benign skin lesions

Question 1

how would you describe a skin lesion?

Answer 1

Site
Size
Shape
Colour

Question 2

what would you record palpating a skin lesion?

Answer 2

Mobility, surface changes, temperature, consistency

Question 3

what are Seborrhoeic Keratoses?

Answer 3

Warty growths, “stuck on appearance”

Can have variable appearance

Question 4

how would you treat Seborrhoeic Keratoses if they are troublesome?

Answer 4

Cryotherapy

Curettage

Question 5

what is Cryotherapy

Answer 5

Liquid nitrogen

Question 6

what are the pros of cryotherapy?

Answer 6

Cheap

Easy to perform “on the day”

Question 7

what are the cons of cryotherapy?

Answer 7

Can scar
Failure/Recurrence
No histology

Question 8

what is sign of leser-trelat?

Answer 8

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

Question 9

whatare viral warts due to?

Answer 9

Human Papilloma Virus

Question 10

what is the surface like on viral warts?

Answer 10

Rough hyperkeratotic surface

Question 11

what are cysts?

Answer 11

Encapsulated lesion containing fluid or semi-fluid material

Question 12

what are the different types of cysts?

Answer 12

Epidermoid cyst (often wrongly called sebaceous)
Pilar cyst			
Steatocystoma
Dermoid cyst
Hidrocystoma
Ganglion cyst

Question 13

what is bad about cysts?

Answer 13

can rupture and cause inflammation of surround skin

Question 14

how are cysts treated?

Answer 14

Treated with excision
If inflammed/infected
Antibiotics
Intralesional steroid
Incision & Drainage

Question 15

what is dermatofibroma?

Answer 15

Benign fibrous nodule, often on limbs

Proliferation of fibroblasts

Question 16

what is the cause of dermatofibroma?

Answer 16

Cause is unknown. They are sometimes attributed to an area of trauma

Question 17

what are the symptoms of dermatofibroma?

Answer 17

Firm nodule, tethered to skin but mobile over fat. Pale pink/brown. Often paler in centre.
Dimple sign positive

Question 18

what are lipomas?

Answer 18

Benign tumour consisting of fat cells

Question 19

what are the causes of lipomas?

Answer 19

unknown

Question 20

what are the concerns of lipoma is tender?

Answer 20

angiolipoma

?Liposarcoma – rare malignancy

Question 21

what are angiomas?

Answer 21

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

Question 22

what are the symptoms of angiomas?

Answer 22

Generally asymptomatic. Can be unsightly or bleed

Question 23

what is the treatment of angiomas?

Answer 23

Excision or laser

Question 24

what are pyogenic granulomas?

Answer 24

Rapidly enlarging red/raw growth, often at a site of trauma.

Question 25

how are pyogenic granulomas removed?

Answer 25

curettage & cautery

Question 26

what are risk factors for pre malignant lesions?

Answer 26

UV radiation- dna damage and immunosuppression

Question 27

what is Actinic Keratoses

Answer 27

Rough scaly patches on sun damaged skin

Question 28

what is the treatment of Actinic Keratoses

Answer 28

Cryotherapy Curettage Diclofenac Gel Imiquimod

Question 29

what is bowens disease?

Answer 29

Squamous cell carcinoma in situ

Question 30

what are the signs of bowens disease?

Answer 30

Irregular, scaly erythematous plaque

Question 31

what is the treatment of bowens?

Answer 31

Cryotherapy Curettage Lesion scraped off and heat applied to seal vessels and destroy residual cancer cells photodynamic therapy Imiquimod

Question 32

how does photo dynamic therapy work?

Answer 32

Photochemical reaction to selectively destroy cancer cells Topical photosensitising agent applied Concentrates in cancerous cells Red light applied Photodymanic reaction occurs

Question 33

what is imiquimod?

Answer 33

Aldara Immune response modifier Stimulates cytokine release Inflammation and destruction of lesion

Question 34

what are the pros of imiquimod?

Answer 34

Useful where surgery is undesirable | Usually good cosmetic result

Question 35

what are the cons of imiquimod?

Answer 35

Treatment time is 6 weeks Significant inflammation Failure/recurrence

Question 36

where is melanoma cells confined to?

Answer 36

epidermis

Question 37

does melanoma in situ have the potential to be metastatic

Answer 37

no

Question 38

how are melanomas treated

Answer 38

excision