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D&D Unit 4 > Benign Skin Tumors > Flashcards

Benign Skin Tumors Flashcards

1
Q

What are cherry hemangiomas?

A
  • they are RED
  • arise in middle age
  • most common vascular tumor
  • no underly disease

On trunk – can be multiple maybe hundreds

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2
Q

What is the tx for cherry hemangiomas?

A
  • Superficial electrodesiccation
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3
Q

What is infantile hemangioma?

A
  • Most common soft tissue tumor of infancy
  • 10-12% in infants
  • Benign endothelial
  • Stain with Glut-1
  • Rapid proliferation in first 1-3 months
  • Precursor lesion noted at birth
  • Spontaneous involution over years

AKA strawberry/capillary hemangioma

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4
Q

Primary pop’n for infantile hemangioma

A
  • Girls
  • Premature infants
  • Infants of moms post-chorionic villus sampling
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5
Q

What are complications associated with infantile hemangioma?

A
  • Location:peri-ocular (probs w/ vision), beard area (airway involvemnet), lip, anogenital, nasal tip
  • Ulceration
  • Size (large distorts normal tissue/function)
  • Multiple => maybe internal involvement
  • Congenital syndromes (PHACES)
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6
Q

What is the tx for infantile hemangioma?

A
  • Observation
  • Local wound care
  • Pulse dye lase
  • Topical, intralesional and systemic steroids
  • Bta-blockers
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7
Q

What is port wine stain?

A
  • Vascular malformation
  • Present at birth => persists through adulthood
  • Often irregular vascular channels => DO NOT stain w/ Glut-1
  • Somatic mutation in GNAQ

No gender/gestational predilection

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8
Q

What are complications are associated w/ port wine stain?

A
  • Klippel-trenaunay syndrome
  • Overgrowth of an extremity
  • Varicose veins => venous stasis, edema, ulceration
  • Sturge-Weber Syndrome (on face, developmental delay, seizures, glaucoma)
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9
Q

What is the tx for port wine stain?

A
  • Pulse dye laser

Why treat?

  • Persist into adulthood
  • Get worse with time
  • Dark purple, nodular, bleeding blebs
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10
Q

What is nevus sebaceus?

A
  • Enlargement of sebaceus glands => associated with alopecia
  • rapid growth occur at puberty => epidermal hyperplasia
  • Somatic mutation: HRAS and KRAS
  • Yellow-orange linear plaque on face/scalp
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11
Q

What are complications associated with nevus sebaceus?

A
  • Epidermal nevus syndrome (neuro probs)

- Epithelial neoplasms

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12
Q

What is tx for nevus sebaceus?

A
  • Observation

- Surgical excision

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13
Q

What is sebaceous hyperplasia?

A
  • common benign tumor of oil gland
  • increased frequency after mid age
  • Distribution: face>trunk>extremities
  • Primary lesion: 1-6mm => yellow-white papule w/ central dell
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14
Q

What is the tx for sebaceous gland hyperplasia?

A

a

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15
Q

What is acrochordon?

A

Skin tages, fibroepithelial polyps

  • Common => 1/4 of all adults have at least one
  • Solitary or multiple
  • Soft, flesh colored (1-4mm)
  • Large ones: soft fibroma

Complications: recurrent trauma, torsion

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16
Q

What is the tx for acrochordon?

A

a

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17
Q

What is lipoma?

A

a

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18
Q

what is the tx for lipoma?

A
  • No tx (observation)

- Surgical excision

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19
Q

What is dermatofibroma?

A
  • Distribution: legs (80%)
  • Typically solitary (80%)
  • Primary lesion
  • Positive dimple (fitzpatrick) sign — when you squeeze it, you make a dimple

Complications: pain, pruritis

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20
Q

What is the tx of dermatofibroma>

A

a

21
Q

What are keloid scars?

A

type of scar

22
Q

What is the tx for keloid scars?

A
  • Topical steroids under occlusion
  • Intralesional steroids
  • Surgical excision (best for ear keloids)
  • Surgery +/- radiation
23
Q

What are seborrheic keratosis?

