Created by Andrew Street
about 8 years ago
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Question | Answer |
3578 & 3582 List & describe benign skin lesions. | * Melanocytic naevi (moles) * Basal cell papilloma (seborrhoeic wart) - overgrowth of the basal cell layer. The lesion can be flesh coloured, brown, or black. Often has a greasy appearance. Surface is iregular and warty. * Dermatofibroma - firm, elevated, pigmented, nodules. May feel like a button in the skin. Peripheral ring of pigmentation may be seen. * Epidermoid cyst (sebaceous cyst) - cystic swellings of the skin with a central punctum. Contain 'cheesy' keratin. * Keratocanthoma - rapidly growing epidermal tumours which develop central necrosis & ulceration. * Pyogenic angioma - benign overgrowth of BD vessels. Rapidly growing pinkish red nodules which are friable & bleed easily. |
3578 ? | Seborrhoeic wart |
3578 ? | Dermatofibroma |
3578 ? | Epidermoid cyst (sebaceous cyst) |
3578 ? | Keratoacanthoma |
3578 ? | Pyogenic granuloma |
3578 List potentially pre-malignant cutaneous tumours. | * Solar keratoses (actinic keratoses) - erythematous, silver, scaly papules or patches with a conical surface & red base. * Bowen's DS - form of intraepidermal carcinoma-in-situ. Isolated scaley red patch or plaque with an irregular edge. Slowly ^ size. * Atypical mole syndrome (dysplastic naevus syndrome) - +++ naevi. ^ risk of malignant melanoma. * Giant congenital melanocytic naevi - large moles present at birth. >20 cm ^ risk of malignant melanoma. * Lentigo maligna - slow growing macular area of pigmentation seen in the elderly esp on the face. Border & pigmentation often irregular. K & C p1224. |
3578 ? | Lentigo maligna |
3578 ? | Atypical mole (dysplastic naevus) |
3578 ? | Solar keratosis |
3578 ? | Giant congenital melanocytic naevi |
3578 ? | Bowen's DS |
3579 ? | Basal cell carcinoma |
3578 ? | Squamous cell carcinoma |
3578 ? | Squamous cell carcinoma |
3578 ? | Hugh Jackman's basal cell carcinoma! |
3579, 3580, 3581 Features & Rx of BCC. | Nodular: pearly nodule with rolled telagietic edge. May have a central ulcer. Superficial: red scaly plaques with a raised smooth edge. BCC almost never metastasizes. Rx: excision, curettage, cautery, radiotherapy - all with 5-10% recurrence rate. Can invade deeper structures such as cartilage and bone. OHCM p598 & MAAG p498. |
3579, 3580, 3581 Features & Rx of SCC. | Usual presentation is as an ulcerated lesion with hard, raised edges, in sun exposed sites or the lips of smokers. Other risk factors are solar keratoses, HPV, & chronic inflammation (Marjolin's ulcer of leg seen in venous ulceration). Can metastasize to lymph nodes & cause extensive local destruction. Rx is therefore ablative (excision or radiotherapy). MAAG p498 & OHCM p598. |
3583 ? | Malignant melanoma |
3583 Types ,and features, of malignant melanoma. | Most serious form of melanoma as can metastasize early. Four types: 1 Lentigo maligna melanoma - lentigo maligna develops a papule or nodule. 2 Superficial - large, flat, irregular, pigmented lesion which grows laterally before vertical invasion. 3 Nodular - most aggressive form. Rapidly growing pigmented nodule which bleeds or ulcerates. 4 Acral lentiginous malignant melanomas - pigmented lesions on the palm, sole, or under the nails. K & C p1226. |
3584 Explain to a patient which features suggest malignant change of a mole and how to look for these. | Asymmetry Border - irregular Colour - non-uniform Diameter - >7 mm Elevation. OHCM p599. |
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