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Dermatology > Benign Skin Tumors > Flashcards

Benign Skin Tumors Flashcards

1
Q

Chrondrodermatitis nodularis helicis population affected

A

40 yo

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2
Q

Chrondrodermatitis nodularis helicis cause

A

unknown, actinic damage, cold exposure, trauma, local ischemia, those who work outside during winter

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3
Q

Chrondrodermatitis nodularis helicis sx

A

Early: central crust at apex
Late: dense rolled edge
Pain with anything touching the ear

well-circumscribed, rounded nodule with raised edges and a crust in its center, often overlying an ulcer which may occasionally have exposed cartilage at the bottom w/ erythema around it
diameter of 4 mm to 6 mm

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4
Q

Chrondrodermatitis nodularis helicis TX

A

Co2 laser
Injectable collagen implants
Intralesional steroid injections
Nitroglycerin gel-2% gel – regeneration of and regrowth
Photodynamic therapy (PDT)
Removal of causative factor/relieving pressure (Doughnut pillow)
Topical steroids
Cartilage excision
Curettage
Wedge excision

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5
Q

Chrondrodermatitis nodularis helicis ddx

A

Squamous cell carcinoma
Basal cell carcinoma
Actinic keratosis

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6
Q
A

Chrondrodermatitis nodularis helicis

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7
Q

Dermatofibroma

A

Area of focal dermal fibrosis, often with overlying epidermal hyperpigmentation and thickening

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8
Q

Dermatofibroma population affected

A

young adults, female

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9
Q

Dermatofibroma sx

A

Small brown papules
Indurated
1-10
Asymptomatic
Purutius
>15 Multiple can be seen with SLE
On trunk or extremities

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10
Q

Dermatofibroma PE

A

Typically about 3-10 mm in size, slightly elevated, scaly lesions
Vary in color from light tan to dark brown
Firm, fibrotic consistency on palpation
Dople sign: central dimpling in the center with lateral compression

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11
Q

Dermatofibroma tx

A

Not needed
Excision

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12
Q

Dermatofibroma ddx

A

Nevi
Malignant melanoma
Dermatofibrosarcoma protuberans

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13
Q
A

Dermatofibroma

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14
Q

Dermatosis Papulosa Nigra population affected

A

Fitzpatrick Skin Type III-VI

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15
Q

Dermatosis Papulosa Nigra sx

A

bumps are about 1-5 millimeters in diameter and 1-3 millimeters high
are harmless and don’t cause any ulcerations (breaks in the skin), scaling, or crusting
Smooth in adolescence, freckle-like bumps and gradually become rougher with time, may grow in size and number with age
On face and neck

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16
Q

Dermatosis Papulosa Nigra tx

A

Cryotherapy
Shave

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17
Q

Dermatosis Papulosa Nigra ddx

A

Sebaceous cyst

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18
Q
A

Dermatosis Papulosa Nigra

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19
Q

Digital mucous cyst population affected

A

middle aged and elderly

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20
Q

Digital mucous cyst sx

A

Over DIP or nail base
usually solitary, rubbery, can be translucent
filled with clear gelatinous viscous fluid

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21
Q

Digital mucous cyst tx

A

Puncture and drainage w/ compression
Excision
Intralesional corticosteroids
Cryotherapy

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22
Q

Epidermal Inclusion Cysts cause

A

traumatic implantation or spontaneous from upper portion of hair follicle of epidermis into dermis.
giant comedones (blackheads or whiteheads)

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23
Q

Epidermal Inclusion Cysts sx

A

Appear as flesh-colored, firm, but often malleable, skin nodules with surface opening appears as a small, round, sometimes imperceptible pore
Range in size from 0.5 - 5 cm
Located anywhere, most commonly on the scalp, neck, and trunk.
Asymptomatic
Oily and foul smelling inside

