Benign Skin Lesions Flashcards
What are benign congenital lesions
Strawberry Naevus / Haemangioma
Port Wine Stain - Naevus flammeus
Salmon patch - Naevus simplex
What is strawberry naves
Benign developmental vascular tumour (haemangioma)
Most common tumour of infancy
What is DDX
Vascular malformation
What are the features
Present 2-3 weeks after birth Oval / round shape Well defined borders Multi-lobed Scarlet colour Smooth or lobulated Max size reached within 3-6 months Common in upper eyelid with orbital extension, face, scalp and back
What do you get if 3+ lesions
Full body MRI
How do you Rx
Conservative as should resolve
Plastics may be needed to remove loose skin or fibro-fatty deposits
What are complications and how do you Rx
Obstruct visual feed
Bleeding
Thrombocytopenia
Ambylopia (lazy eye)
Astigmatism
If causing airway obstruction - may need tracheostomy
Intra-lesional steroid / BB will slow growth if going to obstruct
What is a port wine stain
Vascular malformation present from birth
Can be missed due to hyperaemia of neonate
What are features
Light pink - dark red / purple Trigeminal nerve = most common region then upper trunk Unilateral Well defined age Darkens and thickens with age
Does it regress
No
How do you Rx
Cosmetic camouflage
Lasers to destroy blood vessel under GA
What is salmon patch
Vascular malformation
What are the features
Macular Dull pink colour Irregular border Linear telangiectasia Trigeminal distrubtion Most common on neck, eyed, forehead and nose
How do you Rx
Most fade after 1 month
Laser therapy if persist
What are sebaceous cyst
Epidermoid
Pilar
What are the features
Encapsulated lesion containing fluid Found under skin Central pedunctum = Dx Firm Mobile Very common
Complications
Can rupture causing inflammation
How do you Rx
Excision
Ax / steroid if infected
What is chondrodermatitis nodular helicus
Small inflamed hard painful nodule
Upper part of ear
Red / yellow
Crust and scale may form
What should you do and why
Biopsy to rule out BCC SCC Keratocanthoma Acitinic keratosis
What causes
Unknown
Repeat damage to ear / trauma / cold exposure
More common in M and increasing age
How do you Rx
Reduce pressure on ear Ax if infected Topical / intralesional steroid Cryotherapy Laser therapy Curettage and electrocauterization Surgery if doesn't work
What are seborrheic keratosis
Benign epidermal skin lesions Warty growth Dry or sclary Stuck on appearance Fleshy colour to light brown
What do you often have
Multiple lesions +- cherry angioma
How do you Rx
Conservative
Cryotherapy or curettage if troublesome
Can mimic melanoma so remove if suspect
What is Laser-trelat sign
Abrupt onset of widespread seborrheic keratosis
Signify underlying GI adenocarcinoma
- DO OGD + biopsy
What is a dermatofibroma
Benign fibrous nodule Firm Pale pink or brown Can be tender Tethered to skin Mobile over fat so will dimple if squeeze
How do you Rx
Excision if concern e.g. of melanoma
What is a lipoma
Benign tumour of subcutaneous / fatty tissue
What is very rare complication
Malignant transformation to liposarcoma
What are features
Smooth Rubbery Mobile Painless Felt or seen underneath the skin
If painful what should you suspect
Angiolipoma
Liposarcoma
How do you Dx
Clinical
Remove if uncertain or compressing structure
What features are suggestive of liposarcoma requiring USS
> 5cm
Increased size
Pain
Deep anatomical lesion
What is an angioma
Overgrowth of blood vessels in the skin
What are types of angioma
Spider naevi Cherry haemangioma (Cambell de Morgan)
What are spider naevi
Central red papule
Blanches
Surrounding capillaries
Usually upper part of body
How do you differentiate from telangiectasia
Press and watch filling
Spider will fill from central
Telangiectasia fills from the edge
What are Cambell de Morgan
Erythematous papular lesion
Non-blanching
1-3mm
What are associations with spider naevi
Pregnancy
Liver disease
OCP
How do you Rx
Excision
Laser
What is a pyogenic granuloma
Rapidly enlarging red or brown growth at site of trauma or infection
Pedunculated mass
May bleed or ulcerate
How do you Rx
Excision
Curettage and cautery if not related to pregnancy
