Benign skin lesions (Dermatofibroma, Sebborheic keratoses) Flashcards
what is Sebborhic dermatitis, recognise and treat
fungal infection by M/furfur
Symetrical and sebum areas (hair, nasal folds)
if severe-HIV
treatment-azole antifungals, maintenance and possible steroids if needed
Crude guide to approach any pigmented skin lesion?
ABCDE - Asymmetry, irregular, two or more Colours, diameter, evolution -
Evolution is probably the most important one
Crude approach to examining a skin lesion?
Surface -erosion/ulcer/scaly/warty
Consistency -soft, semi soft etc,
Mobility
tenderness
temperature
Features of benign lesions?
Symettry in shape and colours and structures
stable or Slowly evolving (moles can appear till mid 30’s)
Absence of spontaneous bleeding
Categories of benign/skin lesions
Pigmented-melanocytic vs non melanocytyc
Melanocytic-
Melanocytic naevi-mole
Solar lentigo, ephilidies
non benign-melanoma in situ, lentigo melanoma, malignant melanoma
Non melanocytic-seborrheic keratosis, dermatofibroma (scar after skin trauma), skin tags
Non pigmented
Intradermal nave, lipoma,
Precursors: actinic keratosis, Bowens
SCC, BCC
vascular -
Heamoangiomas,
Kaposis sarcoma, angiosarcoma
what is a melanocytes naevus
Local proliferation of melanocyte-can be congenital or acquired
they are MOLES
can occur anywhere
flat or not,
coloured or not
size can vary wildly
junctional -flat
Dermal -raised
Compound -both junctional and dermal (flat out, raised centre)
Combines-2 neavi in one area
acral, nail nave
spitz neavi -pink/brown- starburst pattern
people with many atypical naevi -higher risk of melanoma
can be dysplastic-
what does a dermatoscope reveal about naevi
Pigment network -
regular ones: reticular network,
globular (can be sign of activity), blue (deeper), starburst (lines around periphery)
what is familial atypical nevus syndrome?
Genetic-large amount of atypical moles (100’s) -and are a lot higher risk of melanoma
followed to mole mapping clinic that follows their moles
what are Ephilides
Freckles -
Well defines brown macules in sun exposed areas
What is solar lentigo? And ink spot lentigo
patch of darkened skin due to UV radiation -very common
well dermacated and sharp edges -stay there forever
especially face, arm and hands
ink spot lentigo-born with, looks like ink spot
What is sebborheic ketatosis? what does it look like under dermatocytes
A PIGMENTED non melanocytes lesion
harmless warty lesion-well dermacated and look STUCK on -important polymorphic appearance (brown, black, flat, raised, etc)
appear slowly and over time
age related, but cause unknown
very common in older people
nothing to worry about EXCEPT if 100 appear very fast
get brown and white holes, fingerprinting, blood vessels
what is a dermatofibroma
Nodule, especially after bite/trauma
firm to palpate, can be whiter in center
tethered
Pinch test-get button whole /dimple in the skin
What are acrochordon
Skin tags-common with age, found in skin folds
can be annoying and bleed
maybe friction related?
what are intradermal naevus?
mole, raised but NON pigmented
what are epidermoid cysts?
Follicular nodule with central punctum -
skin colour and full of yellow smelly material
can be removed surgically
symmetrical, and punctum in reassuring
What are lipoma
Lump of fat deep in subcutaneous layer
Soft tissue growth
Soft, rubbery, mobile
usually back neck or trunk -not annoying usually
What is a clear cell acanthoma
Pink dome shaped nodule or plaques
scales at edges
unclear edges
what is porokeratosis
abnormal keratosis -
keratosis border-white scare around a small spot
tend to be benign but can be precancerous
what is sebaceous hyperplasi
growth around areas with sebaceous areas-enlarged glands-
small yellow lumps
can be mimicked for BCC but with dermatoscope-see yellow spots -clould like
what is a fibrous papule
Firm bump, doesn’t grow or change, usually there
can be mistaken for BCC
What is lichenoid keratsis
small solitary inflamed macule or thin plaque -on fair skinned pt
immune attack on pigmented area
usually regressing lentigo or seb Ker
usually needs biopsy -need to wander why
What are pygoneic granulmoa
VASCULAR lesion-bleed
common-reactive proliferation of Cap blood vessels
red mas that bumps off skin
discomfort and bleed-need to differentiate with Melanoma
trauma, infection, hormone (pregnancy)
treat with steroids or just cut em out
what are angiomas/heamoangiomas/cherry angiomas
Red/purple dots around the body, often in kids or older adults-
very common and benign
under dematoscope-looks like well dermacated grapes