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24
Q

Epidermal Inclusion Cysts complications

A

Infection: tender and increased discharge

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25
Epidermal Inclusion Cysts tx
Don’t need Excision- make sure to remove entire cyst and lining but not when inflamed Corticosteroid when inflamed but not infected Incision and drainage Take at least 4-6 weeks Poultice or antibiotics
26
Epidermal Inclusion Cysts ddx
Pilar cyst Milia Digital mucous cyst Ganglion cyst Lipoma Nasal gliomas
27
Epidermal Inclusion Cysts
28
Ganglion cyst
cystic swelling surrounded by a fibrous tissue wall occurring in the vicinity of joint capsules and tendon sheaths
29
Ganglion cyst population
female, second and third decade
30
Ganglion cyst cause
degenerative process in the mesoblastic tissues surrounding the joint, herniation of a tendon sheath, trauma
31
Ganglion cyst sx
Dorsum of the wrist, flexor aspect of the wrist adjacent to the radial artery, elbow, ankle, foot, and back of knee Usually smooth and rounded; at other times multilocular, hard/firm, crystal clear, very thick gelatinous content occasionally tinged with blood, cystic and fluctuant. increases in size after excessive movement or use and size decreases with rest Pain dull and constant or painless or sharp pain Weakness
32
Ganglion cyst complications
Infection risk with aspiration Sclerosing agent can cause damage to surrounding structures
33
Ganglion cyst tx
Intentional rupture: smack the cyst Aspiration Injection of sclerosing solution- Sodium morrhuate Excision Compression early Acupuncture Corticosteroid injections
34
Ganglion cyst
35
Gardner’s syndrome cause
autosomal dominant, heritable disorde
36
Gardner’s syndrome sx
multiple epidermal cysts fibromas osteomas and intestinal polyps, which often undergo malignant degeneration.
37
Gardner’s syndrome
38
Hypertrophic scar
Enlargement of the sar within the boundary of the original scar
39
Hypertrophic scar cause
Genetics Body site Quality of the surgery Skin tension Skin type The patients health status at the time
40
Hypertrophic scar RF
young age, female gender, dark skin, neck or upper limb burns, multiple surgical procedures, greater than 3 weeks to healing, meshed skin graft use, and burn severity
41
Hypertrophic scar sx
1 to 2 months after injury Irritation pruritus neuropathic pain increased induration and often dyspigmentation over the site of a wound
42
Hypertrophic scar Tx
Surgery Corticosteroid Cryotherapy Laser
43
Hypertrophic scar ddx
Keloid scarring Sarcoma dermatofibrosarcoma protuberans Dermatofibroma nodular scleroderma Lobomycosis
44
Keloid scarring
Enlargement of the scar beyond the original scar boundary
45
Keloid scarring cause
Genetics Body site Quality of the surgery Skin tension Skin type The patients health status at the time Response to trauma * Acne * Body piercing * Tattoos * Insect bites * Vaccination * Surgery
46
Keloid scarring population
darker skin types, 10-30 years
47
Keloid scarring RF
darker skin type
48
Keloid scarring Tx
Silicone-based therapy (gel, sheets, spray)- week or 2 after surgery Intralesional corticosteroids Acupuncture Topical steroids Laser therapy Radiation therapy Cryotherapy Pressure therapy(local hypoxia) Surgery–last option d/t recurrence
49
Hypertrophic scar
50
Keloid scarring
51
Lipoma
52
Lipoma
Deeper than an epidermal inclusion cyst
53
Lipoma population
middle life
54
Lipoma cause
genetics, trauma, fat metabolism problems
55
Lipoma sx
Feel rubbery but is usually not malleable Move freely only slightly elevated above the skin’s surface, but easily palpable deep to the skin Asymptomatic and slow growing trunk, neck, and upper extremities Flesh-colored Range in size from 1 - 10 cm May be solitary or multiple
56
Lipoma diagnosis
Slightly malleable If the skin moves over top of the lesion, the lesion is sub-dermal in origin and probably is a lipoma Biopsy MRI US
57
Lipoma complications
Gardner’s syndrome Multiple symmetrical lipomatosis Dercum’s disease
58
Lipoma tx
