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5. Dermatology (Med) > Benign Skin Lesions > Flashcards

Benign Skin Lesions Flashcards

1
Q

What is used to describe a skin lesion?

A

Site

Size

Shape

Colour

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2
Q

When palpating a skin lesion, what are we checking?

A

Mobility

Surface changes

Temperature

Consistency

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3
Q

What are some examples of different kinds of benign skin lesions?

A
  • Seborrhoeic keratosis
    • Causing Sign of Leser-Trelat
  • Viral warts
  • Cysts
  • Dermatofibroma
  • Lipoma
  • Vascular lesions
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4
Q

What does SK stand for?

A

Seborrhoeic keratoses (SK)

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5
Q

What is seborrhoeic keratoses?

A

Warty growths, stuck out appearance

Patients often have multiple

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6
Q

What is the treatment of seborrhoeic keratoses?

A

Causes sign of Leser-Trelat, which is a paraneoplastic phenomenon with abrupt onset of widespread seborrheic keratosis:

  • Particularly in younger person
  • Usually benign but may indicate underlying solid organ malignancy
    • Such as GI adenocarcinoma
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7
Q

What does cyrotherapy utilise?

A

Liquid nitrogen

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8
Q

What are the pros of cyrotherapy?

A
  • Cheap
  • Easy to perform on the day
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9
Q

What are the cons of cyrotherapy?

A
  • Can scar
  • Failure/recurrence
  • No histology
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10
Q

What is cyrotherapy?

A

Use of low temperatures in medical therapy

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11
Q

What causes viral warts?

A

Human papilloma virus

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12
Q

Describe the lesion due to viral warts?

A

Rough hyperkeratotic surface

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13
Q

What is the treatment of viral warts?

A
  • Will clear when immunity developed to virus
  • Cryotherapy or wart paints can stimulate immune system slightly
  • Can curette in severe cases
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14
Q

What are cysts?

A

Encapsulated lesion containing fluid or semi-fluid material

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15
Q

What are some different types of cysts?

A
  • Epidermoid cyst (often wrongly called sebaceous)
  • Pilar cyst
  • Steatocystoma
  • Dermoid cyst
  • Hidrocystoma
  • Ganglion cyst
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16
Q

What can happen if a cyst ruptures?

A

Inflammation of surrounding skin, may become secondary infected

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17
Q

What is the treatment of cysts?

A
  • Excision
  • If inflamed/infected
    • Antibiotics
    • Intralesional steroid
    • Incision and damage
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18
Q

What is dermatofibroma?

A

Benign fibrous nodule, often on limbs:

Proliferation of fibroblasts

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19
Q

What is the aetiology of dermatofibroma?Cause is unknown, sometimes due to area of trauma

A

Cause is unknown, sometimes due to area of trauma

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20
Q

Describe the lesion due to dermatofibroma?

A

Firm nodule, tethered to skin but mobile over fat, pale pink/brown often paler in centre

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21
Q

What is the clinical presentation of dermatofibroma?

A

Firm nodule, tethered to skin but mobile over fat, pale pink/brown often paler in centre

Dimple sign positive

Usually asymptomatic, can be itchy or tender

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22
Q

What is the treatment for dermatofibroma?

A

Excision if concern of symptomatic

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23
Q

What is lipoma?

A

Benign tumour consisting of fat cells

24
Q

Is lipoma common or uncommon?

