Derm, Biopsy, Shave Excision Flashcards
Basal cell carcinoma
- Most common malignant tumor of eyelid
- Slow developing, nonresolving lesion
- Hx of extensive UV exposure
- More common with age, fair-complected patients, with previous Hx skin malignancy
Clincal presentation of BCC
- More prevalent on lower lid
- Central, umbilicated ulceration
- Raised, pearly borders
- +/- discharge, crustation, erythema
Management of BCC
- Non-responsive to antibiotic/steroid tx suggestive of neoplasia • Metastasis rare
- Slow growing
- Monitor closely
- Photodocument
- Referral for biopsy
SCC
• Less common, more aggressive than BCC
• Much higher potential for mets
• ~5-10% of eyelid malignancies, arising de novo or from pre-existing keratosis
• Difficult to distinguish from BCC often, tends to have less surface
vascularization
• Occurs in plaque, nodular, and ulcerating forms
• Conjunctival form as well
Hemangioma
- Congenital or appears soon after birth
- Colors vary from faint pink, purple, blue to red
- Typically resolve by adolescence
- Differentiate from other forms of vascular tumors
- Port-Wine stains (nevus flammeus)
Hordeolum
Bacterial infection (typically Staph sp.) of multiple glands • Zeiss/Moll (External) • Meibomian (Internal) Clinical presentation • Focal tenderness • Erythema • Pointed lesion (like a pimple) Management • Compresses/massage • Oral antibiotics • Monitor for preseptal cellulitis
Seborrheic keratosis
Common
• Some forms regarded as premalignancies
• Slow to change
Clinical characteristics • Flat, or elevated plaques • Circumscribed with distinct borders • Appear as “stuck on” lesions • Dry, scaly, feels like sandpaper
Molluscum contagiosum
• Most frequent in children
•
Clincal characteristics of molluscum contagiosum
•
Managment of molluscum
- Dry lesions will resolve
* “Chees
Melanocytic nevus
- Typically congenital or early onset
- Junctional, Dermal, and Compound forms
- Usually pigmented
- Well defined borders, presence of hair
Papilloma
- Benign, epithelial overgrowths
- Variable presentation in size, shape, and pigmentation
- Typically avascular
- Cosmetic, or functional concerns
- Irritation
- Itching
- Obscures vision
Sebaceous cyst
- Vary in size .5mm to 1cm
- Caseous, yellow appearance
- Single or multiple lesions
- Common around lids
- Typically not painful
Managment of sebaceous cyst
Incise/evacuate
Sudiferous cyst
- Glands of Moll
- Similar to sebaceous cyst but contents are clear
Management
• Lance with needle and drain
Verrucae
- AKA verruca vulgaris
- Likely viral, in the wart family
- Single or multiple nonsecreting papillomatous lesions on eyelids
Managment
- monitor
- excision
Xanthelasma
- Elderly patients
- Association with hyperlipidemia and hypercholesterolemia
- Flat, triangular masses in the superior and inferior canthal sulci
- May be excised, or smoothed out with RF procedure
Dermatoscopy
A noninvasive diagnostic technique for the early
diagnosis of melanoma and the evaluation of other pigmented and
non-pigmented lesions on the skin that are not as well seen with
the unaided eye. Also known as surface microscopy, dermoscopy,
and epiluminescence microscopy.
Originally used oil immersion to visualize skin lesions to assist in
the evaluation of malignancy potential
• Modern devices use polarized light; oil immersion not required
Biopsy
Procedure to sample tissue for histopathologic analysis • Basic types utilized for skin biopsies • Punch • Shave • Excisional
Most common biopsy for ophthalmic use
Shave
