|
Arabic
Bengali
Chinese
English
French
German
Hebrew
Hindi
Italian
Japanese
Korean
Malay
Polish
Portuguese
Spanish
Turkish
Ukrainian
Vietnamese|
Lecture notes, cheat sheets
Dermatovenerology. Skin tumors (most important)
Directory / Lecture notes, cheat sheets Table of contents (expand) LECTURE No. 14. Tumors of the skin Skin tumors are non-inflammatory neoplasms that consist of structural elements of the skin that do not tend to regress. All tumors are divided into epithelial, neuroectodermal and mesenchymal. Distinguish tumors benign, malignant and intermediate forms - potentially malignant (precancrosis of the skin). In the group of precancroses, obligate (pigmented xeroderma and Dubrey's melanosis) and facultative (chronic dermatitis caused by the action of carcinogens, radiation skin lesions, senile keratoma, skin horn, keratoacanthoma, leukoplakia, kraurosis, chronic cheilitis, pigmented nevi) are distinguished. 1. Epithelial tumors Nevus warty Limited lesions with a brownish-brown verrucous surface. May be multiple, there is no favorite localization; sometimes arranged linearly. Keratosis seborrheic Appears at the age of 30-40 years. Brownish-brown or almost black formations with a papillomatous surface, sharply limited, covered with fatty scales. Rise above the level of healthy skin. Localization: closed areas of the skin, less often - the face, scalp. Keratoma senile Facultative precancrosis that occurs in the elderly and old people. Dense dry nodules of brownish or gray color, covered with scales, when removed, a warty surface is exposed. Prone to peripheral growth with the formation of large plaques. Localization: open areas of the skin (face, back surface of the hands). Cutaneous horn Precancrosis. In elderly people, in open areas (lips, nose, cheeks, auricles), horny brownish cones are localized on a wide base. The appearance of a peripheral inflammatory zone is one of the signs of malignancy. Keratoacanthoma (sebaceous mollusk) It is more common in people over 40 years of age. There is a connection with insolation. Solitary hemispherical nodules or nodules of pinkish color of unchanged skin, in the center of which there is a depression filled with horny masses. Localization: exposed areas of the skin (face, hands). Spontaneous regression is possible. Leukoplakia Precancrosis of the mucous membranes of the oral cavity, less often - of the genitourinary organs. Development is promoted by traumatization (dentures, smoking, insolation). There are the following forms: leukoplakia of smokers (nicotinic stomatitis), flat, warty and erosive-ulcerative. The onset is preceded by a limited inflammatory response. In the future, the focus becomes dense, elevated, acquires a whitish color. The smooth surface gradually becomes verrucous with cracks and erosions. Epithelioma calcific Malherba A benign tumor that develops in the epidermal cyst as a result of an embryonic anomaly in the development of the epidermis. Deep single nodule of unaltered skin color, slowly growing. As a result of the deposition of calcium salts, it acquires a dense texture and can turn into a skin osteoma. Predominant localization: head, limbs. Basalioma Nevoid formation with local destructive changes in the skin, prone to relapses. Solitary, rarely multiple tumor, clinically occurring in several variants. Nodular ulcer - the most common. Nodules with a waxy tint and telangiectasia grow slowly. Gradually, the center ulcerates and becomes covered with a dense crust, which, when removed, causes bleeding. On the periphery there is an elevated roller, consisting of nodules ("pearls"). Pigmentary - characterized by a dark brown color of the focus. Sclerosing - a raised, dense, scleroderma-like plaque that may ulcerate over time. Superficial - multiple foci, superficial, eczema-like. Localization: face, neck, less often - other areas. Mucous membranes are not affected. Bowen's disease (Bowen's cancer) Isolated single sharply limited reddish-brown plaque, raised above the skin surface. Covered with a crust, under which a granular (velvety) surface is found. Often the plaque has a warty or eczema-like character. Develops slowly, turns into spinocellular carcinoma. Localization: torso, eyelids, genitals. Keyr's disease (Erythroplasia of Keyr) Intraepidermal spinocellular carcinoma. The focus is bright red with sharp borders and a granular surface. Develops slowly; metastases to the lymph nodes. Localization: glans penis, preputial sac, vulva, oral mucosa. Paget's cancer An erythematous eroded lesion with sharp borders, a weeping surface, scales and crusts, resembling microbial eczema. Dense nodes are palpated in the underlying tissue; regional (axillary) lymph nodes are enlarged. The breast nipple is retracted. Mostly women are ill. Localization: nipple area and surrounding skin. Spinalioma (spinocellular cancer) Development is often preceded by chronic cheilitis, leukoplakia (precancrosis). Men are predominantly ill. There are 2 clinical forms. 1. Tumor form - dense (cartilaginous consistency), rapidly growing nodes with a papillomatous surface and ridge-like edges. 2. Ulcerative form - rapid decay leads to the formation of superficial or deep ulcers with clear edges, a bumpy bottom, growing along the periphery. Metastasizes lymphogenously. Localization: open areas of the skin (back of the nose, lips, eyelids, auricles, back of the hands). Pseudocarcinomatous hyperplasia Benign proliferation of the epithelium in chronic dermatoses of various etiologies. Clinically resembles spinalioma. 