25
Describe the lesion due to lipoma?
Smooth and rubbery subcutaneous mass
26
What is the clinical presentation of lipoma?
Usually asymptomatic
27
What are 2 types of vascular lesions?
* Angioma * Overgrowth of blood vessels in skin due to proliferating endothelial cells * Usually asymptomatic, can be unsightly or bleed * Occurs in pregnancy and liver disease * Excision or laser * Pyogenic granuloma * Rapidly enlarging red/raw growth, often at site of trauma * Bleeds easily * Cause is unknown * Common on head and hands * Removed by curettage and cautery
28
What is angioma?
* Overgrowth of blood vessels in skin due to proliferating endothelial cells
29
What is the clinical presentation of angioma?
Usually asymptomatic, can be unsightly or bleed
30
In who does angioma usually occur?
Pregnancy and liver disease
31
What is the treatment of angioma?
Excision or laser
32
What is pyogenic granuloma?
* Rapidly enlarging red/raw growth, often at site of trauma
33
What is the aetiology of pyogenic granuloma?
Unknown
34
What is the treatment of pyogenic granuloma?
Removed by curettage and cautery
35
Where on the body is pyogenic granuloma most common?
Head and hands
36
What is the main risk factor for pre-malignant lesions?
* UV radiation * Causes DNA damage and immunosuppression * Ultraviolet radiation is split into vacuum UV, UVC, UVB and UVA (in order of decreasing frequency)
37
What are the different kinds of ultraviolet radiation in order of decreasing frequency?
Vacuum UV UVC UVB UVA
38
What are some examples of pre-malignant tumours?
* Actinic keratoses * Bowen’s disease * Melanoma in situ
39
Describe the spectrum of damaged cells?
1) Normal/benign 2) Hyperplasia 3) Dysplasia 4) In-situ disease 5) Invasive malignancy
40
What is actinic keratoses?
Rough scaly patches on sun damaged skin
41
How high is the risk of actinic keratoses transforming to SCC?
Low risk
42
What is the treatment for actinic keratoses?
* Cryotherapy * Curettage * Diclofenac gel * Imiquimod
43
What is Bowen's disease?
Squamous cell carcinoma in situ: * Full thickness dysplasia, entirely contained within the epidermis * No metastatic potential * Potential to become malignant (around 5%)
44
Describe the lesion due to Bowen's disease?
Irregular, scaly erythematous plaque
45
What is the treatment of Bowen's disease?
* Cryotherapy * Curette * Lesion scrapped off and heat applied to seal vessels and destroy residual cancer cells * Photodynamic therapy * Photochemical reaction to selectively destroy cancer cells * Topical photosensitising agent applied * Concentrates in cancerous cells * Red light applied and photodynamic reaction occurs * Imiquimod * Called Aldara and is topical cream * Immune response modifier * Stimulates cytokine response, causing inflammation and destruction of lesion * Pros * Useful where surgery undesirable * Good cosmetic result * Cons * Treatment time is 6 weeks * Signifianct inflammation * Failure/recurrence
46
Describe a curette procedure?
* Lesion scrapped off and heat applied to seal vessels and destroy residual cancer cells
47
What is photodynamic therapy?
* Photochemical reaction to selectively destroy cancer cells * Topical photosensitising agent applied * Concentrates in cancerous cells * Red light applied and photodynamic reaction occurs
48
How is imiquimob administered?
Topical cream
49
What is the mechanism of action of imiquimod?
* Immune response modifier * Stimulates cytokine response, causing inflammation and destruction of lesion
50
What are the pros of imiquimob?
* Useful where surgery undesirable * Good cosmetic result
51
What are the cons of imiquimob?
* Treatment time is 6 weeks * Significant inflammation * Failure/recurrence
52
What is melanoma in situ?
Melanoma cells entirely confined to epidermis No metastatic potential
53
Does melanoma in situ have any metastatic potential?
No
54
What is the treatment for melanoma in situ?
Excision
55
What are some ways to protect yourself from the sun?
Cover up Avoid sun at peak hours Don’t burn and try not to tan Avoid sunbeds Suncreen: * UVA and UVB protected * At least SPF 30/4 star * Need to apply 2 tablespoons every 2 hours
56
How much sunscreen should be applied to be effective?
* UVA and UVB protected * At least SPF 30/4 star * Need to apply 2 tablespoons every 2 hours

5. Dermatology (Med) (11 decks)

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