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SPM- Dermatology > Benign Skin Tumours > Flashcards

Benign Skin Tumours Flashcards

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Dermatology Board Prep flashcards
1
Q

What should you ask about in the history when assessing skin lesions to assess their risk of being benign or malignant?

A

Age of patient (increasing age= increasing chance of malignancy
Symptoms
Growth changes over time (rapid or over a long period of times?)
Single or multiple (single is more concerning)
Location- sun exposed areas?

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2
Q

How should skin lesions be examined?

A

Inspection and palpation

Palpate to see if solid, fluctuant or fluid filled. Fluctuant lesions are likely to be a cyst or an abscess.

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3
Q

For solid lesions what should you inspect?

A

Inspect to see if there is overlying surface change and their colour

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4
Q

What is a seborrhoeic keratosis? What are they also known as?

Describe their features and where they are normally found.

Is intervention needed?

A

Very common benign lesion that has a stuck on appearance.

They’re also known as basal cell papillomas or seborrhoeic warts

Usually have a raised and rough surface. Colour is variable from light to dark brown. May cause itching. Most often found on the trunk but also common on the head and neck. There is often multiple.

Intervention is rarely needed.

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5
Q

What is are the four types of melanocytic naevi?

What is the common term for melanocytic naevi?

A

Congenital
Junctional
Intra-dermal
Compound

Commonly these are called moles.

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6
Q

Describe the features of congenital naevi

A 
Large
Pigmented
Protuberant
Hairy
Found at birth
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7
Q

Describe the features of junctional naevi

A

Small
Flat
Dark
(Melanocyte is confined to the base of the epidermis and so the mole is usually flat, junction of epidermis and dermis)

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8
Q

Describe the features of compound naevi

A 
Centrally raised with surrounding patch
Warty
Hyperkeratotic
May be hair
Pigmented 
(Melanocytes are within the epidermis and the dermis)
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9
Q

Describe the features of intra-dermal naevi

A

Melanocytes are entirely within the dermis so they are often skin coloured
Papule or nodule
Firm raised lesions

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10
Q

What does a halo naevus describe?

A

Loss of pigment around a naevi- often seen in young adults

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11
Q

What causes a naevus?

A

Melanocyte proliferation

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12
Q

What skin colour tends to have more naevi?

A

Fairer skinned individuals

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13
Q

What features of a mole would raise suspicion of malignant melanoma?

A 
ABCDE- Characteristics
Asymmetry
Irregular Borders
Colour Inconsistency
Diameter>6mm
Evolving changes over time

Or (check by specialist if)
Appears different to other moles
New mole in people aged >40
Bleeding, crusting or itching

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14
Q

If someone has a melanocytic naevus what is the important differential diagnosis not to be missed?

A

Malignant melanoma- to be reviewed by a dermatologist if there is any uncertainty

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15
Q

Name the two types of cyst that can arise from a hair follicle

A

Pilar

Epidermoid

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16
Q

Describe the features of an epidermoid cyst

A

Epidermoid cysts commonly have a punctum (small dark plug and contents can be squeezed out through this)
May become painful due to secondary infection
Often present on parts of the body with little hair- face, neck, hair, chest, shoulders, skin around the genitals

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17
Q

On palpation what is a characteristic of a cyst?

A

Fluctuant

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18
Q

What do epidermoid and pilar cysts contain?

A

A cheesy looking material that is made up of keratin

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19
Q

What did epidermoid/pilar cysts used to be known as? Why is this no longer the case?

A

Used to be called sebaceous cysts but this is reserved for cysts that contain sebum which are comparatively rare. Epidermoid and pilar cysts contain keratin.

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20
Q

What condition are epidermoid cysts more likely to occur with?

A

Acne as they can arise when a hair follicle has been inflamed

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21
Q

What is the inheritance pattern of pilar cysts?

A

Autosomal dominant trait-

Epidermoid cysts however are not hereditary

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22
Q

What symptoms might someone with an epidermoid or pilar cyst describe?

A

Often painless raised cystic lumps
May become painful due to secondary infection
Pilar cysts commonly affect the scalp so may be painful when brushing or combing hair
May produce a foul-smelling discharge

23
Q

Describe the features of a pilar cyst?

A 
Commonly affect areas with hair so scalp
Dark punctum usually present
May have several
Inherited in autosomal dominant pattern
Round dome shaped lumps 
Fluctuant on palpation
Foul-smelling cheese like discharge
24
Q

How might epidermoid or pilar cysts be managed?

A

Antibiotics may be used for secondary infection

Surgical removal under local anaesthetic

25
Q

Why might an epidermoid or pilar cyst be surgically removed?

