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What is a chalazion?
- granulomatous sterile inflammatory lesion
- build up of meibomian oil
- epitheloid cells, macrophages, neutrophils, giants cells, plasma cells
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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
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What is a hordeolum and sx?
- staph infection of meibomian gland
- swelling of tarsal plate
- may discharge through skin
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hordeolum tx
- lid hygiene and warm compresses
- antibiotics
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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
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What are milia?
- blocked pilosebaceous glands- retention of keratin
- tiny white superficial papules- in groups
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Comedones?
- blocked with keratin and sebum
- white/black heads
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Squamous cell papilloma appearance and tx?
- finger like projection
- raspberry like surface
- fibrovascular connective tissue
- surgical excision
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Basal cell papilloma?
- discrete greasy brown plaques
- associated with ageing
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Naevi? 3 types of acquired?
- developed from epidermal/dermal melanocytes
- junctional
- compound
- intradermal
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What is a junctional naevi?
- flat
- well circumscribed
- pigmented
- low malignant potential
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What is an intradermal naevi? ddx?
- elevated
- benign
- may be non pigmented
- ddx: cyst of moll/zeiss
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Compound naevi?
both intradermal and junctional naevi
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What is a congenital naevi?
- rare
- split between upper and lower eye
- numerous
- uniform colour
- 15% malignancy
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What is the most common type of tumour in the orbit/periorbital area in childhood?
capillary haemangioma
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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
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Signs and sx of capillary haemangioma?
- small red lesion upper eyelid
- blanches with pressure
- swells with crying
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What is a port wine stain? tx?
- rare, congenital, subcutaneous lesion
- unilateral
- assoc ipsi glaucoma
- laser treatment
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What is a xanthoma?
yellow subcutaneous plaques- macrophages, lipids, cholesterol
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What are the common features of xanthoma?
- bilateral
- upper eyelid
- elderly with hypercholesterolaemia
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Which is more common/aggressive BCC or SCC?
- common: BCC
- aggressive: SCC
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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
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What is a nodular BCC?
- shiny, firm nodule
- surface vascularisation
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What is ulcerative BCC?
bleeding and rolled up edges
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What is a sclerosing BCC?
indurated plaque- hard to see because it is beneath epidermis
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What are the general features of SCC?
lower lid margin
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What are the features of a nodular SCC?
- hard
- NO surface vascularisation
- maybe crusting
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What is an ulcerative SCC?
- red base
- more sharply defined
- indurated
- elevated
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What is a sebaceous gland carcinoma (SGC)?
- slow growing rare tumour
- G>B
- upper eyelid and meibomian gland
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SGC presentation?
- early- very similar to chalazion or blepharitis
- but yellowish material (lipid) in tumour= SGC
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What is a lentigo maligna?
- slowly expanding pigmented maculae
- elderly
- sun damaged skin
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