Benign Skin Growths Flashcards Preview

Z Dermatology Clin Med > Benign Skin Growths > Flashcards

Flashcards in Benign Skin Growths Deck (49)
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1
Q

Definition and Incidence of

A

Acrochordon
•Common, fleshy lesions along skin folds
–neck, eyes, axilla, intertriginous areas
•Incidence:
–females > males
–uncommon before age 30
–more common with familial tendency, obesity

2
Q

Characteristics of

A

Acrochordon
•skin-toned to medium brown color
•flat, fleshy, mobile
•attached via stalk (pedunculated)
•most persist lifelong
•symptomatic due to
–clothing
–jewelry
trauma (torsion - becomes black/hemorrhagic

3
Q

D/dx and Tx of

A

Ddx:

  • wart
  • nevus

Tx:

  • reassurance
  • snip excision
  • electrodessication
  • cryotherapy
  • pathology not required *

*SEND IF UNCERTAIN

4
Q

Definition and Incidence of

A

Cafe au lait spot

•Uniformly pigmented light brown macule/patch
•Usually present at birth
–Almost always present by 1 yo
–Tendency to be inherited

  • •6+ café-au-lait macules

> 1.5 cm diameter may indicate neurofibromatosis type 1

–2+ features of NF required for dx

5
Q

Tx of

A

Cafe au lait

None

6
Q

Definition/Incidence of

A

Cherry Angioma

  • Round, slightly raised bright red papule
  • MC vascular growth on the skin
  • Incidence increases with age
  • Asymptomatic
  • Most commonly on the trunk
  • Persistent
7
Q

Characteristics of

A

Cherry angioma

  • dome-shaped
  • smooth
  • cherry-red
  • superficial trauma may induce bleeding
8
Q

Characteristics and Incidence of

A

Cutaneous Horn

•Common, hyperkeratotic lesion
•Skin colored, horney growth
•Most frequently on face/scalp
–Also on hands, penis, eyelids
•Usually asymptomatic
•Increased incidence with age
–Risk of underlying malignancy increases with age, fair complexion

9
Q

Tx of

A

Cherry angioma

•Reassurance – no treatment required

•Cosmetic removal
–Electrocautery
–Vascular laser (PDL, KTP)

10
Q

This lesion can arise from…

A

Cutaneous Horn
•Can arise from benign, pre-CA, malignant lesions

11
Q

Tx of

A

Cutaneous Horn

•Excisional biopsy
–Must include base in order to determine underlying diagnosis
–Then treatment of underlying lesion if necessary

12
Q

Defintion and Incidence of

A

Dermatofibroma

•Common
•Firm, dense, dermal papule or nodule
•Female > Male
–Lower extremities MC
–UE above elbows
•Arise secondary to skin injury?

13
Q

Characteristics of

A

Dermatofibroma
•Papule or nodule
•0.5 to 1 cm diameter
–max. size over mos to yrs
–usually stable thereafter
•Feels firm to touch
•Dimple sign: depression noted over thin/flat/nodular DF when grasped between thumb and forefinger
•Skin-colored to pink

14
Q

What is Dimple Sign and what lesion does it indicate?

A

A depression noted over thin/nodular skin when grasped between thumb and forefinger

Indicative of Dermatofibroma

15
Q

D/dx of

A

Dermatofibroma

  • amelanotic melanoma
  • molluscum contagiosum
  • neurofibroma
  • DFSP
16
Q

Tx of

A

Dermatofibroma

  • reassurance
  • elliptical excision – linear scar
  • shave removal – DF may recur
  • Cryosurgery – can lead to PIH
  • ILK if pruritic
  • Excisional biopsy imperative if enlarges >2cm diameter: r/o DFSP
17
Q

Definition and Indicence of

A

Epidermal Inclusion Cyst

•One of the most common benign tumors
•Benign, firm, mobile nodule filled with keratin
•Begin as plugged hair follicle
–common on face, neck, trunk
•Arise spontaneously
•Predisposing factors
–hair-bearing region
–trauma, friction
•Solitary > Multiple
•Usually asymptomatic
–May become inflamed s/p ruptureàconfused with infection (redness, pain, swelling, warmth)

18
Q

Characteristics of

A

Epidermal Inclusion Cyst

  • firm, dome-shaped nodule
  • mobile with central plug
  • soft cheese-like keratinous contents
  • can be inflamed, red
  • rarely infected
  • grow slowly, persist indefinitely
19
Q

Tx of

A

Epidermal Inclusion Cyst

•Reassurance
•I&D
•Excision
–If cosmetically undesirable or recurrent inflammation
–Must excise cyst wall
•Rarely antibiotics

20
Q

Definition and Incidence of

A

Infantile Hemangiomas

  • MC vascular tumor of infancy
  • Red/purple/violaceous-colored benign vascular neoplasm
  • Usually occurs during first year after birth (1/3 present at birth)
  • 60% appear on head and neck
21
Q

Superficial versus Deep Cavernous Characteristics of

A

•Superficial (“strawberry”)
–Dull to bright red
–Proliferate 8-18 months, then regress