A

Cysts is large and unsightly
Cosmetic reasons
If it is causing issues with daily life, such as catching on combs or hair brushes
Recurrent infections of the cyst

26
Q

What is a cherry angioma/Campbell de Morgan spot?

A

Overgrowth of dilated capillaries
Asymptomatic
Numbers increase in age

27
Q

Describe the features of a cherry angioma

A 
Benign
Bright red to purple
Papule
Asymptomatic 
Increasing number with age
28
Q

Do cherry angiomas require treatment?

A

Not really
Only for cosmetic reasons or if bleeding often
They are benign

29
Q

How might Campbell de Morgan spots/cherry angiomas be removed?

A

Electrocautery
Laser
Surgical excision

30
Q

What is a pyogenic granuloma?

A

Lobular proliferation of blood vessels (wrongly named as nothing to do with infection)

31
Q

What causes a pyogenic granuloma?

A

Cause is unknown

Some appear following minor trauma

32
Q

Where do pyogenic granulomas commonly arise?

A

Fingers
Hands
Face
Scalp

33
Q

Describe the features of pyogenic granuloma

A

Red raised nodule (>0.5cm in diameter) that grows fairly rapidly and then stabilises
Prone to oozing and bleeding
Usually not painful

34
Q

What is the treatment for pyogenic granuloma?

A

Surgical removal- curette and cauterised

Note- that all excised pyogenic granulomas should be sent for histology as they can appear very similar to an amelanotic (non-pigmented) melanoma

35
Q

What is telangiectasia?

A

Dilation of capillaries that is visible at the skin surface

36
Q

What is a spider naevus?

A

Central arteriole dilation and surrounding capillary network dilation.

Occur in large numbers in pregnancy and liver disease

37
Q

What is a strawberry naevus?

A

It is a capillary haemangioma, due to proliferation of capillaries. They’re the commonest benign tumours of infancy, develop in the first few days of life and resolve after about one year.

38
Q

Where do the majority of capillary haemangiomas affect?

Do they cause symptoms?

A

The face and head.

They are the most common benign tumours of infancy. Don’t cause any symptoms but can be alarming for parents. May cause bleeding or ulceration (especially in nappy areas)

39
Q

What is a dermatofibroma?

A

Firm nodule that arrises due to proliferation of fibroblasts in the dermis.

40
Q

Describe some of the features of dermatofibromas?

A 
Firm
Nodular (>0.5cm)
Variable pigment (pink to brown)
Located particularly on legs
Most commonly thought the occur after insect bites

Note- benign but if diagnosis uncertain excision biopsy should be performed under LA.

41
Q

What is a keloid scar?

A

Scar overgrowth that occurs following trauma to the skin
Overgrows to become larger than the original wound
There is overproduction of collagen at keloid scar sites

42
Q

What population group are keloid scars more common in?

A

People with darker skin e.g. Afro-Caribbean

43
Q

Describe the appearance of a keloid scar

A 
Enlarged, raised scar
Can be pink, red, brown or skin coloured
Firm and smooth
Shiny
Hairless
44
Q

How can keloid scars be treated?

A 
Surgical removal is rarely suitable as it causes a bigger scar to com back
Steroid injections
Steroid creams
Cryotherapy
Radiotherapy
Laser therapy
45
Q

What is the difference between a neuroma and a neurofibroma?

A

Neuroma is a nerve tumour

Neurofibroma is a nerve sheath tumour

46
Q

What are multiple neurofibromas a sign of?

A

Neurofibromatosis Type 1

Also get cafe au lait macules

47
Q

What is a lipoma?

A

Benign tumour formed from adipose tissue

48
Q

Describe the features of a lipoma

A 
Soft
Slow growing
Rubbery texture
Superficial
Mobile
Painless
May be singular or multiple
Commonly located shoulders, neck, trunk and arms
49
Q

What is the management for lipoma?

A

Surgical excision under LA

Or may be observed as they are benign

50
Q

What is a sebaceous adenoma?

A

Benign overgrowths of the sebaceous gland

51
Q

Describe the features of a sebaceous adenoma?

A

Firm yellowish papule or nodule

52
Q

What may sebaceous adenoma be a sign of?

A

An underlying cancer syndrome called Muir Torre Syndrome

Autosomal dominant cancer syndrome- sub-type of HNPCC. Individuals are prone to developing cancers of the colon, genitourinary tract and skin.

53
Q

What is the management for skin tags?

A

Skin tags may be removed for cosmetic reasons. Options include:
Cryotherapy
Surgical excision
Electrosurgery
Ligation- a suture is tied around the neck of the skin tag.

SPM- Dermatology (10 decks)

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