Disease 4 - lumps and bumps
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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
Chalazion sx and tx and ddx?
- gradually enlarging nodule
- firm round
- tx- cut it out if long term
- ddx: sebaceous gland carcinoma, preseptal cellulitis, other granulomas
What is a hordeolum and sx?
- staph infection of meibomian gland
- swelling of tarsal plate
- may discharge through skin
- lid hygiene and warm compresses
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
What are milia?
- blocked pilosebaceous glands- retention of keratin
- tiny white superficial papules- in groups
- blocked with keratin and sebum
- white/black heads
Squamous cell papilloma appearance and tx?
- finger like projection
- raspberry like surface
- fibrovascular connective tissue
- surgical excision
Basal cell papilloma?
- discrete greasy brown plaques
- associated with ageing
Naevi? 3 types of acquired?
- developed from epidermal/dermal melanocytes
What is a junctional naevi?
- well circumscribed
- low malignant potential
What is an intradermal naevi? ddx?
- may be non pigmented
- ddx: cyst of moll/zeiss
both intradermal and junctional naevi
What is a congenital naevi?
- split between upper and lower eye
- uniform colour
- 15% malignancy
What is the most common type of tumour in the orbit/periorbital area in childhood?
What is a capillary haemangioma?
- rare tumour presents soon after birth
- strawberry naevus
- forms due to lots of capillaries forming in the wrong place
Signs and sx of capillary haemangioma?
- small red lesion upper eyelid
- blanches with pressure
- swells with crying
What is a port wine stain? tx?
- rare, congenital, subcutaneous lesion
- assoc ipsi glaucoma
- laser treatment
What is a xanthoma?
yellow subcutaneous plaques- macrophages, lipids, cholesterol
What are the common features of xanthoma?
- upper eyelid
- elderly with hypercholesterolaemia
Which is more common/aggressive BCC or SCC?
- common: BCC
- aggressive: SCC
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
What is a nodular BCC?
- shiny, firm nodule
- surface vascularisation
What is ulcerative BCC?
bleeding and rolled up edges
What is a sclerosing BCC?
indurated plaque- hard to see because it is beneath epidermis
What are the general features of SCC?
lower lid margin
What are the features of a nodular SCC?
- NO surface vascularisation
- maybe crusting
What is an ulcerative SCC?
- red base
- more sharply defined
What is a sebaceous gland carcinoma (SGC)?
- slow growing rare tumour
- upper eyelid and meibomian gland
- early- very similar to chalazion or blepharitis
- but yellowish material (lipid) in tumour= SGC
What is a lentigo maligna?
- slowly expanding pigmented maculae
- sun damaged skin
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