Benign Skin Lesions Flashcards
what are benign skin lesions?
Seborrhoeic keratoses
Viral warts
Cysts
Dermatofibroma
Lipoma
Vascular lesions
what ar premalignant skin lesions?
Bowens disease
Actinic Keratoses
Melanoma in situ
benign lesions
Are Seborrhoeic Keratoses benign or maligant?
benign but commonly referred?
what are Seborrhoeic Keratoses?
They are benign growths due to a build-up of skin cells
Warty growths, “stuck on appearance”
Can have variable appearance
Patients often have multiple +/- cherry angiomas
what is the treatment of Seborrhoeic Keratoses?
• Generally left untreated, but if troublesome
- Cryotherapy
- Curettage
what is cryrotherapy?
Liquid nitrogen
Cryotherapy is the use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions
what are the pros of Cryotherapy?
Cheap
Easy to perform “on the day”
what are the cons of Cryotherapy?
Can scar
Failure/Recurrence
No pathology result
what is and what are the signs of Leser-Trelat?
Paraneoplastic phenomenon
Abrupt onset of widespread seborrhoeic keratosis, particularly in a younger individual
SKs remain benign but may indicate underlying solid organ malignancy - GI adenocarcinoma
what are viral warts and what causes them?
- Due to Human Papilloma Virus
- Rough hyperkeratotic surface
what is the treatment of viral warts?
- Difficult to treat - Do we need to treat at all?
- Will clear when immunity developed to virus
- Cryotherapy or wart paints can stimulate immune system slightly
- Can curette in severe cases - surgical instrument designed for scraping or debriding biological tissue or debris in a biopsy, excision, or cleaning procedure
what are cysts?
- Encapsulated lesion containing fluid or semi-fluid material
- Usually firm and fluctuant
are cysts common or rare?
Common
Affect ~20% adults
multiple different types of cysts exist, what are they?
- Epidermoid cyst (often wrongly called sebaceous)
- Pilar cyst
- Steatocystoma
- Dermoid cyst
- Hidrocystoma
- Ganglion cyst
what can happen tocysts which is dangerous?
- Can rupture and cause inflammation of surround skin
- May become secondary infected
what is the treatment of cysts?
- Treated with excision
- If inflammed/infected
- Antibiotics
- Intralesional steroid
- Incision & Drainage
what is a Dermatofibroma?
- Benign fibrous nodule, often on limbs - Proliferation of fibroblasts
- Firm nodule, tethered to skin but mobile over fat. Pale pink/brown. Often paler in centre.
- Dimple sign positive
what cause dermatofibromas?
Cause is unknown. They are sometimes attributed to an area of trauma
what are the symptoms and treatments of a dermatofibroma?
Usually asymptomatic. Can be itchy or tender
Excision if concern or symptomatic.
what is a lipoma, what causes it and is it common or rare?
- Benign tumour consisting of fat cells
- Common
- Cause unknown
- Smooth and rubbery subcutaneous mass
benign tumor made of fat tissue, usually occur jsut under the skin
what are the symptoms of a lipoma?
- Usually asymptomatic
- If tender:
- ?angiolipoma
- ?Liposarcoma – rare malignancy
what is an angioma?
Angiomas are benign tumors derived from cells of the vascular or lymphatic vessel walls (endothelium) or derived from cells of the tissues surrounding these vessels
Overgrowth of blood vessels in the skin due to proliferating endothelial cells
It is a vascular lesion
what are the symptoms of an angioma?
Generally asymptomatic. Can be unsightly or bleed
who is at risk of an angioma?
Occur in all age groups, both sexes
Pregnancy & liver disease
what is the treatment of an angioma?
Excision or laser
what is a Pyogenic Granuloma?
reactive proliferation of capillary blood vessels. It presents as a shiny red lump with a raspberry-like or minced meat-like surface
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
what is the treatment of a pyogenic granuloma?
Removed by curettage & cautery
pre-malignant lesions
what is a pre-malignant lesion?
If premalignant then it is entirely in the epidermis and as soon as it goes into dermis it becomes an invasive malignancy
what are risk factors for pre-malignant skin lesions?
UV radiation - DNA damage and immunosuppression
what is Bowen’s Disease?
• 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
what is the treatment of Bowens?
- Cryotherapy
- Curettage - Lesion scraped off and heat applied to seal vessels and destroy residual cancer cells
- Photodynamic therapy
- Imiquimod
What is Photo-Dynamic Therapy?
- Photochemical reaction to selectively destroy cancer cells
- Topical photosensitising agent applied - Concentrates in cancerous cells (due to higher metabolic rate)
- Red light applied (light colour dependant on which agent is used)
- Photodymanic reaction occurs between light, photosensitiser and oxygen causing inflamation and destruction of cells
what are the pros of photodynamic therapy?
Done for the patient by hospital staff
Can treat multiple areas, including those which would be hard to reach by patient
Requires 1 or 2 treatments
what are the cons of photodynamic therapy?
Requires hospital appointments
Can be painful and scar
what is imiquimod
- Aldara
- Immune response modifier - Stimulates cytokine release
- Inflammation and destruction of lesion
topical treatment
what are the pros of imiquimod?
- Useful where surgery is undesirable
- Usually good cosmetic result
- Large surface area
what are the cons of imiquimod?
- Treatment time is 6 weeks
- Significant inflammation
- Failure/recurrence
what is Actinic Keratoses?
Rough scaly patches on sun damaged skin
a rough, scaly patch on your skin that develops from years of exposure to the sun
what is the risk of Actinic Keratoses transforming to SCC?
Low risk of transformation to SCC - If average of 7.7 AK, the probability of developing an SCC within 10 years is 10%
whatis the treatment of Actinic Keratoses?
- May spontaneously resolve
- Treatment
- Cryotherapy
- Curettage
- Diclofenac Gel
- Imiquimod
what is a Melanoma in situ?
Melanoma cells entirely confined to epidermis
No metastatic potential
Treated with excision
what is Lentigo Maligna?
- Type of melanoma in situ
- Usually facial
Lentigo maligna is a melanoma in situ that consists of malignant cells but does not show invasive growth
what ways is there for sun protection?
- 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 (for UVA)
- Need to apply 2 tablespoons every 2 hours
