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
P for solar/actinic keratosis (3)
malignant potential
photos to monitor
refer for biopsy & excision (exclude BCC, SCC)
S for naevus (2)
cosmesis, dx
O for naevus (5)
O: Well circumscribed lesion (<1cm usually)
Flat or elevated, pigmented or nonipigmented
Epidermis, dermis, rarely deeper (blue)
Intradermal: most common, dome shaped, tan, brown,
Appear at puberty, may become pedunculated, in older age
A for naevus (1.5)
FAT and photos for yearly review
P for naevus (1)
Refer for biopsy if suspicious
S for malignant melanoma (1)
cosmesis
O/A for malignant melanoma (5)
Raised nodule or plaque Has active halo, variable colour Increased size, thickness, irregular edges, inflammation, bleeding, satellite lesions, lympadenopathy, Growth and rapid change Take photos and watch yearly
P for malignant melanoma (1)
Refer for excision/biopsy
S for kaposis sarcoma (3)
S: Elevated red/purple lesion/plaques
May present on lower lid first
~ 25% of patients with AIDS
O for kaposi’s sarcoma (1.1)
lid + conj involvement
A for kaposi’s sarcoma (2)
look for multiple lesions, lid eversion/gazes
P for kaposi’s sarcoma (2)
Referral for immune system elevation,
Biopsy (abnormal endothelium-spindle cells)
S for Cyst of moll/sweat (1)
cosmetic
O for cyst of moll/sweat (4)
O: sweat glands give Multiple & flat: Syringoma When keratin cyst = milia Multiple hard “pimples” Do not squeeze
A for cyst of moll/sweat (1)
direct view/slit lamp
P for cyst of moll/sweat (3)
P: excision for cosmesis
Pouching of small hydrocystoma
- consider size of lid margin for this
Refer all else
