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Y5 Skin > List II - Less Common 'Know of' Conditions > Flashcards

List II - Less Common 'Know of' Conditions Flashcards

1
Q

What is solar keratosis also known as?

A
  • Actinic keratosis
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2
Q

What are the clinical features of actinic keratosis?

A
  • Actinic keratosis is viewed as a premalignant lesion because there are atypical keratinocytes present in the epidermis
  • In a person with 7 actinic keratosis, the risks of subsequent SCC is of the order of 10% at 10 years
  • Primary lesion is a rough erythematous papule with a white to yellow scale
  • Lesions are typically clustered at sites of chronic sun exposure
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3
Q

What does actinic keratosis look like?

A
  • A flat or thickened papule or plaque
  • White or yellow; scaly, warty or horny surface
  • Skin coloured, red or pigmented
  • Tender or asymptomatic
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4
Q

What is the treatment of actinic keratosis?

A
  • Actinic keratoses are usually removed because they are unsightly or uncomfortable, or because of the risk that skin cancer may develop in them
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5
Q

What are the treatment options for actinic keratosis?

A
  • Cryotherapy using liquid nitrogen
  • Shave, curettage and electrocautery
  • Excision
  • Field treatments
  • Diclofenac - gel BD for 3 months
  • 5-fluorouracil BD for 2 to 8 weeks
  • Imiquimod cream 2 to 3 times weekly for 4 to 16 weeks
  • Photodynamic therapy
  • Ingenol mebutate gel 2 to 3 applications
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6
Q

What is a keloid scar?

A
  • Tumour like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound
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7
Q

What are the predisposing factors for developing a keloid scar?

A
  • Ethinicity: More common in people with dark skin

* Occur more commonly in young adults, rare in the elderly

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8
Q

What are the common sites of keloid scars?

A
  • Order of decreasing frequency:
  • Sternum
  • Shoulder
  • Neck
  • Face
  • Extensor surface of limbs
  • Trunk
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9
Q

How can the risk of Keloid scars be reduced in clinical practice/surgery?

A
  • Keloid scars are less likely if the incisions are made along relaxed skin tension lines
  • Langer lines were historically used to determine the optimal incision line
  • Better cosmetic results are seen when following Langer lines than skin tension lines
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10
Q

What are the management options for keloid scars?

A
  • Early keloids may be treated with intra-lesional steroids e.g. triamcinolone
  • Excision may sometimes be required
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11
Q

What is a ganglion?

A
  • Presents as a cyst arising from a joint or tendon sheath
  • Most commonly seen around the back of the wrist and are 3 times more common in women
  • Ganglions often disappear spontaneously after several months
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12
Q

What is Kaposi’s sarcoma?

A
  • Associated with HIV
  • Caused by human herpes virus 8 (HHV-8)
  • Presents as purple papules on the skin or mucosa (e.g. GI and respiratory tract)
  • Skin lesions may later ulcerate
  • Respiratory involvement may cause massive haemoptysis and pleural effusion
  • Management is with radiotherapy and resection
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13
Q

How is HHV8 transmitted?

A
  • Sexual contact
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14
Q

What are the types of kapossi’s sarcoma?

A
  • Classic - older males, slow growing, affects legs
  • Endemic - young adult males, africa, aggressive
  • Epidemic - AIDS, affects different body parts such as skin, mouth, GI tract and lungs
  • Immunosuppression related - skin, develops following organ transplantation
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15
Q

What is the treatment of Kaposi’s sarcoma?

A
  • Treatment directed at underlying cause
  • HIV - HAART
  • Cytotoxic chemotherapy agents
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16
Q

What are the vascular skin lesions?

A
  • Pyogenic granuloma
  • Port wine stain
  • Haemangioma
  • Angiosarcoma
  • Microvenular hemangioma
  • Angioserpiginosum
17
Q

What is a pyogenic granuloma?

A
  • Relatively common benign skin lesion
  • (may also be known as eruptive haemangioma)
  • Unknown cause but has a number of linked factors:
  • Trauma
  • Pregnancy
  • More common in women and young adults
18
Q

What are the features of pyogenic granuloma?