Not required Incision and blunt dissection Liposuction Injection with low dose deoxycholate
59
Meibomian cyst cause
blockage of meibomian gland of eye
60
Meibomian cyst sx
Painless Initial lid edema and irritation firm nodule on eyelid
61
Meibomian cyst tx
Hot compress 10-15 min qid/ 2-3 weeks Steroid injection after 6 weeks Incision and curettage w/ or w/o antibiotics
62
Meibomian cyst
63
Milia
Small epidermoid cysts
64
Milia cuase
trauma
65
Milia sx
Face 1-2 mm white to yellow Single or multiple
66
Milia Tx
Lidocaine, scalpel, express it Retinoid therapy
67
Nasal Gliomas population
children at birth
68
Nasal Gliomas cause
genetics
69
Nasal Gliomas
70
Neurofibromas/Von Recklinghausen’s disease
Focal proliferation of neural tissue within the dermis
71
Neurofibromas/Von Recklinghausen’s disease types
Neurofibromatosis type 1: most common Neurofibromatosis type 2 Schwannomatosis: enlargement of nerve bundles
72
Neurofibromas/Von Recklinghausen’s disease population
20-40 yo, childhood (NF1), 16-20 (NF2)
73
Neurofibromas/Von Recklinghausen’s disease cause
inherited disorder or no known cause
74
Neurofibromas Type 1 sx
Cafe au lait spots: Flat, light brown spots on the skin birth-1 year Freckling in the armpits or groin area 3-5 Bone defects: bowed legs or Scoliosis Lisch nodules: tiny bumps on the iris of the eye Optic glioma: at age Soft, pea-sized bumps on or under the skin Learning difficulties Larger than average head size Short stature
75
Neurofibromatosis type 2 sx
Hearing loss Tumors in both ears Ringing in the ears Poor balance Headaches Soft, pea-sized bumps on or under the skin
76
Schwannomatosis sx
Numbness and weakness in the arms or legs Pain Balance difficulties Facial drop Vision problems or the development of cataracts Soft, pea-sized bumps on or under the skin
77
Neurofibromas PE
on compression, invaginate into a slit-like defect in the skin = “buttonhole” sign
78
Neurofibromas diagnosis
Crowe’s Criteria for Diagnosis of Neurofibroma Six or more café-au-lait spots, each greater than 1.5 cm in diameter, are diagnostic. Axillary freckling Biopsy
79
Neurofibromas tx
Don’t need to remove Lift and snip Shave Hyfrecator Radiosurgery
80
nevi
A nevus (mole) is a benign neoplasm derived from the pigment-forming (melanocyte) nevus cell.
81
nevi population
white, middle-aged adult,
82
nevi cause
congenital or acquired
83
Junctional Nevi
Initial pinpoint (1-2 mm) Expands to 4-6 mm Flat, slightly elevated Smooth or slightly elevated Sharply circumscribed Uniformly pigmented (brown, tan, black) Nevus cells at dermo-epidermal junction Round or oval and symmetrical border Hairless 0.1-0.6 cm Develop after age 2 years Palms, soles, and genitalia Very rare to melanoma Can change into compound 25-40 moles is normal Appear singularly and rarely in crops
84
Compound Nevi signs
Slightly elevated dome shaped, papule, Smooth or warty, Flesh, brown, halo nevus (white halo at the periphery) , Uniformly, round, oval, and symmetric Hair may be present Appear singularly and rarely in crops
85
milia
86
Neurofibroma
87
Junctional nevi
88
compound nevi
89
Intradermal/dermal nevi
Dome shaped Verrucoid (warty) Pedunculated Sessile Brown or black, but may become lighter or flesh-colored with age Vary in size from a few millimeters to a centimeter Variety of shapes
90
intradermal/dermal nevi
91
Atypical nevi sx and signs
Slow growing 3-15mm Irregular, ill defined Asymmetrical Tan, brown, dark brown, black, pink Central papule surrounded by macular ring Asymptomatic Risk of melanoma Back, upper, lower limbs, female breasts, scalp, buttock, groin
92
atypical nevi
93
Nevi diagnosis
When to work up * Symptomatic should be worked up * Blue nevus * Asymmetric * Changing
94
Pilar or Trichilemmal Cyst population
women with family history
95
Pilar or Trichilemmal Cyst sx
Scalp 5-5 cm nodule/tumor - smooth, firm, dome Pain free
96
Pilar or Trichilemmal Cyst Tx
Excision
97
Pilar or Trichilemmal Cyst
98
Sebaceous cyst cause
poor hygiene
99
Sebaceous cyst sx
flesh-colored, dome-shaped nodules that feel firm (not hard) Range in size from 0.5 to 5 cm
100
Sebaceous cyst dx
