Superficial Swellings Flashcards
Common skin lesions
Lipoma Sebaceous cyst Dermoid cyst Ganglion Keloids, hypertrophic scars
What is a soft tissue
Non epithelial
Extraskeletal mesenchyme which is not lymphohematopoietic tissue, viscera and glia
Types of soft tissue
Fibrous CT Adipose tissue Skeletal muscle Blood vessels Lymph vessels Peripheral nervous system
Epidermis layer
Stratum corneum Stratum lucidum Stratum granuulosum Stratum spinosum Stratum basale
Type of cells in stratum basale
Basal cells
Type of cells in s Tatum spinosum
Prickle cells
Type of cells in stratum granulosum
Granular cells
Where do you find stratum lucidum
Palms
Sole
Stratum corneum type of cells
Kératinized cells
Type of cells in epidermis
Melanocytes Langerhans Merkel Hair Nails
Classification of soft tissue swelling
Intact & abnormal epidermis
Normal skin (beneath skin )
Overlying epidermis destroyed
Steps in history of lumps
Age, sex, ethnic group, occupation Duration Cause First symptom Other symptoms Progression Persistence Multiple , single ? Systemic symptoms FHx SHx
Examination of lump
Site Size Shape Surface Edge Color Temp Tenderness Depth Mobility Composition (consistency , fluctuation , fluid thrill, translucency, resonance, pulsality, compressibility , bruit ) Local tissue state Regional lymph node Réduciibility
Exam to test fluctuation of lump
Pascals law
Signs of composition of lump
Consistency Fluctuation Translucency Fluid thrill Pulsatility
macule characteristics
Flat, distinct , discolored
Less than 1cm
Papule characteristics
Small
Well defined
Raised
Vesicle characteristics
Small fluid filled sac
Fluid => clear, white, yellow or mixed with blood
Less than 0.5cm
Bulla characteristics
Large
Filled with fluid => clear or blood stained
Thick
More than 0.5cm
Wheal characteristics
Pale skin swelling
Surrounded by erythema
Very itchy
Defined
Cyst characteristics
Small sac Red and swollen Blackhead in the center White , yellow, green discharge Tender Move under skin
Nævus characteristics
Benign
Growth on the skin
Cluster of melanocytes
Can be raised
Papilloma characteristics
Benign growths
Warts and verrucae
Tumor characteris tics
Can be skin colored , waxy, like a scar, or thick
Grows
Can see small blood vessels
Harmatoma charcateritics
Benign lesions
Aberrant disorganized growth of mature tissue
Ulcer characteristics
Round open sore
Outer border raised and thick
Skin discoloration inn area
Red and warm
Lump investigations
USG XRAY CT SCAN MRI excision/incision biopsy
Excision biopsy definition
Removal of entire lump through cut through the skin
Incision lump
Cut of skin to remove sample of lump for diagnosis
Lipoma definition
Overactive distended fat cluster which is palpable
Lipoma characteristics
Spherical Well defined Slip sign positive Non tender with l’ovulation Soft but solid like Pseudo fluctuate No trans illumination
Lipoma treatment
Excision biopsy
Sebaceous cyst definition
Slow growing
Distended sebum filled sebaceous glands
Sebaceous cyst characteristics
Spherical Smooth Well defined Non tender From skin and subcutaneous Punctum (very important ) Not attached deeply
3 complications of sebaceous cyst
Sebaceous horn
Cocks peculiar tumor
Calcification
Dermoid cyst definition
Pièce of skin trapped deep to normal skin
Ganglion definition
Myxomatous degeneration of fibrous tissue
Ganglion characteristics
Spherical Joint and capsule ( wrist, hands ) Smooth Transilluminate Slow growth Painless Irreducible Cross fluctuate Viscous gelatinous material
Differential of ganglion
Bursae
Cystic protrusion
Ganglion treatment
Excision biopsy
What is epidermal inclusion cyst
Transplantation of skin into soft tissue during injury leading to cyst filled with keratin and desquamated cells
What is a subcutaneous bursae
Fluid filled cavities developing between tendons bones and skin
Condition of subcutaneous bursae
Painful Site of repeated trauma Fast growth Circular Indistinct edge Soft or spongy Transilluminate , fluctuate
Treatment of bursae
Excision biopsy
Keloids definition
Benign firm tumor like fibrous swelling arising from scar
Keloidscharacter
Extend beyond scar
No spontaneous regression
Recurs after simple excision
Raised , very vascular, itchy , painful
Complications keloids
Ilcers Infection Malignant change Itching Tenderness
Treatment keloids
Excision + radiotherapy
Or excision + steroid injection o
Triple therapy => surgery, radiation , steroid
Compression therapy
Button therea[py
Zinc oxide
Ear clip
Silicone cream
Hypertrophic scar treatment
Reassurance
Left alone
Spontaneous regression
Benign papilloma characteristics
Plaques, Pedunculated, or variable shape Normal color Soft Incompressible Not enlarged
Treatment of benign papilloma
Excision biopsy
I
Type of malignant tumor common in blacks
Squamous cell carcinoma
Type of tumor common in whites
Basal cell carcinoma
Malignant melanoma
Risks factor of malignant skin cancer
Chronic ulcers Solar and ionizing radiations Carcinogenic chemicals Discoid lupus Hydradenitis suppurativa Albinism Xeroderma pigmentosa Advancing age
Percentage of SCC in blacks
5%
2nd commonest skin cancer
SCC
Scc macro
Ulcerated lesion
Raised everted edges
Indurated/ oedematous base
Dirty/nodular floor
Histo SCC
Well differentiated
Keratinizing lesiosn
Nest cells
SCC investigations
X rays
Biopsy
Treatment SCC
See slide