2. Tumors of the glands of the skin and hair follicle Sweat gland tumors Tumors emanating from eccrine (eccrine poroma, eccrine spiradenoma, syringoepithelioma) and apocrine glands (syringoma, syringoadenoma, papillary hydroadenoma, syringocystadenoma). They develop from the excretory ducts of the sweat glands. Most of them are single hemispherical formations of the color of unchanged skin or slightly erythematous, not prone to ulceration (except for syringoadenoma) and relapses after removal. The diagnosis is established on the basis of histological examination. Syringoma is characterized by a multiplicity of small nodules up to millet grain size, which are cysts of the excretory ducts. Light translucent rashes are located on the face, chest, abdomen, thighs. Occurs in women during puberty. Tumors of the sebaceous glands Fordyce disease. On the red border and mucous membrane of the lips and oral cavity there are small yellowish hemispherical nodules. Nodular hyperplasia of the sebaceous glands. Small yellowish nodules on the face (usually on the chin) that occur in older people. Sebaceous gland adenoma. A solitary tumor the size of a hazelnut, hemispherical in shape, the color of unchanged skin. Most often located on the face. Atheroma. Retention cyst of the sebaceous glands. Tumor-like formation prone to infection. Hair follicle tumors Hair nevus. It occurs predominantly on the face in the form of a small pigmented nodule with a large amount of hair. Trichoepithelioma. During puberty, single or multiple yellowish papules appear on the face (less often the limbs). May be combined with nevus pilaris. Cylinder. Multiple, less often solitary tumors the size of a pigeon egg, dense consistency with a smooth surface. Grouping, the nodes form conglomerates that cover the head in the form of a tuberous cap (“turban tumors”). Localization: scalp, less often - face. 3. Neuroectodermal tumors Pigmented nevi Skin changes of a patchy or papular nature, due to the accumulation of nevus or pigment cells in the epidermis and dermis. The clinical picture is varied. The following varieties are distinguished: borderline nevus (localized mainly on the palms, soles and in the ano-genital region); intraepidermal (the most frequent and varied clinical picture with a smooth or papillomatous surface); mixed. Nevus blue Nodules of a bluish-gray color with sharp borders, located more often on the face, limbs. Their surface is smooth and rounded. The Mongolian spot is one of the varieties of the blue nevus. Bluish-brown spots without a clear outline, determined at birth and disappearing with age. juvenile melanoma A single limited nodule of a hemispherical or flat shape of pinkish-red or yellowish-brown color of various shades. On the periphery - erythematous corolla with telangiectasias. Hair growth is absent. It occurs more often in children. The flow is benign. Localized on any part of the skin. Melanosis precancerous Dubrey Limited brown or black pigment spot with irregular outlines without compaction. Grows slowly. It is an obligate precancrosis of melanoblastoma. Occurs in older people. Localization: face, chest, less often - other areas. Melanoma (melanoblastoma) The most malignant tumor that metastasizes by lympho- or hematogenous route. It develops most often on the basis of pigmented nevi after their traumatization or intense insolation. Signs of malignancy: accelerated growth of the pigment spot, discoloration (darkening or decrease in pigmentation), the phenomenon of reactive inflammation (erythema corolla), the appearance of child nodules, increased vulnerability and bleeding, itching. Formed melanoma can be superficial or nodular - a dark brown or black formation that rises above the skin with a mirror or rough surface. However, there are poorly pigmented melanomas. It grows rapidly and ulcerates early. 4. Tumors of mesenchymal tissue Tumors of adipose tissue Lipoma. Benign tumor. The node is the color of unchanged skin or a yellowish tint, soft, often lobular, painless. Often there are multiple tumors. Fibrolipoma. Fibrous tissue develops, and therefore the tumor has a dense consistency. Liposarcoma. Multiple nodes or diffuse infiltration in the subcutaneous tissue without clear outlines. The course is malignant. Metastases to visceral organs. Dermatofibroma. Slightly raised dense nodules of brown color, dense consistency. Fibroma. Nodes the color of unaltered skin. A hard fibroma is isolated - dense whitish nodules; soft - papillomatous soft formations on a thin stalk with a wrinkled surface. Keloid. A benign neoplasm of connective tissue - fibroma. It develops as an independent process (primary keloid), as well as after thermal burns, wounds, operations and during the resolution of certain skin diseases (boils, acne). A dense, limited formation with a smooth surface, sometimes with bizarre outlines. The color is purplish-red, later whitish. Itching occurs in the initial phases. Fibrosarcoma. The course is malignant. Metastasizes to lymph nodes and visceral organs. Dense yellowish-brown nodules with a smooth surface, located isolated or in groups. Tumors of muscle tissue Leiomyomas. Tumors arising from smooth muscle fibers. There are multiple leiomyomas of smooth muscles of the skin, solitary leiomyomas of the genitals and breast nipples, and solitary vascular ones. Dense nodes, painful on palpation, capable of contracting when irritated. The course is benign. Leiomyosarcoma. Painless single large node with unclear contours. The course is malignant. 