Lumps and Bumps

chalazion

granulomatous inflammatory lesion of the meibomian gland

sebaceous secretion leaking from the meibomian gland or adjacent sebaceous glands

What is the cause of a chalazion?

no --they are painless nodules

Are chalazion painful?

upper

What lid are chalazion usually found, upper or lower?

in the tarsal plate

Where are chalazion found?

-Monitor (33% wil resolve)

-Surgery to excise and drain

-Steroid injection into the lesion

-Oral antibiotics (tetracycline) prophylactically

What is the treatment for chalazion?

NO -- there is no pain or infection present

Is a chalazion an active infection?

used for its anti-inflammatory properties. Will melt meibum and cause it to express more easily

Why is tetracycline used for chalazion?

xanthelasma

lipid histiocytes in the dermis of the skin around the eye

yellow plaques located medially

What is the presentation of a xanthelasma?

middle ages to elderly individuals

Who are xanthelasmas present in, usually?

bilateral

Are xanthelasmas typically unilateral or bilateral?

elevated cholesterol levels

What are xanthelasmas associated with?

excision or laser removal

What is the treatment for xanthelasmas?

no -- you should order a lipid panel

Would you expect to see a xanthelasma in a 20 year old patient? What would you do if you saw this condition?

moll cyst

small retention cyst of the lid margin apocrine gland

round translucent, on the anterior lid margin

How do moll cysts appear at the lid margin?

No

Are moll cysts typically painful?

monitoring/observation. They are benign and not painful

What is the common treatment for a moll cyst?

blocked pilosebaceous follicle that contains sebaceous secretions

What are sebaceous cysts caused by?

at the inner canthus of the orbit

Where do sebaceous cysts commonly occur?

milia cyst

tiny epidermal cysts that are caused by occlusions of pilosebaceous units

white round papules that occur in groups

What do milia cysts appear (present) as?

observation/monitor

What is the common treatment for milia cyst?

Zeis cyst

small translucent cyst on the anterior lid margin

obstructed sebaceous gland associated with an eyelash follicle

What is the cause of a Zeis cyst?

observation

What is the common treatment plan for a Zeis cyst?

eccrine hidrocystoma

sweat gland cyst

at the medial or lateral aspect of the lid, not directly involving the lid margin

Where would a eccrine hidrocystoma appear?

observation/monitor

What is the common treatment for a eccrine hidrocystoma?

squamous cell pappiloma

finger like projections of fibrovascular connective tissue

-pedunculated (stalk like)

-sessile (broad base)

What are the typical appearances of squamous cell papilloma?

excision if causing issues (blocking visual axis or causing mechanical ptosis for example)

What are the typical treatments for squamous cell papilloma?

seborrhoeic keratosis

expansion of squamous epithelium of the epidermis

discrete, brown, greasy plaques

What is the presentation of seborrhoeic keratosis?

no -- they are slow growing

Are seborrhoeic keratosis fast growing?

elderly

Who are seborrhoeic keratosis commonly seen in?

excision

What are the common treatments for seborrhoeic keratosis?

prob

Will seborrhoeic keratosis get bigger as time goes on?

actinic keratosis (solar keratosis)

irregular dysplastic epidermic with hyperkeratosis

-hyperkeratotic plaque with scaly surface

-seen with large amount of UV exposure

-common on forehead & back of hands

What is the presentation of actinic keratosis (solar keratosis)?

yes

Does an actinic keratosis (solar keratosis) have the potential to develop into cutaneous horn or squamous cell carcinoma?

the elderly

Who does actinic keratosis (solar keratosis) usually affect?

excision, cryotherapy w/ biopsy

What are the common treatments for actinic keratosis (solar keratosis)?

cutaneous horn

compact keratin in a conical or cone shaped mass protruding from the skin

fair skinned, elderly individuals

Who are cutaneous horns more common in?

on sun exposed areas

Where are cutaneous horns mostly found?

2

Cutaneous horns that are found on the face are ___x a likely to be premalignant or malignant

cryotherapy with a biopsy

What are common treatments for cutaneous horns?

pyogenic granuloma

vascularized proliferation of connective tissue that is infiltrated with inflammatory cells in a red polypodia lesion

-red

-painful

-bleeds easily

What are the presentations of a pyogenic granuloma?

excision

What is the common treatment for a pyogenic granuloma?