Benign Skin Lesions

Question 1

Which lesion presents as waxy or verrucous appearing papules or plaques that have a “stuck on” appearance?

Answer 1

seborrheic keratosis

Question 2

Name a differential for seborrheic keratosis

Answer 2

melanoma

Question 3

Which type of lesion appears as “bumps” on the skin caused by virus, pearly/flesh colored w/ central umbilication?

Answer 3

molluscum contagiosum

Question 4

Which benign skin lesion is transmitted through skin to skin contact?

Answer 4

molluscum contagiosum

Question 5

Which benign scaly lesion is precancerous?

Answer 5

actinic keratosis

Question 6

What is a differential for actinic keratosis?

Answer 6

Squamous cell carcinoma Cryotherapy or refer to derm

Question 7

Which type of benign lesions feel like sandpaper and are described as “chicken skin” due to the build up of keratin?

Answer 7

keratosis pilaris

Question 8

What is the treatment for keratosis pilaris?

Answer 8

Moisturize w/ uric acid

Question 9

Acrochordon (skin tags) are associated with what conditions?

Answer 9

Metabolic disorders and obesity

Question 10

What is the treatment for acrochordon (skin tags)

Answer 10

scissor excision electrocautery cryotherapy (may cause hypopigmentation)

Question 11

Which benign lesion is characterized as red or violaceous non-blanching macules or papules arising from capillaries?

Answer 11

Angioma

Question 12

Which benign lesions are firm, flesh colored, dome-shaped nodules that result from trauma such as body hair removal or insect bites?

Answer 12

Dermatofibromas

Question 13

How do you diagnose dermofibromas?

Answer 13

Fitzpatrick sign = squeeze the lesion with the thumb and forefinger. Dimpling is a positive sign.

Question 14

The enlargement of sebaceous glands beneath the skin associated with a pore or follicle is called…

Answer 14

sebaceous hyperplasia

Question 15

An important differential to consider with sebaceous hyperplasia is…

Answer 15

Basal Cell Carcinoma ***Refer to derm for biopsy

Question 16

Which lesion is raised, shiny, superficial, infiltrated most often found on the nose?

Answer 16

Basal cell carcinoma

Question 17

Describe 2 stages of basal cell carcinoma

Answer 17

Stage I = <2cm Stage II = >2cm

Question 18

Which lesion is a non-melanoma, cancer of the epidermal keratinocytes, hyperkeratotic plaque, “rodent bite,” common on the face, ulcerated center, top of ears, back of neck , cheeks, nose, and lips, head on males with no hair.

Answer 18

Squamous cell carcinoma REFER OUT

Question 19

During a total body skin examination for skin cancer, the provider notes are raised, shiny, slightly pigmented lesion on the patients nose. What will the provider do? a. Consult the dermatologist about possible melanoma b. Reassure the patient the lesion is benign c. refer the patient for possible electrodessication and curettage d. Tell the patient this is likely a squamous cell carcinoma.

Answer 19

ANS: C This lesion is characteristic of basal cell carcinoma which is treated with electrodesiccation and curettage. Melanoma lesions are usually asymmetric lesions with the regular borders, variable coloration >6mm diameter which are elevated. They should be referred immediately. All suspicious lesions should be biopsied until the results are known, the provider should not reassure the patient that the lesion is benign. Squamous cell carcinoma is roughed, scaling and bleeds easily

Question 20

What is the initial approach when obtaining a biopsy of potential malignant melanoma lesion? a. Excisional biopsy b. Punch biopsy c. Shave biopsy d. Wide excision

Answer 20

ANS: A A suspected malignant melanoma lesion should be biopsied with excisional biopsy; if diagnosed, a wide excision should follow. Punch and shave biopsy procedures are appropriate for diagnostic evaluation of NMSC lesions.

Question 21

How is molluscum contagiosum transmitted?

Answer 21

Skin to skin. Can be sexually transmitted

Question 22

What is the treatment of molluscum contagiosum?

Answer 22

Can be left alone. Immune system will fight it off in about 6 months. Cryotherapy Trentinoin or Beetlejuice (not used in primary care) homeopathy: apple cider vinegar

Question 23

What is the treatment of actinic keratosis?

Answer 23

Cryotherapy Topical trentinoin Laser +topical 5 uracil

Question 24

What is the treatment for seborrheic keratosis?

Answer 24

Reassurance

Question 25

A benign fast growing vascular lesion that develops over the course of a week is called a…

Answer 25

Pyogenic granuloma

Question 26

Name 2 causes of pyogenic granuloma

Answer 26

Meds (birth control pills) Pregnancy

Question 27

What is the treatment for dermatofibroma?

Answer 27

Reassurance

Question 28

What are the ABCDE’s of malignant melanoma?

Answer 28

Asymmetry

Border

color

Diameter (>6mm or 1/4”)

Elevation

Question 29

What is the definite diagnostic test to determine skin cancer?

Answer 29

Skin biopsy

A suspicious excisional biopsy should be followed up with a wider excision in malignant melanoma is diagnosed.

Question 30

What are the best diagnostic tests to diagnose nonmelanoma squamous cell caracinoma?

Answer 30

Shave or punch biopsy