q

What is the leser-trelat sign

A

Abrupt onset of widespread seborrhoeic keratosis, particularly in a younger individual associated with an underlying malignancy; not direct result but paraneoplastic effect

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10
Q

Leser-trelat sign may indicate what underlying malignancy

A

GI cancer

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11
Q

What differentiates a cyst from an abscess

A

Cyst contains non-infected fluid while abscess contains infected fluid

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12
Q

Most common type of cyst

A

Epidermoid - i.e. epidermis like cells lining the wall of the cyst

affects young/middle aged

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13
Q

Pilar cysts are seen where

A

Scalp

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14
Q

Epidermoid cysts are often confused with what cyst

A

sebaceous cyst

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15
Q

Clinical features of an epidermoid cyst - face, neck, chest (2)

A

firm, elastic, dome-shaped lesion

central keratin-filled punctum may be present

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16
Q

Cysts may get infected and consequently enlarge, becoming red and tender and discharge pus

Treatment of acutely infected cysts (3)

A

Antibiotics
Intralesional steroid - calms inflammation
Incision & Drainage - removing whole sac as sac can refill again if you only drain the fluid

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17
Q

Clinical features of a dermatofibroma

  • firm or soft
  • mobility
  • colour
  • what do you see when you squeeze it
A

Firm nodule,

tethered to skin but mobile over fat (moves with skin)

Pale pink/brown

Dimple sign

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18
Q

Dermatofibromas commonly seen where

A

Lower legs

Upper arms

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19
Q

Treatment if dermatofibroma becomes symptomatic/concerning

A

Excision

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20
Q

What is a lipoma

A

Benign tumour of adipose tissue

21
Q

Clinical features of a lipoma

  • texture
  • mobility
  • superficial/deep
  • size
A

soft,
mobile
superficial

quite big and lumpy <5cm

22
Q

Lipomas could be confused with

A

liposarcomas which have potential to be malignant unlike lipomas

23
Q

Benign vascular lesions include (2)

A

angioma

pyogenic granuloma

24
Q

What is an angioma

A

Overgrowth of blood vessels in the skin due to endothelial hyperplasia (i.e. dilated vessel)

25
Q

Clinical features of angiomas

  • soft or hard
  • colour
  • distribution
A

Soft papules/nodules

Red/ blue/ purple

usually on trunk

26
Q

Angiomas aren’t usually treated but if they start catching on things or bleeding then can be removed by (2)

A

Curettage

Laser

27
Q

What form of angioma is associated with liver disease

A

Spider naevi

28
Q

What is a pyogenic granuloma + initiating factor

A

Sudden onset rapidly growing vascular lesion (rapid overgrowth of tiny blood vessels), often resulting from trauma

29
Q

Clinical feature of a pyogenic granuloma

  • colour
  • texture

usually asymptomatic but vulnerable to what

A

Starts as a small deep red lesion but quickly enlarges into a nodule

Initially smooth and shiny, but often becomes eroded and crusty after they’ve bled

bleeds significantly on mild contact

30
Q

Treatment of pyogenic granuloma

A

Curettage + cautery of area left behind

31
Q

Risk factors of premalignant skin lesions

A

UV radiation

32
Q

How does UV radiation predispose to premalignancy

A

Causes DNA damage + immunosuppression

33
Q

Describe the spectrum normal/benign cells proceed through to become a malignancy (5)

A

Benign –> hyperplasia – dysplasia –> in situ disease –> invasive malignancy

34
Q

What happens to cells in dysplasia (3)

A

Nuclei change, DNA damage, shape change

35
Q

What is wrong with cells in situ disease

A

cells look cancerous under microscope, but not cancer because haven’t invaded anywhere, cell is still where it should be, e.g. epidermal cell is still in epidermis

36
Q

Clinical features of actinic keratoses

  • type of lesion
  • shape
  • texture
  • scaling?
  • colour
A

Irregularly shaped rough hyperkeratotic scaly macules/plaques

yellow/brown

37
Q

Biggest risk factor of actinic keratoses

A

Chronic sun exposure/ sun damage

38
Q

Actinic keratoses (premalignant lesion) may progress to what skin cancer type

A

Squamous cell carcinoma

39
Q

Treatment of actinic keratoses

  • destructive methods (2)
  • topical methods (3)
A

Destructive

  • Cryotherapy
  • Curettage

Topical

  • fluorouracil - interferes with DNA/RNA synthesis
  • imiquimod,
  • diclofenac gel
40
Q

What is Bowen’s disease

A

Squamous cell carcinoma in situ

entirely contained within epidermis

41
Q

Clinical feature of Bowen’s disease (premalignant disease)

A

Irregular scaly erythematous plaque

42
Q

Risk of Bowen’s disease (premalignant lesion) becoming malignant

A

Low

43
Q

Bowen’s disease is often confused with what skin conditions

A

Eczema or psoriasis because it’s an red scaly plaque

44
Q

Treatment of Bowen’s disease (4)

A

Cryotherapy

Curettage + electrocautery (to seal vessel and destroy residual cells)

Photodynamic therapy

Topical imiquimod

45
Q

How does photodynamic therapy work in treating Bowen’s disease

A

Photochemical reaction to selectively destroy cancer cells

  • topical photosensitising agent applied to cancerous cells
  • then red light applied to trigger photodynamic reaction of the photosensitive agent absorbed into the cancerous cells and destroys the cells
46
Q

Topical imiquimod can be used for the premalignant lesions (actinic keratinosis and Bowen’s disease), viral warts and superficial basal cell carcinomas - what does it do/mechanism of action

A

Is an immunotherapy cream, i.e. modifies immune response
-activates the immune system to recognise abnormal cells by flagging the abnormal cells which stimulates cytokine release –> causes inflammation and destruction of lesion

47
Q

Melanoma in situ (a premalignant lesion) aka stage 0 melanoma is confined to which layer of skin + since it is in situ, it has no … potential

A

epidermis

metastatic

48
Q

Melanoma in situ treatment

A

Excision with 5mm margin

Year 2 - Dermatology (10 decks)

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