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Systems: Dermatology AB > Benign Skin Lesions > Flashcards

Benign Skin Lesions Flashcards

1
Q

Give examples of benign skin lesions.

A
  • Seborrhoeic keratoses
  • Viral warts
  • Cysts
  • Dermatofibroma
  • Lipoma
  • Vascular lesions
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2
Q

Give examples of pre-malignant skin lesions

A
  • Bowens disease
  • Actinic Keratoses
  • Melanoma in situ
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3
Q

Describe the appearance of seborrheic keratosis.

A
  • Warty growths, “stuck on appearance”

- Can have variable appearance

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4
Q

What do patients often have alongside seborrheic keratosis?

A

Cherry angiomas

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5
Q

How are seborrheic keratosis treated?

A

Generally left untreated, but if troublesome

  • Cryotherapy
  • Curettage
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6
Q

What agent is used in cryotherapy?

A

Liquid nitrogen

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7
Q

What are the pros of cryotherapy?

A
  • Cheap

- Easy to perform “on the day”

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8
Q

What are the cons of cryotherapy?

A
  • Can scar
  • Failure/Recurrence
  • No pathology result
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9
Q

What is sign of Leser-Telat?

A
  • Paraneoplastic phenomenon

- Abrupt onset of widespread seborrhoeic keratosis, particularly in a younger individual

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10
Q

What may the SKs of sign of Leser-Trelat indicate?

A

SKs remain benign but may indicate underlying solid organ malignancy
-GI adenocarcinoma

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11
Q

What are viral warts due to?

A

Human papilloma virus

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12
Q

How do viral warts appear?

A

Rough hyperkeratotic surface

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13
Q

How are viral warts treated?

A
  • Difficult to treat
  • 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
  • Usually firm and fluctuant
  • Common. Affect ~20% adults
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15
Q

Give examples of 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 to cysts?

A
  • Can rupture and cause inflammation of surround skin

- May become secondary infected

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17
Q

How are cysts treated?

A
  • Treated with excision
  • If inflammed/infected
    • Antibiotics
    • Intralesional steroid
    • Incision & Drainage
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18
Q

What are dermatofibromas?

A
  • Benign fibrous nodule, often on limbs

- Proliferation of fibroblasts

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19
Q

What is the cause of dermatofibromas?

A

Cause is unknown but can sometimes be attributed to an area of trauma

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20
Q

How do dermatofibromas appear?

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 tende
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21
Q

When would dermatofibromas be excised?

A

If concern or symptomatic

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22
Q

What are lipomas?

A

Benign tumour consisting of fat cells

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23
Q

What is the cause of lipomas?

A

Cause unknown

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24
Q

How do lipomas appear?

A
  • Smooth and rubbery subcutaneous mass

- Usually asymptomatic

25
If a lipoma is tender, what else could it be?
- Angiolipoma | - Liposarcoma (rare malignancy)
26
Give examples of vascular lesions.
- Angioma | - Pyogenic granulomas
27
What is an angioma/?
- Overgrowth of blood vessels in the skin due to proliferating endothelial cells - Generally asymptomatic. Can be unsightly or bleed
28
Who is affected by angiomas?
- Occur in all age groups, both sexes | - Pregnancy & liver disease
29
What is the treatment for angiomas?
- Excision | - Laser
30
What are pyogenic granulomas?
- Rapidly enlarging red/raw growth, often at a site of trauma. - Bleed easily
31
What is the cause of pyogenic granulomas?
Cause unknown
32
What condition do pyogenic granulomas occur in 5% of?
Pregnancy
33
Where are the common sites of pyogenic granulomas?
Head and hands
34
How are pyogenic granulomas treated?
Removed by curettage and cautery
35
What is the main risk factor for pre-malignant lesions?
UV radiation – DNA damage and immunosuppression
36
How many people are affected by acitinic keratosis?
Common | -Around 20% of 60yr + had at least one AK in UK study
37
What can happen to acitinic keratosis?
- May spontaneously resolve | - May become malignant
38
What is another name for Bowen's disease?
Intraepidermal squamous cell carcinoma
39
What is Bowen's disease?
- Full thickness dysplasia, entirely contained within the epidermis, no metastatic potential - Irregular, scaly erythematous plaque
40
What is the potential for Bowen's disease to become malignant?
Around 5%
41
How is Bowen's disease treated?
- Cryotherapy - Curettage - Photodynamic therapy - Imiquimod
42
What is curettage?
Lesion scraped off and heat applied to seal vessels and destroy residual cancer cells
43
What is photo-dynamic therapy?
- Photochemical reaction to selectively destroy cancer cells | - Photodynamic reaction occurs between light, photosensitiser and oxygen causing inflamation and destruction of cells
44
How is photo-dynamic therapy carried out?
-Topical photosensitising agent applied Concentrates in cancerous cells -Red light applied ( light colour dependant on which agent is used)
45
What are the pros of photo-dynamic therapy?
- Done for the patient by hospital staff - Can treat multiple areas, including those which would be hard to reach by patient - 1 or 2 treatments
46
What are the cons of photo-dynamic therapy?
- Requires hospital appointments | - Can be painful and scar
47
What is imiquimod?
Immune response modifier that stimulates cytokine release and leads to inflammation and destruction of lesion
48
What are the pros of imiquimod?
- Useful where surgery is undesirable - Usually good cosmetic result - Large surface area
49
What are the cons of imiquimod?
- Treatment time is 6 weeks - Significant inflammation - Failure/recurrence
50
How is actinic keratosis treated?
- Cryotherapy - Curettage - Diclofenac Gel - Imiquimod
51
What is the risk of acitinic keratosis becoming malignant?
Low risk | -If average of 7.7 AK, the probability of developing an SCC within 10 years is 10%
52
What is melanoma in situ?
Melanoma cells entirely confined to epidermis
53
What is the metastatic potential of melanoma in situ?
No metastatic potential
54
How is melanoma in situ treated?
Excision
55
What is lentigo maligna?
Type of melanoma in situ
56
Where does lentigo maligna usually affect?
Face
57
Give examples of sun protection advice.
- Cover up - Avoid sun at peak hours (10am-4pm) - Don’t burn and try not to tan - Avoid sunbeds - Sunscreen (UVA & UVB protection, at least SPF 30 / 4 Star, need to apply 2 tablespoons every 2 hours)
58
What is acitinic keratosis?
Rough scaly patches on sun damaged skin

Systems: Dermatology AB (11 decks)

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