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Dermatology > Benign skin lesions > Flashcards

Benign skin lesions Flashcards

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Dermatology Board Prep flashcards
1
Q

Describe Sebborrhoeic keratosis

A

• Benign, but commonly referred
• Warty growths, “stuck on appearance”
• Can have variable appearance
• Patients often have multiple +/- cherry angiomas
• Generally left untreated, but if troublesome
– Cryotherapy
– Curettage

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2
Q

How is Sebborrhoeic keratosis treated?

A

– Cryotherapy
– Curettage

generally left untreated, only removed if troublesome

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3
Q

What are the pros and cons of cryotherapy?

A 
Pros	
–	Cheap
–	Easy to perform “on the day”
Cons
–	Can scar
–	Failure/Recurrence
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4
Q

What is cryotherapy?

A

Liquid nitrogen (extremely cold) is used to destroy abnormal skin lesions

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5
Q

Describe Leser-Trelat sign

A

Paraneoplastic phenomenon of abrupt onset of widespread seborrhoeic keratosis, particularly in a younger individual

SKs remain benign but may indicate underlying solid organ malignancy
– GI adenocarcinoma, must always investigate

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6
Q

What is Leser-Trelat sign often a sign of?

A

SKs remain benign but may indicate underlying solid organ malignancy
– GI adenocarcinoma, must always investigate

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7
Q

What virus causes viral warts?

A

Human Papilloma Virus

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8
Q

Describe viral warts

A
  • Due to Human Papilloma Virus
  • Rough hyperkeratotic surface
  • Difficult to treat
  • Will clear when immunity developed to virus
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9
Q

How are viral warts treated?

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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10
Q

What is a cyst?

A
  • Encapsulated lesion containing fluid/semi-fluid matter
  • Usually firm and fluctuant
  • Common. Affect ~20% adults
  • Multiple different types of cyst exist
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11
Q

Describe an epidermoid cyst

A

– Epidermoid cyst (wrongly called sebaceous) – hard lumps under skin, grow slowly

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12
Q

Describe a pilar cyst

A

– Pilar cyst – cyst that develops from hair follicle

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13
Q

Describe a steatocystoma

A

Steatocystoma – cyst growth from sebaceous glands

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14
Q

Describe a dermoid cyst

A

– Dermoid cyst – teratoma containing hair follicles, epidermis and glands from residual embryonic cells

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15
Q

Describe a hidrocystoma

A

– Hidrocystoma – adenoma of sweat glands, usually on eyelid

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16
Q

Describe a ganglion cyst

A

– Ganglion cyst – spongy swelling on top of joint or tendon

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17
Q

What are the complications often seen with cysts?

A

Can rupture and cause inflammation of surrounding skin
May become secondary infected

Treated with excision

If inflammed/infected
– Antibiotics
– Intralesional steroid
– Incision & Drainage

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18
Q

How are inflamed/infected cysts treated?

A

– Antibiotics
– Intralesional steroid
– Incision & Drainage

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19
Q

Describe dermatofibromas

A

• Benign fibrous nodule, often on limbs
– Proliferation of fibroblasts
• Cause is unknown. They are sometimes attributed to an area of trauma.
• Firm nodule, tethered to skin but mobile over fat. Pale pink/brown. Often paler in centre.
• Dimple sign positive

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20
Q

What benign skin lesions have positive dimple signs?

A

Dermatofibromas

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21
Q

How are dermatofibromas treated?

A
  • Usually asymptomatic. Can be itchy or tender

* Excision if concern or symptomatic.

22
Q

What is classified as a positive dimple sign?

A

Dimple sign positive – when lateral pressure on the skin causes a depression

23
Q

If someone presents with a firm nodule found on a limb that is tethered to skin/mobile over fat, and is a pale pink/brown which is paler in the centre, what would you suspect?

A

Dermatofibroma

24
Q

What condition is associated with an acute onset of widespread seborrhoeic keratosis, particularly in a younger individual?

A

Leser-Trelat paraneoplastic syndrome - GI cancer??

