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Systems: Dermatology AB > Benign Skin Lesions > Flashcards

Benign Skin Lesions Flashcards

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Dermatology Board Prep 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
Q

If a lipoma is tender, what else could it be?

A
  • Angiolipoma

- Liposarcoma (rare malignancy)

26
Q

Give examples of vascular lesions.

A
  • Angioma

- Pyogenic granulomas

27
Q

What is an angioma/?

A
  • Overgrowth of blood vessels in the skin due to proliferating endothelial cells
  • Generally asymptomatic. Can be unsightly or bleed
28
Q

Who is affected by angiomas?

A
  • Occur in all age groups, both sexes

- Pregnancy & liver disease

29
Q

What is the treatment for angiomas?

A
  • Excision

- Laser

30
Q

What are pyogenic granulomas?

A
  • Rapidly enlarging red/raw growth, often at a site of trauma.
  • Bleed easily
31
Q

What is the cause of pyogenic granulomas?

A

Cause unknown

32
Q

What condition do pyogenic granulomas occur in 5% of?

A

Pregnancy

33
Q

Where are the common sites of pyogenic granulomas?

A

Head and hands

34
Q

How are pyogenic granulomas treated?

A

Removed by curettage and cautery

35
Q

What is the main risk factor for pre-malignant lesions?

A

UV radiation – DNA damage and immunosuppression

36
Q

How many people are affected by acitinic keratosis?

A

Common

-Around 20% of 60yr + had at least one AK in UK study

37
Q

What can happen to acitinic keratosis?

A
  • May spontaneously resolve

- May become malignant

38
Q

What is another name for Bowen’s disease?

A

Intraepidermal squamous cell carcinoma

39
Q

What is Bowen’s disease?

A
  • Full thickness dysplasia, entirely contained within the epidermis, no metastatic potential
  • Irregular, scaly erythematous plaque
40
Q

What is the potential for Bowen’s disease to become malignant?

A

Around 5%

41
Q

How is Bowen’s disease treated?

A
  • Cryotherapy
  • Curettage
  • Photodynamic therapy
  • Imiquimod
42
Q

What is curettage?

A

Lesion scraped off and heat applied to seal vessels and destroy residual cancer cells

43
Q

What is photo-dynamic therapy?

A
  • Photochemical reaction to selectively destroy cancer cells

- Photodynamic reaction occurs between light, photosensitiser and oxygen causing inflamation and destruction of cells

44
Q

How is photo-dynamic therapy carried out?

A

-Topical photosensitising agent applied
Concentrates in cancerous cells
-Red light applied ( light colour dependant on which agent is used)

45
Q

What are the pros of photo-dynamic therapy?

A
  • 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
Q

What are the cons of photo-dynamic therapy?

A
  • Requires hospital appointments

- Can be painful and scar

47
Q

What is imiquimod?

A

Immune response modifier that stimulates cytokine release and leads to inflammation and destruction of lesion

48
Q

What are the pros of imiquimod?

A
  • Useful where surgery is undesirable
  • Usually good cosmetic result
  • Large surface area
49
Q

What are the cons of imiquimod?

A
  • Treatment time is 6 weeks
  • Significant inflammation
  • Failure/recurrence
50
Q

How is actinic keratosis treated?

A
  • Cryotherapy
  • Curettage
  • Diclofenac Gel
  • Imiquimod
51
Q

What is the risk of acitinic keratosis becoming malignant?

A

Low risk

-If average of 7.7 AK, the probability of developing an SCC within 10 years is 10%

52
Q

What is melanoma in situ?

A

Melanoma cells entirely confined to epidermis

53
Q

What is the metastatic potential of melanoma in situ?

A

No metastatic potential

54
Q

How is melanoma in situ treated?

A

Excision

55
Q

What is lentigo maligna?

A

Type of melanoma in situ

56
Q

Where does lentigo maligna usually affect?

A

Face

57
Q

Give examples of sun protection advice.

A
  • 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
Q

What is acitinic keratosis?

A

Rough scaly patches on sun damaged skin

Systems: Dermatology AB (11 decks)

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