A

Barnacles of life

  • Benign tumor of hair follicle
  • Primarily head, neck, trunk
24
Q

Describe the primary lesion of seborrheic keratosis?

A
  • white-gray to tan to brown to black
  • exophytic papule
  • Smooth to verrucous
  • Often friable
  • Studded w/ small pits
25
Q

What are the clinical variants of seborrheic keratosis?

A

a

26
Q

What is the tx for seborrheic keratosis?

A
  • Moisturizers
  • Cryosurgery (liquid nitrogen)
  • Surgical removal
27
Q

What are nevocellular nevi?

A

MOLES

  • infancy to adults
  • any skin surface area
  • # increased w/ sun exposure

Types

  • intradermal
  • junctional
  • compound
28
Q

Describe intradermal nevus

A

a

29
Q

Describe junctional nevus

A

a

30
Q

Describe compound nevus

A

a

31
Q

What are indications for tx for nevocellular nevi?

A
  • No tx for most

- ABCDE is unsure

32
Q

What are appropriate tx’s for nevocellular nevi?

A

a

33
Q

What are inappropriate tx’s for nevocellular nevi?

A

a

34
Q

What are blue nevus?

A
  • Dermal proliferation of melanocytes => produce lots of melanin
35
Q

What are the clinical features of blue nevi?

A
  • Congenital or acquired (more common)
  • Most common in Asians and whites
  • Primary lesion: blue to blue-gray
  • 1mm to 2cm
36
Q

What is the tx for blue nevi?

A
  • No tx
  • Monitor
  • Surgical removal (PUNCH IT!)
37
Q

What are congenital nevi?

A
  • Solitary or multiple
  • Cutaneous surfaces
  • 1mm to HUGE

Complications
- head, neck, posterior midline => risk for cancer

38
Q

What is the tx for congenital nevi?

A

Monitor over time — look for ABCDE

Sometimes elective surgery (not usually recommended)

39
Q

What are dysplastic nevi?

A
  • acquired melanocyte proliferation
  • epidermal a/o dermal proliferation
  • Abnormal growth
40
Q

Wha tare the clinical features of dysplastic nevi?

A

Males = females

  • Age of onset: 20
  • Location: any cutaneous, usually trunk
  • Number: 1 to 100s
41
Q

Describe the primary lesion of dysplastic nevi

A
  • Round to oval, irregular
  • Varying colors
  • Margins: fuzzy, pigment bleeds into surrounding skin
  • No size limit
42
Q

What is the clinical importance of dysplastic nevi?

A
  • Could be w/ melanomas

- Familial atypical mole and melanoma syndrome (increased risk)

43
Q

What is the tx of dysplastic nevi?

A

Biopsy the ugly duckling

Atypical ones: difficult to get it all => potentially not worth the procedure

44
Q

What is neurofibromatosis?

A
  • AD inheritance w/ variable expression
  • 50% of cases b/c of spontaneous mutations
  • Defect in neurofibromin gene on chromosome 17 (tumor suppressor)
45
Q

What is the diagnostic criteria of neurofibromatosis?

A

1) 6 or more cafe au lait patches (>1.5cm)
2) 2 or more neurofibromas, 1 plexiform
3) Axillary/inguinal freckling
4) Optic glioma
5) 2 or more Lisch nodules
6) Osseous lesion
7) First degree relative w/NF

46
Q

What are neurofibromas?

A
  • Soft flesh colored papules (button hole sign)
  • Focal proliferation of neural tissue w/in the dermis
  • solitary? => don’t worry
  • multiple? => maybe NF, worry
47
Q

What are cafe au lait spots?

A
  • Subtle increase of melanocytes # w/ increase melanin production
  • Congenital/early childhood
  • On trunk, proximal extremities
  • Usually solitary
  • Multiple?? => THINK neurofibromatosis
48
Q

What is the tx of cafe au lait spots?

A
  • No tx (cosmetic concern)

- Pigmented laser (expensive, varying results)

D&D Unit 4 (18 decks)

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