wk3/4: AED Lumps + Bumps 3/4 Flashcards
In what condition can you get a choroidal hemangioma? Define it. What can this lead to? Describe
Can occur in Sturge-weber syndrome. A choroidal hemangioma is an overgrowth of blood vessels in the choroid that gives a lump in the retina. This can predispose to serous fluid accumulation which can lead to retinal detachment and increased risk of glaucoma
SOAP for cyst of zeiss (4x1)
S: cosmesis
O: visible lesions
A: direct view/slit lamp
P: pouching incision, curettage, cosmesis.
What does SOAP stand for?
Subjective, Objective, Assessment, Plan
SOAP for hordeolum
S: red, swollen (localised), discomfort,
distortion of lid margin (cosmesis),
concerned of possible dx?
O: red/erythematous skin, tender nodule, purulent material, base of lash, bleph
A: VA, touch (tender, firm, mobile); SL incllid eversion & NaFl; size; photodoc, dx
P: Warm compresses to assist release, most resolve spontaneously within 2-3 days, topical broad spectrum antibiotic (chlorsig) if persistent ±pouching (small)
Care for cellulitis (fever = oral a/biotics
SOAP for Sebaceous gland carcinoma
S: chronic non-healing bleph, recurrent mass, multi-lobedred irritated eye for months to yrs
loss of lashes and eye lid structure
O: resembles chalazion early = ‘Great Masquerader’ –long lasting
A: Biopsy
P: Careful examination & review with referral of suspicious cases
SOP for viral warts
S: lump, dx, cosmesis
O: Two forms:
Small papule with digitatedsurface & broad base
Elongated filiform
P: Refer for excision & cautery
S for molluscum contageosum (7)
S: skin lesion (1-2 weeks), mild photophobia, lacrimation, VA sldown, hyperaemia, or asymptomatic, cosmesis,
O for molluscum contageosum (6)
O: Dome shaped (1-3 mm), waxy papule, w central umbilications, solitary or multiple, unilator bilat, histol: marked surface layer distortion
Ax for molluscum contageosum (3)
A:
Check eyebrows & evert
No lymphadenopathy
Elsewhere?
P for molluscum contageosum (5)
P:
Counsel (hygiene), spread by skin-skin contact, self limiting, non-scarring, refer for excision & cautery,
S for keratocanthoma (4)
S
Papule, grows rapidly initially over 2-6 weeks (volcano appearance but not as cratered –more raised, lack halo)
Middle aged or elderly
Sun damaged skin (premalignant?)
Central umbilicationwith keratin core
A for keratocanthoma (2)
Otherwise healthy px
Biopsy = Keratin core
P for keratocanthoma (3)
Refer for excision & biopsy
Exclude SCC
Spontaneous involution by 1 yr
S for Xanthelasma (2)
Cosmesis
Soft yellowish plaques,
O for Xanthelasma (4)
usually bilateral, medial aspect, follow folds of skin
Often permanent & slowly progressive
Middle-aged or elderly
May occur in hypercholesterol-aemia/ lipoprotein, disorders
A for Xanthelasma (2)
systemic lipid profile
manage for CVD
P for Xanthelasma (4)
refer to GP to manage systemic overlay
check /control lipid levels (TGs, cholesterol),
systemic work up (fasting blood lipids)
Consider excision for cosmesis(recurrent) + refer for biopsy (to make sure it’s benign)
S for Seborrheic keratitis (4)
Usually asymptomatic, caused by UV
Present for mths-yrs
May slowly enlarge
Often multiple in light affected skin
O for Seborrheic keratitis (4)
Rare before 30
Small hard lesion above the skin surface
Proliferation basal epidermal cells
Keratin filled cysts
May have rough surface
Elsewhere (trunk, neck, upper extremities)
A for Seborrheic keratitis (1)
Referal for excision & biopsy (if suspicious)
P for Seborrheic keratitis (1)
Progressive, suspicious or cosmesis
excise exclude BCC, SCN
S for solar/actinic keratosis (2)
Rough/scaly elevated lesion
May be present for months
O for solar/actinic keratosis (2)
Flat skin coloured or light coloured scaley plaque
Sun exposed, fair, elderly
A for solar/actinic keratosis (2)
Photos look for change?
Biopsy for signs of malignancy
