wk3/4: AED Lumps + Bumps 3/4 Flashcards

1
Q

In what condition can you get a choroidal hemangioma? Define it. What can this lead to? Describe

A

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

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2
Q

SOAP for cyst of zeiss (4x1)

A

S: cosmesis
O: visible lesions
A: direct view/slit lamp
P: pouching incision, curettage, cosmesis.

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3
Q

What does SOAP stand for?

A

Subjective, Objective, Assessment, Plan

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4
Q

SOAP for hordeolum

A

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

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5
Q

SOAP for Sebaceous gland carcinoma

A

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

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6
Q

SOP for viral warts

A

S: lump, dx, cosmesis

O: Two forms:
Small papule with digitatedsurface & broad base
Elongated filiform

P: Refer for excision & cautery

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7
Q

S for molluscum contageosum (7)

A

S: skin lesion (1-2 weeks), mild photophobia, lacrimation, VA sldown, hyperaemia, or asymptomatic, cosmesis,

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8
Q

O for molluscum contageosum (6)

A

O: Dome shaped (1-3 mm), waxy papule, w central umbilications, solitary or multiple, unilator bilat, histol: marked surface layer distortion

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9
Q

Ax for molluscum contageosum (3)

A

A:
Check eyebrows & evert
No lymphadenopathy
Elsewhere?

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10
Q

P for molluscum contageosum (5)

A

P:

Counsel (hygiene), spread by skin-skin contact, self limiting, non-scarring, refer for excision & cautery,

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11
Q

S for keratocanthoma (4)

A
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
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12
Q

A for keratocanthoma (2)

A

Otherwise healthy px

Biopsy = Keratin core

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13
Q

P for keratocanthoma (3)

A

Refer for excision & biopsy
Exclude SCC
Spontaneous involution by 1 yr

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14
Q

S for Xanthelasma (2)

A

Cosmesis

Soft yellowish plaques,

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15
Q

O for Xanthelasma (4)

A

usually bilateral, medial aspect, follow folds of skin
Often permanent & slowly progressive
Middle-aged or elderly
May occur in hypercholesterol-aemia/ lipoprotein, disorders

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16
Q

A for Xanthelasma (2)

A

systemic lipid profile

manage for CVD

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17
Q

P for Xanthelasma (4)

A

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)

18
Q

S for Seborrheic keratitis (4)

A

Usually asymptomatic, caused by UV
Present for mths-yrs
May slowly enlarge
Often multiple in light affected skin

19
Q

O for Seborrheic keratitis (4)

A
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)
20
Q

A for Seborrheic keratitis (1)

A

Referal for excision & biopsy (if suspicious)

21
Q

P for Seborrheic keratitis (1)

A

Progressive, suspicious or cosmesis

excise exclude BCC, SCN

22
Q

S for solar/actinic keratosis (2)

A

Rough/scaly elevated lesion

May be present for months

23
Q

O for solar/actinic keratosis (2)

A

Flat skin coloured or light coloured scaley plaque

Sun exposed, fair, elderly

24
Q

A for solar/actinic keratosis (2)

A

Photos look for change?

Biopsy for signs of malignancy

25
P for solar/actinic keratosis (3)
malignant potential photos to monitor refer for biopsy & excision (exclude BCC, SCC)
26
S for naevus (2)
cosmesis, dx
27
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
28
A for naevus (1.5)
FAT and photos for yearly review
29
P for naevus (1)
Refer for biopsy if suspicious
30
S for malignant melanoma (1)
cosmesis
31
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 ```
32
P for malignant melanoma (1)
Refer for excision/biopsy
33
S for kaposis sarcoma (3)
S: Elevated red/purple lesion/plaques May present on lower lid first ~ 25% of patients with AIDS
34
O for kaposi's sarcoma (1.1)
lid + conj involvement
35
A for kaposi's sarcoma (2)
look for multiple lesions, lid eversion/gazes
36
P for kaposi's sarcoma (2)
Referral for immune system elevation, | Biopsy (abnormal endothelium-spindle cells)
37
S for Cyst of moll/sweat (1)
cosmetic
38
O for cyst of moll/sweat (4)
``` O: sweat glands give Multiple & flat: Syringoma When keratin cyst = milia Multiple hard “pimples” Do not squeeze ```
39
A for cyst of moll/sweat (1)
direct view/slit lamp
40
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