Disease 4 - lumps and bumps

  1. What is a chalazion?
    • granulomatous sterile inflammatory lesion
    • build up of meibomian oil
    • epitheloid cells, macrophages, neutrophils, giants cells, plasma cells
  2. Chalazion sx and tx and ddx?
    • gradually enlarging nodule
    • painless
    • firm round
    • tx- cut it out if long term
    • ddx: sebaceous gland carcinoma, preseptal cellulitis, other granulomas
  3. What is a hordeolum and sx?
    • staph infection of meibomian gland
    • swelling of tarsal plate
    • may discharge through skin
  4. hordeolum tx
    • lid hygiene and warm compresses
    • antibiotics
  5. What is the different between a cyst of zeiss and a cyst of moll?
    • zeiss is white, opague- oil gland
    • moll is translucent- sweat gland
  6. What are milia?
    • blocked pilosebaceous glands- retention of keratin
    • tiny white superficial papules- in groups
  7. Comedones?
    • blocked with keratin and sebum
    • white/black heads
  8. Squamous cell papilloma appearance and tx?
    • finger like projection
    • raspberry like surface
    • fibrovascular connective tissue
    • surgical excision
  9. Basal cell papilloma?
    • discrete greasy brown plaques
    • associated with ageing
  10. Naevi? 3 types of acquired?
    • developed from epidermal/dermal melanocytes
    • junctional 
    • compound
    • intradermal
  11. What is a junctional naevi?
    • flat 
    • well circumscribed
    • pigmented
    • low malignant potential
  12. What is an intradermal naevi? ddx?
    • elevated
    • benign
    • may be non pigmented
    • ddx: cyst of moll/zeiss
  13. Compound naevi?
    both intradermal and junctional naevi
  14. What is a congenital naevi?
    • rare
    • split between upper and lower eye
    • numerous
    • uniform colour
    • 15% malignancy
  15. What is the most common type of tumour in the orbit/periorbital area in childhood?
    capillary haemangioma
  16. What is a capillary haemangioma?
    • rare tumour presents soon after birth
    • G>B
    • strawberry naevus
    • forms due to lots of capillaries forming in the wrong place
  17. Signs and sx of capillary haemangioma?
    • small red lesion upper eyelid
    • blanches with pressure 
    • swells with crying
  18. What is a port wine stain? tx?
    • rare, congenital, subcutaneous lesion
    • unilateral
    • assoc ipsi glaucoma
    • laser treatment
  19. What is a xanthoma?
    yellow subcutaneous plaques- macrophages, lipids, cholesterol
  20. What are the common features of xanthoma?
    • bilateral
    • upper eyelid
    • elderly with hypercholesterolaemia
  21. Which is more common/aggressive BCC or SCC?
    • common: BCC
    • aggressive: SCC
  22. What is BCC caused by, sx, what 3 types are there?
    • pluripotent basal cells proliferating downwards and palisading at the bottom
    • signs: ulceration, hardness, irregular borders
    • 3types: nodular, ulcerative, sclerosing
  23. What is a nodular BCC?
    • shiny, firm nodule
    • surface vascularisation
  24. What is ulcerative BCC?
    bleeding and rolled up edges
  25. What is a sclerosing BCC?
    indurated plaque- hard to see because it is beneath epidermis
  26. What are the general features of SCC?
    lower lid margin
  27. What are the features of a nodular SCC?
    • hard
    • NO surface vascularisation 
    • maybe crusting
  28. What is an ulcerative SCC?
    • red base
    • more sharply defined
    • indurated
    • elevated
  29. What is a sebaceous gland carcinoma (SGC)?
    • slow growing rare tumour
    • G>B
    • upper eyelid and meibomian gland
  30. SGC presentation?
    • early- very similar to chalazion or blepharitis
    • but yellowish material (lipid) in tumour= SGC
  31. What is a lentigo maligna?
    • slowly expanding pigmented maculae
    • elderly
    • sun damaged skin
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Disease 4 - lumps and bumps