Benign Skin Lesions

Question 1

What are the identifying features of Seborrhoeic Keratoses?

Answer 1

• Benign
• Warty growths -> “stuck-on” appearance
• Pts have multiple +/- cherry angiomas
• Sign of Leser-Trelat
• > abrupt onset of widespread seborrhoeic keratoses
• > sign of underlying GI adenocarcinoma (paraneoplastic phenomenon)

Question 2

What is the treatment of Seborrhoeic Keratoses?

Answer 2

• Generally left untreated

but if troublesome..

• Cryotherapy (liquid nitrogen)
• Curettage

Question 3

What is the underlying cause of viral warts?

Answer 3

HPV

Question 4

What is the treatment of viral warts?

Answer 4

• Self-limiting - will clear when immunity developed to virus
• Cryotherapy or wart paints - can stimulate immune system slightly
• Can currette - in severe cases

Question 5

What are the identifying features of Dermatofibroma?

Answer 5

• Benign fibrous nodule, often on limbs
• Firm nodule, tethered to skin but mobile over fat -> pale pink/brown -> often paler in the centre
• Dimple sign positive
• Usually asymptomatic
• Excision if concern or symptomatic

Question 6

What are the identifying features of Lipoma?

Answer 6

• Benign tumour consisting of fatcells
• Smooth and rubbery S/C mass
• If tender: sample to exclude possible malignancy

Question 7

What are Angiomas a sign of?

Answer 7

• cherry angiomas, spider naevi, venous lakes*
• Pregnancy
• Liver disease

Question 8

What are the identifying features of Pyogenic Granulomas?

Answer 8

• Rapidly enlarging red/raw growth, often at a site of trauma
• > “gardener who pricks his finger on a rosebush and develops one of these on his finger.”
• Bleed easily
• Common on head and hands
• Larger ones are removed by curettage and cautery

Question 9

What is Bowen’s disease?

Answer 9

• Early form of skin cancer (dysplasia)
• Entirely contained within the Epidermis
• Potential for malignancy
• Irregular, scaly erythematous plaque

Question 10

What is the treatment of Bowen’s disease?

Answer 10

• Cryotherapy + Curettage
• Imiquimod cream
• Photodynamic Therapy

Question 11

What is Actinic Keratoses?

What is its treatment?

Answer 11

• Rough, scaly patches on sun damaged skin

- Treated by Cryotherapy, Curettage, Diclofenac gel or Imiquimod

Question 12

What are the different pre-malignant skin lesions?

Answer 12

• Bowen’s disease
• Actinic Keratoses
• Melanoma in situ
• Lentigo Maligna

Question 13

What is the treatment of Melanoma in situ?

Answer 13

Surgical excision!!