A
  • Most common sites are head/neck, upper trunk and hands
  • Lesions in the oral mucosa are common in pregnancy
  • Initially small red/brown spot
  • Rapidly progress within days to weeks forming raised, red/brown lesions which are often spherical in shape
  • Lesions may bleed profusely or ulcerate
19
Q

What is the management of pyogenic granuloma?

A
  • Pregnancy associated lesions often resolve spontaneously post partum
  • Other lesions persist - removal methods include curettage and cauterisation, cryotherapy, excision
20
Q

What is a port wine stain?

A
  • Vascular birth marks that tend to be unilateral
  • Deep red of purple in colour
  • Unlike other vascular birthmarks such as salmon patches and strawberry haemangiomas, they do not spontaneously resolve, can become darker and raised over time
  • Treatment is with cosmetic camoflage or laser therapy
21
Q

What is associated with the port wine stain?

A
  • Sturge-Weber syndrome

- Port wine stain externally on the face and head with trigeminal nerve involvement internally

22
Q

What is a haemangioma?

A
  • AKA strawberry naevus / capillary haemangioma
  • Usually not present at birth but may develop rapidly in the first month of life
  • Appear as erythematous, raised and multilobed tumours
  • Typically increase in size until around 6-9 months before regressing over the next few years (around 95% resolve before the age of 10 years)
23
Q

What are the common sites of a haemangioma?

A
  • Face, scalp and back

* Rarely present in the upper respiratory tract leading to potential airway obstruction

24
Q

Who do haemangiomas affect?

A
  • Around 10% of white infants
  • Female infants, premature infants and those of mothers who have undergone chorionic villous sampling are more likely to be affected
25
Q

What are the potential complications of haemangiomas?

A
  • Mechanical e.g. obstructing visual fields or airway
  • Bleeding
  • Ulceration
  • Thrombocytopenia
26
Q

If treatment is required for haemangioma e.g. visual field obstruction, what are the treatments?

A
  • Propanolol is increasingly replacing systemic steroids

* Topical beta-blockers such as timolol are sometimes used

27
Q

What is cavernous haemangioma?

A
  • Type of deep capillary haemangioma
28
Q

What is an angiosarcoma?

A
  • Aggressive neoplasm mainly divided into 3 variants:
  • Angiosarcoma of the head and scalp, lyphoedema-associated angiosarcoma and radiationinduced angio-sarcoma
  • Characterised by a tendency to metastasize to regional lymph nodes and lungs
  • Prognosis is poor
  • Clinically, early lesions develop as ill defined violaceous to bluish areas with an indurated border and advanced lesions become elevated or nodular and occasionally ulcerated
29
Q

What is the appearance of angiosarcoma?

A
  • Homegenous pattern with combinations of colurs i.e. whitish, pinkish, reddish, bluish or violaceous
  • White lines at the nodular parts
30
Q

What is a cherry haemangioma?

A
  • ‘Campbell de Morgan spots’ are benign skin lesions which contain an abnormal proliferation of capillaries
  • More common with advancing age and affect men and women equally
31
Q

What is the appearance of Campbell de Morgan spots?

A
  • Erythematous, papular lesions
  • Typically 1-3 mm in size
  • Non-blanching
  • Not found on the mucous membranes

As they are benign, no treatment is usually required

32
Q

What is a mircovenular haemangioma?

A
  • Acquired, slowly growing, asymptomatic, benign vascular tumour that usually presents on the upper limbs, forearms or trunk of young to middle aged adults
  • Appears as sharply circumscribed, bright red, solitary lesions varying in size from 0.5 to 2 cm
33
Q

What is the appearance of a microvenular haemangioma?

A
  • Diffuse erythema with multiple well-demarcated small red globules of different sizes
  • Peripheral fine pigment network
34
Q

What is angioma serpiginosum?

A
  • Benign vascular disorder, characterised clinically by multiple minute, red to purple. grouped macules distributed in a serpiginous or gyrate pattern
  • Numerous small, relatively well demarcated, round to oval red lacunae

Y5 Skin (3 decks)

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