an oily substance rather than macerated keratin. Biopsy is usually not necessary
101
Sebaceous cyst tx
Don’t need Excision- make sure to remove entire cyst and lining but not when inflamed Corticosteroid when inflamed but not infected Incision and drainage Take at least 4-6 weeks Poultice or antibiotics
102
Sebaceous cyst
103
Sebaceous hyperplasia
Small tumors of enlarged sebaceous glands
104
Sebaceous hyperplasia population
> 30 yo
105
Sebaceous hyperplasia cause
sun exposure, trauma
106
Sebaceous hyperplasia sx
On Forehead, cheek, lower lid, and nose 1-3 mm Telangiectasia Central umbilication Soft Blood vessels occur in the valleys between lobules
107
Sebaceous hyperplasia dx
Biopsy
108
Sebaceous hyperplasia tx
Carbon dioxide laser ablation Shave excision Electrodessication with curettage Trichloroacetic acid Photodynamic therapy Cryotherapy Not required
109
Sebaceous hyperplasia
110
Seborrheic keratosis population
middle age
111
Seborrheic keratosis cause
autosomal dominant, benign proliferation of immature keratinocytes,
112
Seborrheic keratosis sx
Vary in size from 2 mm to more than 3 cm Slightly to markedly elevated Rough verrucous or crumbly, dry and cracked with accentuation of the hair follicles, papule or plaque Smooth smooth dome- shaped surface with tiny, round, 1 mm in diameter white or black horny cysts/pearls embedded in the surface, papule or plaque
113
Seborrheic keratosis types
Rough * verrucous or crumbly, dry and cracked with accentuation of the hair follicles. Smooth * smooth dome- shaped surface with tiny, round, 1 mm in diameter white or black horny cysts/pearls embedded in the surface
114
Seborrheic keratosis dx
Excisional or shave biopsy
115
Seborrheic keratosis TX
No treatment Liquid nitrogen cryotherapy Light electrocautery Dermabrasion Laser treatment * Only for darker lesions Trichloroacetic acid Topical tretinoin Local anesthesia by shaving/curetting along with hyfrecation or radiosurgery
116
Seborrheic keratosis
117
Seborrheic keratosis
118
Skin Tag (acrochordon) population
adulthood
119
Skin Tag (acrochordon) cause
obesity, diabetes, metabolic syndrome, aging
120
Skin Tag (acrochordon) sx
Increase with age soft, skin-colored to slightly pigmented pedunculated papule-neck, axilla, groin, eye, mouth Multiple in one spot May appear necrotic Hyperpigmentation
121
Skin Tag (acrochordon) PE
tan to flesh-colored, 1 -10 mm., soft, fleshy, pedunculated, papules
122
Skin Tag (acrochordon) TX
Cosmetic or irritation but not pathological Scissor excision Cryotherapy Radiosurgery Electrodesiccation Lift-and-snip Shave procedure Dental floss
123
Skin Tag (acrochordon) ddx
Intradermal nevi Neurofibromata
124
Seborrheic keratosis ddx
Warts Actinic keratosis Nevi Pigmented basal cell carcinomas Dermatofibroma Malignant melanomas
125
Sebaceous hyperplasia ddx
Basal Cell Carcinoma Small keratoacanthoma Molluscum contagiosum Syringoma
126
Sty or external hordeolum Tx
Hot and cold compress
127
Sty or external hordeolum
128
Syringoma
Most common tumor of the intraepidermal eccrine sweat glands
129
Syringoma population
women, any age, >30
130
Syringoma cause
autosomal dominant
131
Syringoma sx
Symmetrical Small, firm, multiple, flesh-colored papules Occur on lower lids, and less commonly on forehead, chest, abdomen and vulva No malignant potential
132
syringoma dx
Shave biopsy
133
syringoma Tx
Electrodessication and curettage Cryotherapy Laser trichloroacetic acid Glycolic acid at 10%-20% concentration May cause scarring
134
Venous ulcers
Location: Medial lower leg Irregular margins Superficial Ruddy granular tissue Painless-moderate pain Exudative Periwound is weepy or dry and thin Firm edema/woody Lipodermatosclerosis Hemosiderin staining
135
syringoma
136
venous ulcers
137
Arterial ulcers
Location: lateral malleolus, between toes, phalangeal heads Even wound margins Pale deep wound bed Pale dry granulation Painful Minimal exudate-dry Thin, shiny dry skin Pallor elevation/dependent rubor Cool Diminished/absent pulses

Dermatology (11 decks)

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