Ch. 7-Dermal & Subcutaneous Growths Flashcards
What is helpful with distinguishing features of dermal & subcutaneous growths?
color & consistency
an area of focal dermal fibrosis, often accompanied by overlying epidermal thickening & hyperpigmentation.
dermatofibroma
Dermatofibromas are common and most often seen in ____.
young adults
Dermatofibromas are symptomatic/asymptomatic.
asymptomatic
What is a helpful diagnostic test used to determine dermatofibromas?
‘dimple sign’
Where is the most common locations where dermatofibromas occur?
thighs and legs
How does dermatofibroma appear clinically?
a brown papule or small nodule, often more indurated than elevated
a low-grade malignant fibrous tumor that grows slowly but persistently, and rarely metastasizes; it is distinguished from a dermatofibroma by its larger size, irregular shape, and continued growth.
dermatofibrosarcoma protuberans
What may be an initiating factor for some of dermatofibroma lesions?
trauma
a cyst derived from the upper portion of the epithelial lining of a hair follicle and is located in the mid and lower dermis
epidermal inclusion cyst
T/F: epidermal inclusion cysts are usually asymptomatic, slow growing, and most frequently are found incidentally by either the patient or the examining physician
TRUE
How do epidermal inclusion cysts present clinically?
flesh-colored, firm but malleable, solitary nodule in the skin
What are the key diagnostic features of epidermal inclusion cysts?
a central pore and cheesy, foul-smelling discharge
T/F: to prevent recurrence of epidermal inclusion cysts, the entire cyst, with its lining, should be removed
TRUE
What is the range in size of epidermal inclusion cysts?
0.5 - 5 cm
What are multiple epidermal inclusion cysts a feature of?
Gardner syndrome
an uncommon, autosomal dominant, heritable disorder manifested by multiple epidermal cysts, fibromas, osteomas, and intestinal polyp.
Gardner syndrome
a benign proliferation of blood vessels in the dermis and subcutis.
hemangioma
What is the most common soft tissue tumor of infancy, occurring more frequently in premature, white females.
hemangioma
What are the types of hemangiomas?
- superficial
- subcutaneous
- mixed
How do superficial hemangiomas appear clinically?
a lesion of bright red color
How do subcutaneous hemangiomas appear clinically?
a lesion with a bluish hue
How do mixed hemangiomas appear clinically?
bright red, dome-shaped nodules
What is a diagnostic feature found in many (but not all) hemangiomas?
blanchability
T/F: Most hemangiomas continually increase in size.
FASLE (most involute spontaneously during childhood)
A malignant vascular tumor derived from endothelial cells
Kaposi’s sarcoma
What are the 3 types of Kaposi’s sarcoma?
- classic
- lymphadenopathic
- AIDS-associated
Which form of Kaposi’s sarcoma occurs primarily in elderly men of Eastern European descent?
Classic Kaposi’s sarcoma
Which form of Kaposi’s sarcoma is an aggressive form that primarily occurs in equatorial Africa, where it accounts for approximately 9% of all cancers?
Lymphadenopathic Kaposi’s sarcoma
T/F: You should test for HIV in patients who are newly diagnosed with Kaposi’s sarcoma.
TRUE
How does Kaposi’s sarcoma present clinically?
the lesions may appear as macules, papules, dermal plaques, or nodules that are purple.
excessive proliferation of collagen (scar tissue) after trauma to the skin
keloid
How do keloids present clincally?
as elevated, firm, protuberant nodules or plaques pink or dark-brown in color
Who is keloids most common in?
black people 10 - 30 years old
What regions of the body are more common locations for keloids?
earlobes, shoulders, upper chest, and back
What does histologic examination of keloids show?
whorls and nodules of highly compacted hyalinized bands of collagen
a benign tumor of subcutaneous fat
lipoma
How does a lipoma present clinically?
as a rubbery nodule that appears only slightly elevated above the skin’s surface but is easily palpable deep in the skin
What is the size range of lipomas and where are they most often found?
- range from 1-10cm
- found on the trunk, neck, and upper extremities
T/F: A lipoma is usually shallower, more stable, and less rubbery than an epidermal inclusion cyst.
FALSE (deeper, more freely movable, and more rubbery)
How does a lipoma appear histologically?
as an encapsulated collection of normal fat cells
What represents a focal proliferation of nerual tissue within the dermis?
neurofibroma
What two ways may a neurofibroma appear clinically?
- soft, protruding papules and nodules (most often)
2. deep, firm, subcutaneous nodules (less often)
a dominantly inherited neurocutaneous disorder with prominent skin, skeletal, and nervous system abnormalities
von Recklinghausen’s disease (neurofibromatosis 1)
Ophthalmologic examination of ___ is useful in diagnosing neurofibromatosis 1.
Lisch nodules
What is a characteristic sign of soft papules and nodules of neurofibroma?
‘buttonhole’ sign
What is neurofibromatosis 1 caused by?
an abnormal gene, NF-1, on chromosome 17
What represents a focal collection of lipid-laden histiocytes in the dermis or tendons?
xanthoma
How do xanthomas located in the dermis appear clinically?
yellowish papules, plaques, and nodules
How do tendon xanthomas appear clinically?
deep, flesh-colored, hard nodules located within peripheral tendons
What are the most frequently encountered xanthomas?
flat xanthomas on the eyelids
A type of xanthoma that presents as yellowish plaques on the eyelids & is the only type that is not accompanied by an increase in either plasma cholesterol or triglyceride concentration.
xanthelasma
A type of xanthoma that presents as reddish-yellowish papules & plaques on the extensor surfaces of patients with markedly raised triglyceride levels
Eruptive xanthomas
A type of xanthoma that presents as stony hard nodules occurring on tendons, most often the Achilles tendon & the extensor tendons of the fingers in patients with severe hypercholesterolemia
Tendon xanthomas
A type of xanthoma that presents as yellowish ‘potato-like’ papules and nodules most often found on the elbows & buttocks in patients with increased serum triglyceride or cholesterol levels
Tuberous xanthomas
What are the major causes of the yellow color in skin papules of xanthoma?
- sebaceous glands
- lipid deposits
- granulomas
What is the suggested therapy for a patient with xanthoma?
lowering the abnormal lipid levels with diet or meds
T/F: Eruptive xanthomas usually resolve when triglyceride levels are lowered.
TRUE