25
Q

Describe a lipoma

A
  • Benign tumour consisting of fat cells
  • Common
  • Cause unknown
  • Smooth and rubbery subcutaneous mass
  • Usually asymptomatic
26
Q

If a lipoma is found to be tender, what should be suspected?

A

angiolipoma

?Liposarcoma – rare malignancy

27
Q

What would you suspect if someone presented with a smooth and rubbery asymptomatic non-tender subcutaneous mass?

A

Lipoma

28
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
– Occur in all age groups, both sexes

29
Q

What conditions can cause angioma development?

A

– Pregnancy & liver disease

30
Q

How are angiomas treated?

A

– Excision or laser therapy

31
Q

List 3 types of angioma

A
  • Cherry angiomas
  • Spider naevi
  • Venous lakes
32
Q

What should be suspected if someone presents with a blue papule on a sun exposed region of skin e.g. ear, lips?

A

Venous lake angioma

33
Q

What should be suspected if someone presents with a mole like growth that appears red as it is full of blood vessels?

A

Cherry angiomas

34
Q

What should be suspected if someone presents with a central red spot with extensions?

A

Spider naevia angioma

Increased in women on OCP or pregnant women due to increased oestrogen levels

35
Q

Describe a pyogenic granuloma

A 
–	Rapidly enlarging red/raw growth, often at a site of trauma.
–	Bleed easily
–	Cause is unknown
–	Occur in up to 5% of pregnancies
–	Common on head and hands
36
Q

What conditions is pyogenic granuloma usually associated with?

A

Pregnancy

trauma to head or hand

37
Q

What risk is associated with pre-malignant lesions?

A

UV radiation – DNA damage and immunosuppression

38
Q

Describe Bowens disease

A

Aka Intraepidermal squamous cell carcinoma
– Full thickness dysplasia, entirely contained within the epidermis, no metastatic potential
– Potential to become malignant (around 5%)

Irregular, scaly erythematous plaque

39
Q

What number of spider naevi is suspicious and should elicit investigations?

A

> 5 on total body (may be higher in pregnancy/if on OCP)

40
Q

What is Bowen’s disease also called?

A

Intraepidermal squamous cell carcinoma

41
Q

How is Intraepidermal squamous cell carcinoma/Bowens disease treated?

A

– Cryotherapy
– Curettage followed by cauterisation
– Photodynamic therapy
– Imiquimod

42
Q

What is photodynamic therapy?

A 
•	Photochemical reaction to selectively destroy cancer cells
•	Topical photosensitising agent applied
–	Concentrates in cancerous cells
•	Red light applied
•	Photodymanic reaction occurs
43
Q

What is Imiquimod?

A

• Aldara
• Immune response modifier
– Stimulates cytokine release to cause inflammation and destruction of lesion

44
Q

What are the pros and cons of Imiquimod?

A

Pros
– Useful where surgery is undesirable
– Usually good cosmetic result

Cons
– Treatment time is 6 weeks
– Significant inflammation
– Failure/recurrence

45
Q

What skin lesions presents as a rough scaly patch on sun damaged skin that is associated with a risk of transforming into squamous cell carcinoma?

A

Actinic keratoses

46
Q

How is Actinic keratoses treated?

A

– Cryotherapy
– Curettage
– Diclofenac Gel
– Imiquimod

47
Q

What is Actinic keratoses?

A
  • Rough scaly patches on sun damaged skin

* Low risk of transformation to SCC

48
Q

What is melanoma in situ?

A
  • Melanoma cells entirely confined to epidermis
  • No metastatic potential
  • Treated with excision
49
Q

Describe 3 pre-malignant conditions

A

Bowen’s disease/Intraepidermal squamous cell carcinoma
Actinic keratoses
Melanoma in situ

50
Q

What are the recommendations for sunscreen use?

A

– UVA & UVB protection
– At least SPF 30 / 4 Star
– Need to apply 2 tablespoons every 2 hours

51
Q

What are peak hours of sunlight?

A

10am-4pm

Dermatology (12 decks)

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