Dermatology CONTINUED Flashcards
How to examine lumps?
Site - neck, face, scalp, nose
Size - 2 dimensions unless it’s round
Shape - as above
Mobile or fixed - can it be moved freely, fixed to skin, bone, muscle
Consistency - hard, firm, soft, rubbery, fluctuant
Surface - irregular, smooth, craggy
Covering skin/mucosa - normal, ulcerated, colour, erythema, blanches
What does it mean if the lump is fixed?
It’s growing into the tissue = invasive = probably cancer
What else can lumps be?
Compressible
Pulsatile
Thrill
Bruit
List the common skin lumps and pigmented lesions
Epidermal cyst Basal cell carcinoma Squamous cell carcinoma Vascular malformations Seborrheic warts Benign pigmented naevi Melanoma
Features of seborrheic warts?
More in elderly Basal cell papilloma May be multiple Well defined Raised edge Looks like cornflake stuck to skin Can be shaved off, benign
Epidermal cysts features?
Fixed to skin Punctum (sharp tip) History of discharge May become infected = red and sore - can burst them Can be left or removed if not infected
Basal cell carcinoma features?
Common in elderly Scalp, face and neck (80%) Light exposure, genetic predisposition Variable appearance Well defined Rarely metastasises Slow growing Pearly edge May crust, then appear to regress Shiny around the outside
Pigmented naevi features?
Freckle or mole
Skin cancer: BCC, SCC, Melanoma features?
BCC:
- Elderly
- Sun exposure
- Face and head
- Slow growing
- Does not metastasise
SCC:
- Elderly
- Sun exposure
- Face, head, arms
- Variable growth
- May metastasise
Melanoma:
- Younger pts
- Sun exposure
- Trunk and limbs
- Variable growth
- Metastasise often
What do SCC’s look like?
Ulcer with rolled margins
What does a keratoacanthoma look like?
Look like a rolled margin and necrotic centre but grow very fast = centre necroses
Malignant melanoma features?
Irregular
Variable pigmentation
Can itch
Can get anywhere
Treatment of BCC?
Surgery - 4mm margin
Radiotherapy
Imiquimod (immune stimulation)
Tx of SCC?
Surgery - 1cm margin
Primary, lymph node metastasis
Radiotherapy
Tx of melanoma?
Surgery 1-3cm margin
- Primary, lymph node metastasis
Radiotherapy