•Deep Cavernous
–deeper variant
–often multiple, ill defined
–Dark red/blue
–tend to persist
–Can ulcerate, painful

22
Q

Proliferative versus Involutional Phase of

A

Infantlie Hemangiomas

•Proliferative phase: during the first year
– with the most growth occurring during the first 4-6 months of life
–slows between the middle and end of the first year of life
•Involutional phase: rapid or prolonged
–30% by 3 yo, 50% by 5 yo, 70% by 7 yo
–Remainder take 3-5 years to involute
–Streaks or areas of white as lesion involutes
–After 6 y.o, ~40% have residual scar formation, telangiectasia, anetodermatype skin changes (increased skin laxity)

23
Q

Tx of

A

Infantile Hemangiomas

•Usually left to involute
•Intervention when lesions interfere with function/development
–*Specialist
–Laser surgery - PDL
–Corticosteroids
–Beta Blockers
•DOC for complicated lesions
–Interferon
–Imiquimod (rarely used)
–Cryosurgery
–Excision

24
Q

Defintion and Location of

A

Port Wine Stain

•AKA Nevus Flammeus
•Capillary malformation during development
–Always present at birth
–Pink to dark/bluish red
–Smooth texture; nodules may develop over time
•Location
–MC head and neck
•Think Sturge-Weber syndrome when in distribution of CN5

25
Q

Evolution of

A

Port Wine Stain

–Begin as pink or red lesion
–Become more bluish or purple with age
–Nodules may develop in adulthood

26
Q

What is this and who does it occur in

A

Nevus Simple (Salmon Patch)

40% of newborns on nape of neck or forehead

27
Q

Characteristics of

A

Keloid

  • develop early in healing
  • linear to nodular
  • pink, red-purple, flesh-toned, or black
  • raised
  • extends beyond margins
  • tender
  • can enlarge over time
28
Q

D/dx and tx of

A

Differential Diagnosis

  • sarcoidosis
  • hypertrophic scar
  • recurrent malignancy

Treatment

•discourage piercing
•Reassurance
•Treatment if sx or cosmetically undesirable
–Serial intralesional steroid injections
–Laser: PDL or FCO2
–Silicone gel sheets – symptomatic tx
•dermatology/plastics referral

29
Q

What are soft, skin-colored to brown, compressible papules or nodules?

A

Neurofibromas

30
Q

What is this?

A

Neurofibroma

31
Q

Distinguishing features of neurofibromatosis

A

>6 cafe au lait spots
>2 neurofibromas
axillary freckling

32
Q

Characteristics of Nevi (moles)

A

Flat, round, uniformly colored

Pigmented (pink, tan, dark brown)

  • darker skin types have darker moles

Stimulated by sun exposure

Mostly asymptomatic

Common proliferation of melanocytes

33
Q

Type of nevi that are flat, more common in children, and are nests of melanocytes at the dermoepidermal junction

A

Junctional

(Junctional nevi are usually on palms, soles, genitalia, and mucosa)

34
Q

Features of dermal nevus

A

Course, dark hairs grow from the nevus

Found within the dermis

Pigmentation often arranged in flecks

35
Q

Defining characteristic of halo nevus found in adolescents

A

A rim of hypopigmentation that surrounds the nevus

36
Q

Identify

A

Halo nevus

37
Q

What’s the name for this condition which consists of multiple, atypial nevi that are at risk for becoming malignant?

A

Dysplastic Nevus Syndrome

38
Q

Meaning of the A, B, C, D, E’s in evaluating pigmented lesions

A

A- asymmetry

B- borders

C- color

D- diameter

E- evolution

Also can evaluate with the ugly duckling sign

39
Q

The type of blue/black gray nevus that is 2-8cm, often located in the sacral region is sometimes mistaken for bruises in children.

A

Mongolian spot

40
Q

Treatment and prevention for nevi

A

Total body skin exams by self and provider

Sun protection

If suspicious, biopsy or refer

41
Q

Tyndall effect

A

Light dispersion that causes dermal brown melanin to appear blue-gray

-seen in Blue Nevus and Mongolian spots

42
Q

Characteristics of

A

Solar lentigo (sun spots)

  • 2 -20 mm
  • oval, irregular macules
  • hyperpigmentation
  • associated with sun damage and common in fair skin types
43
Q

Treatment of solar lentigo

A
  • Hydroquinone cream
  • Tretinoin cream
  • Chemical peels
44
Q

Common locations for a venous lake

A
  • lips
  • face
  • ears
  • neck
  • dorsum of hands
  • forearms
45
Q

Skin findings of

A
  • dark blue to purple papule
  • 2-10mm
  • will blanch with pressure
46
Q

Venous lake treatment

A
  • Reassurance
  • Can be cauterized and excised for cosmetic reasons
47
Q

Features of

A

Alot of variability- can be raised, flat, and variety of colors

“stuck on” appearance

surface will crumble when picked

48
Q

Differential diagnosis of

A
  • skin tags
  • warts
  • melanoma
49
Q

Treatments for symptomatic seborrheic keratosis lesions

A
  • cryotherapy
  • cautery and curettage

-shave removal is uncertain because highly pigmented lesions resemble melanoma