Lump/skin lump examination

Question 1

Intradermal lumps (impossible to slide skin over)

Answer 1

Sebaceous cyst
Abscess
Dermoid cyst
Granuloma

Question 2

Subcutaneous lumps (skin can slide over)

Answer 2

Lipoma
Ganglion
Neurofibroma
Lymph node

Question 3

Signs of inflammation

Answer 3

Rubor (redness)
Calor (hot)
Tumor (swelling)
Dolor ( pain)
Loss of function

Question 4

Lipoma features

Answer 4

Benign fatty tumour

Site - anywhere fat can expand (not scalp or palms)

Subcutaneous

Smooth, imprecise margins, fluctuant

Complications - pressure effects, malignancy very rare

management - conservative, excision for cosmetic reasons

Question 5

Sebaceous cyst features

Answer 5

Epidermal proliferation within dermis

Site: anywhere on body (trunk, neck, face, scalp)

Intradermal

Central punctum

Complications - infection common

Mx - incision and drainage if infected, non-infected cysts can be shelled out under LA

Question 6

Ganglion features

Answer 6

Degenerative cyst from synovum of joint/tendon

Site - dorsum of hand/wrist, dorsal foot

Subcutaneous

Moves with tendon, may transilluminate

Complications rare

Mx - 50% disappear, aspiration, excision

Question 7

Erythema nodosum causes

Answer 7

Painful, purple raised lesions on shins:
Idiopathic
Sarcoidosis
Infection - Strep, TB
IBD
Drugs (OCP, sulphonamides)
Malignancy (lymphoma, leukaemia)
Pregnancy

Question 8

Neurofibromatosis features

Answer 8

Autosomal dominant genetic disorders

Type 1: von Recklinghausen's disease
CATCHES
Cafe au lait spots
Axillary freckling
Tumours of nervous system
Cutaneous neurofibromata
Hypertension
Eye features (Lisch nodules)
Scoliosis

Type 2:
Bilateral acoustic neuromas
Other tumours of nervous system
Fewer cutaneous features

Question 9

Ulcer by edge type:
Sloping
Punched-out
Undermined
Rolling
Everted

Answer 9

Sloping - venous ulcer
Punched-out - arterial
Undermined - TB, pressure necrosis
Rolling - BCC
Everted - SCC

Question 10

Warning signs of melanoma

Answer 10

ABCDE
Asymmetry
Border irregularity
Colour variation
Diameter (>6mm)
Elevation