Common benign skin lesions Flashcards

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1
Q

what is this lesion?

A

benign acquired nevi

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2
Q

compound nevi are common in

A

individuals with lighter skin phototypes

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3
Q

nevi on palms, soles, conjuctiva, and nail bed are more common in individuals of ______ and _______ descent

A

African and Asian

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4
Q

what is this lesion?

A

junctional nevi

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5
Q

describe junctional nevi

A

mole in junction (border) between the epidermis (outer) and the dermis (inner) layer

flat and macular

symmetry of color and shape

more common in younger individuals

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6
Q

what is this lesion?

A

compound nevi

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7
Q

describe compound nevi

A

pigmented

papule (elevated)

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8
Q

what is this lesion?

A

intradermal nevi

flesh colored papule

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9
Q

when should biospy be considered

A

new, changing, atypical appearing melanocytic lesion

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10
Q

what are the ABCDE’s for lesions

A

A- asymmetry

B- border (if irregular or indistinct)

C- color (pigmentation is not uniform, variegated, or different shades)

D- diameter (>6mm)

E- evolving (changes over time)

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11
Q

what is this lesion

A

congenital melanocytic nevuc (CMN)

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12
Q

describe congenital melanocytic nevus

A

flat and tan in color or elevated, can have variation in pigmentation

vary in size

mostly on trunk or extremities, less commonly on head and neck

earlier onset, larger with more heterogeneous morpholoy

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13
Q

how do you categorize CMN

A

size

small: <1.5cm
medium: >10-20cm
large: >30-40cm
giant: >60cm

greater size, more risk for malignancy

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14
Q

what is this a presentation of?

A

infantile hemangioma

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15
Q

describe infantile hemangioma

A

most common soft tissue tumour of infancy

benign endothelial cell neoplasm

early proliferation followed by gradual, spontaneous involution

absent at birth

F>M

premature/low weight infants

older mothers/chorionic villus sampling

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16
Q

growth pattern of hemangiomas

A

volumetric rather than centrifugal growth

80% of final size by end of early proliferative phase (mean=3.2mo)

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17
Q

what are signs of involution of infantile hemangiomas

A

color change from red to grey-purple and flattening of surface

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18
Q

what is this condition?

A

pericoular hemangioma

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19
Q

tx for hemangioma

A

small: spontaenous resolution
severe: non-selective beta blocker propranolol

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20
Q

what is this lesion?

A

vascular malformation (port wine stain)

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21
Q

describe vascular malformation

A

slow expansion

evident at birth

no predilections

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22
Q

what is sturge weber syndrom

A

combo of vascular malformation, trigeminal distribution, seizure

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23
Q

how to distinguish vascular malformation and hemangioma

A

sharp midline dermarcation

24
Q

sequela of vascular malformation

A

hypertrophy of limb

soft tissue hypertrophy

25
Q

what is this presentation?

A

milia

more common in pediatric

26
Q

describe milia

A

small firm white papule containing keratin and representing small inclusion cysts

40-50% will have milia

resolve spontaneously within first 4 weeks of life

27
Q

what is this a presentation of

A

miliaria

28
Q

describe miliaria

A

occlusion of eccrine sweat ducts

small vesicles of retained sweat trapped under swollen stratum corneum

29
Q

what is this a presentation of?

A

mastocytosis

excessive collections of otherwise normal mast cells

generalized form of childhood mastocytosis is called urticaria pigmentosa

frequently resolve for peds

can cause excessive histamine

30
Q

what is this?

A

Darier’s sign

urtication of lesions of mastocytosis caused by the stroking or scratching

31
Q

what is this lesion

A

halo nevi

32
Q

describe halo nevi

A

<20 yr

no gender predilection

risk of overall increased # of melanocytic nevi

20% have vitiligo

33
Q

what is this lesion?

A

mongolian spot

34
Q

describe a mongolian spot

A

congenital dermal melanosis

blue-grey patch

lumbosacral distribution

asian descent

resolve spontaneously

35
Q

what is this a presentation of?

A

alopecia areata

36
Q

describe alopecia areata

A

non-scarring patterned alopecia

circular areas

organ-specific autoimmune disease involving T-cells

complete scalp hair loss: alopecia totalis

complete scalp and body hair loss: alopecia universalis

37
Q

what is the pathognomonic feature of alopecia areata

A

exclamation point hair which narrows proximally as it exits the hair follicle

38
Q

what is this a presentation of?

A

cherry hemangioma

39
Q

describe cherry hemangioma

A

proliferation of dilated venules

increase in number with age

small cherry red papules or maules

40
Q

what is this a presentation of?

A

venous lake

41
Q

describe venous lake

A

dilation of venules

ear or lip

sun damage

95% in men

42
Q

what is this a presentation of?

A

dermatofibroma

43
Q

describe dermatofibroma

A

benign skin neoplasms compoased of collagen, macrophages (histiocytes), capillaries, fibroblasts

firm, skin colored or slightly pigmented papules or nodules, measuring 0.5-1cm in diameter

tender or pruritic

round/ovoid with well-defined border

44
Q

why does dimple sign occur for dermatofibroma

A

epidermis is tethered to underlying fibrotic component

overlying skin does not slide over the underlying nodule

dimple sign - skin pucker inwards also known as Fitzpatrick sign

45
Q

what is this a presentation of?

A

spider angioma

46
Q

describe spider nevus/angioma

A

telangiectasia

central arteriole (body), radiating vessels (legs)

common in normal children

parturition or cessation of oral contraceptives

47
Q

what is the diagnostic marker for spider angiomas?

A

classic refill pattern

refill radiating from the central vessel outward

48
Q

what is this lesion?

A

seborrheic keratoses

49
Q

describe seborrheic keratoses

A

common benign neoplasms

stuck on appearance

papules and plaques with well defined borders

familial trait (AD)

increased prevalence w age

can have verrucous-appearing papules or plaques

scaling when scratched

50
Q

what is this lesion?

A

dermatosis papulosis nigra

SK on darker skin phototype

oriented in lines of skin relaxation (Langer lines)

51
Q

what is this lesion?

A

achrochordon

skin tag

flesh-colored, pendunculated, fleshy papules

spontaneously fall off if blood supply becomes strangulated

increasing age, diabetes, obesity

52
Q

achrochordons may occur on the _______

A

oral, anal, or vulvovaginal mucosa

53
Q

what is this lesion?

A

fibrous papules of the nose

54
Q

how to distinguish fibrous papule from other papular lesions (BCC, nevi, sebaceous hyperplasia?

A

look for single firm, dome shaped, flesh colored papule on nose or central face

lesions rarely occur on forehead, cheeks, chin, or neck

55
Q

what is this lesion?

A

pyogenic granuloma

rapidly growing, benign, vascular growths

solitary red papule or nodule

ulcerates or bleeds easily

more common in children and women of child-bearing potential

56
Q

drugs associated with pyogenic granuloma

A

isotretinoin, topical retinoids, indinavir, 5-fluorouracil, capecitabine, mitoxantrone, anti-epidermal growth factor inhibitors