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Skin Lumps (Sebaceous cyst (Epithelial-lined cyst containing keratin (Two…
Skin Lumps
Sebaceous cyst
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Inspection
Occur @ sites of hair growth
- Scalp, face, neck, chest, back
- NOT soles or palms
Central Punctum
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Complications
- Infection: pus discharge
- Ulceration
- Calcification
Cock’s Peculiar Tumour
- Large ulcerating trichilemmal cyst
on the scalp
- Resemble an SCC
Gardener’s Syndrome: FAP +
- Thyroid tumours
- Osteomas
- Dental abnormalities
- Epidermal cysts
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Neurofibroma
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Extras
Examine skin: Café-au-Lait Spots
Examine the eyes: Lisch nodules
Examine the axilla: Freckles
Examine the cranial nerves (esp. 8)
BP
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NF 1: von Recklinghausen’s
- AD, Chr 17
- Cafe-au-lait spots (>6, >15mm)
- Freckling
- Neurofibromas
- Lisch nodules (iris)
Lipoma
Pathology
Benign tumour of mature adipocytes
Sarcomatous change probably doesn’t
occur.
Liposarcomas arise de novo
- Older pts.
- Deeper tissues of the lower limbs
Inspection
Occur anywhere fat can expand
- i.e. NOT scalp or palms
- inc. spermatic cord,
submucosa
May be a scar from recurrence
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Viva
Dercum’s Disease / Adiposis dolorosa
- Multiple, painful lipomas
- Assoc. peripheral neuropathy
- Obese, postmenopausal women
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Bannayan-Zonana Syndrome
- Autosomal dominant
- Multiple lipomas
- Macrocephaly
- Haemangiomas
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Ganglion
Cystic swelling related to a synovial-lined
structures: joint, tendon
Myxoid degeneration of fibrous tissue
Contain thick, gelatinous material
Inspection
Can be found anywhere
Often dorsum of hand or wrist
May be scar from recurrence
Weakly transilluminable
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Tx
Non-Surgical
- Aspiration followed by 3wks of immobilisation
Surgical Excision
- Recurrence in 50%
- Neurovasc damage
Differential
- Bursae
- Cystic protrusion from synovial cavity of
arthritic joint.
Pyogenic granuloma
Rapidly growing capillary haemangioma.
Neither pyogenic, nor a granuloma
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Inspection
Most commonly on hands, face, gums
and lips.
Bright red hemispherical nodule
May have serous / purulent discharge
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Dermoid Cyst
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Viva
Child / young adult: congenital
Adult: acquired
Tx
Congenital
- CT to establish extent
- Surgical excision
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Dermatofibroma
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Inspection
Can occur anywhere
Mostly on the lower limbs of young to
middle-aged women
Small, brown pigmented nodule
Differential
- Malignancy: melanoma, BCC
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Palpation
Firm, woody feel: characteristic
Intradermal: mobile over deep tissue
Seborrhoeic keratosis
Benign hyperplasia of basal cell layer
- Hyperkeratosis: corneum thickening
- Acanthosis: spinosum thickening
- Hyperplasia of basal cells
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