Benign Skin Lesions Flashcards

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1
Q

What is the appearance of seoborrhoeic keratoses?

A

Warty growths

Stuck on appearance

Variable appearance

Patients may or may not have several cherry angiomas

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2
Q

What is the treatment for seborrhoeic keratoses?

A

Generally left untreated but if troublesome - cryotherapy / curettage

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3
Q

What is cryotherapy?

A

Liquid nitrogen

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4
Q

What are the pros and cons of cryotherapy?

A

•Pros

–Cheap

–Easy to perform “on the day”

•Cons

–Can scar

–Failure/Recurrence

–No pathology result

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5
Q

What condition does a rapid onset of seborrhoeic keratoses indicate? (particularly in a younger individual)

A

Leser - Trelat

SK’s remain benign but may indicate underlying solid organ malignancy

GI adenocarcinoma

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6
Q

What are these?

They have a rough hyperkeratotic surface

A

They are viral warts (due to the human papilloma virus)

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7
Q

What is the treatmet of viral warts?

A

Tend to be difficualt 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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8
Q

What is this?

(encapsulated lesion containing fluid or semi-fluid material)

Firm and fluctulant

A

Cysts

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9
Q

What are different types of cyst?

A

Epidermoid

Pilar

Steatocystoma - genetic predisposition - may be treated with isotretinoin

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10
Q

What risks are associated with cysts?

A

Can rupture and cause inflammation of surrounding skin

May become secondary infected

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11
Q

What are the treatments of cysts?

A

Treated with excision

If inflamed / infected:

  • Antibiotics
  • Intralesional steroid
  • Incision and drainage
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12
Q

What is this?

(described as a benign fibrous nodule - often on limbs)

A

Dermatofibroma

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13
Q

The proliferation of what type of cell causes dermatofibroma?

A

Fibroblasts

The cause is unknown, they are sometimes attributed to an area of trauma

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14
Q

What are the features of dermatofibroma?

A

Firm nodule, tethered to skin but mobile over fat

Pale/pink brown

Often paler centre

Dimple sign positive

Usually asymptomatic - can be itch or tender

Excision if concern or symptomatic

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15
Q

What is a lipoma?

A

It is a benign tumour consisting of fat cells

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16
Q

What are the features of lipomas?

A

Common

Smooth and rubbery subcutaneous mass

Usually asymptomatic

17
Q

If the lipoma is tender what might that indicate?

A

Angiolipoma

Liposarcoma - rare malignancy

18
Q

What is an angioma?

A

Overgrowth of blood vessels in the skin due to proliferating endothelial cells

19
Q

What are the features of angiomas?

A

Generally asymptomatic but they may bleed and can be described as unsightly

They occur in liver disease or pregancy

20
Q

What is the treatment for angiomas?

A

Excsion or laser

21
Q

What is this?

A

Pyogenic granuloma

22
Q

What are the features of pyogenic granuloma?

A

Rapidly enlarging

Bleed easily

Occur in 5% of pregnancies

Common on the head and the hands

23
Q

What is the treatment for pyogenic granuloma?

A

Curettage and cautery

24
Q

So what were the vascular lesions?

A

Pyogenic granuloma

Angioma

25
Q

What are some pre-malignant skin conditions?

A

Actinitic keratoses

Bowen’s disease

Melanoma in situ

26
Q

What does actinitc keratoses progress to?

A

SCC

Common in the elderly population

Described as a crusty scaly patch - sign of partial thickness epidermal dysplasia

27
Q

If actinitic keratoses is partial thickness epidermal dysplasia - what is full thickness epidermal dysplasia known as?

A

Bowen’s disease

It is entirely contained within the epidermis so there is no metastatic potential

Potential to become malignant is around 5%

It is described as irregular, scaly, erythematous plaque

28
Q

What is the treatment if bowens?

A

Cryotherapy

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

Photodynamic therapy

Imiquimod

29
Q

How does photodynamic therapy work?

A

A topical photosensitising agent causes cancer cells to become sensitised to a specific colour of light - the agent conecntratres in cancer cells

A photodynamic reaction occurs between light photosensitiser and oxygen causing inflamation and destruction of cells

30
Q

Pros and cons of photodynamic therapy

A

•Pros

–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

•Cons

–Requires hospital appointments

–Can be painful and scar

31
Q

How does imiquimod work?

A

Stimulates cytokine release - inflammation and destruction of lesion

32
Q

Pros and cons for imiquimod

A

•Pros

–Useful where surgery is undesirable

–Usually good cosmetic result

–Large surface area

•Cons

–Treatment time is 6 weeks

–Significant inflammation

–Failure/recurrence

33
Q

What is treatment of actinitic keratoses?

A

–Cryotherapy

–Curettage

–Diclofenac Gel

–Imiquimod

34
Q

What is meant by melanoma in situ?

A

Melanoma cells are entirely confined to the epidermis

No metastatic potential

Treated with excision

35
Q

Give an example of a melanoma in situ

A

Lentigo maligna

Usually facial

36
Q

What are ways to avoid the sun?

Actinitic keratoses is described as rough scaly patches on sun damaged skin

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

37
Q
A