5. Tumors of the blood and lymph vessels Skin angioma Benign vascular formation of nevoid origin. There are such clinical forms as: flat angioma (vascular spots with telangiectasias); cavernous (a soft towering tumor of a purple-red color - a "blood sponge", is easily injured); stellate (reminiscent of the outlines of a spider); ruby dots (dark red small dotted nodules on the trunk, less often on the face); tuberous (purple-red tumor-like nodules on the face); verrucous (has hyperkeratotic growths on the surface). Osler's disease A congenital disease that is manifested by multiple telangiectasias of the skin, mucous membranes and internal organs, a tendency to bleeding. Hemangioma pyogenic Considered as one of the atypical forms of pyoderma. It is a capillary hemangioma. A rounded, hazelnut-sized formation of soft or dense consistency, whitish-gray or purple-red, sometimes has a stalk. Easily ulcerated and bleeds, covered with a dark brown crust. Localization: fingers, back surface of the hands, red border of the lips. Glomus angioma of Bare - Masson A benign tumor, located almost always on the tips of the fingers in the area of the nail bed. It is characterized by sharp paroxysmal pain. Mibelli's angiokeratoma Multiple dark red vascular nodules up to a pea size with a warty surface and horny scales, when removed, bleeding occurs. More often young women are ill. Localization: the back surface of the hands and fingers, auricles. Fabry trunk angiokeratoma is a rare variant of angiokeratoma. Rashes are disseminated in the form of small horny nodules of dark red color, resembling beads. When injured, they bleed. Combined with hypertension, kidney and heart damage. Lymphangioma Tumor-like soft nodule or nodule with a smooth or bumpy surface of the color of unchanged skin, if damaged, a clear liquid is released. Kaposi's angioreticulosis Bluish-red spots that resemble nevoid formations transform into nodes and plaques ranging in size from a pea to a plum, rising above the level of healthy skin. Gradually they acquire a brownish-red hue. As a result of the merger, large foci are formed. The surface of the lesions may be smooth or warty, covered with scales. Characterized by the presence of telangiectasias and hemorrhages. Ulcers that do not heal for a long time may form. Elephantiasis often develops. Multiple nodes are located symmetrically, mainly on the feet and legs, less often on the upper limbs and mucous membranes. Men are ill mainly at advanced age. The course is chronic progressive with involvement of visceral organs in the process. Histopathology. In the dermis, the blood vessels are dilated and there are many new growths. Perivascular infiltration by lymphoid and plasma cells; hemosiderin deposition. Differentiate with fungal mycosis and lymphoreticular skin diseases. Treatment. Penicillin injections of 20-30 million units per course, radiotherapy (up to 2000 rads per course), prospidin 75-100 mg per day (up to 2000-3000 mg per course); preparations of resokhin (delagil, chloroquine, hingamine), arsenic, vitamins B1 and D. It is also advisable to include corticosteroids in complex treatment. Surgical removal of nodes. Nevi are not subject to treatment. In some cases, removal is performed for cosmetic reasons, with trauma and a tendency to rebirth. Benign tumors can be removed surgically, electrocoagulation or cryodestruction. Treatment of keloids: chipping the focus with lidase, a suspension of hydrocortisone and other steroids; excision followed by radiation therapy; electrophoresis of potassium iodide, phonophoresis of collagenase or hydrocortisone; cryotherapy. Treatment of basaliomas should be differentiated. In superficial forms, ointments with cytostatics are widely used (0,5% colhamic or methotrexate, 5% fluorouracil or fluorofur). Nodular-ulcerative variants undergo cryosurgical treatment; in some cases, radiation therapy and surgical removal are used. Malignant neoplasms of the skin are subject to treatment in a specialized oncological institution. The therapy is based on the principle of complexity (surgical removal, radiation therapy, polychemotherapy, general strengthening treatment). Author: Sitkalieva E.V. << Back: Eczema >> Forward: Principles of external therapy (External therapy. Forms of external medications)
▪ Valuation and property management. Lecture notes
The existence of an entropy rule for quantum entanglement has been proven
09.05.2024 Mini air conditioner Sony Reon Pocket 5
09.05.2024 Energy from space for Starship
08.05.2024
▪ Found the relationship between attention to the child and his intelligence ▪ Smartphone ZTE Grand S3 with an iris scanner ▪ The cost of traditional and alternative energy is equal ▪ Cookies baked in space for the first time
▪ section of the site Protection of electrical equipment. Article selection ▪ article Law of the minimum. History and essence of scientific discovery ▪ article Why is gold considered a precious metal? Detailed answer ▪ article Managing editor. Job description ▪ article Consumer electronics. Calls and audio simulators. Directory
Home page | Library | Articles | Website map | Site Reviews
www.diagram.com.ua |
We recommend interesting articles Section 
See other articles Section 
Latest news of science and technology, new electronics:
All languages of this page