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page: 434
alphabeticalpicturecausebasic lesion
Chapter 14:
Premalignant skin
tumours
Basic Lesions:
Causes:
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Premalignant skin tumours page: 435
alphabeticalpicturecausebasic lesion
Solar keratoses
(senile keratoses)
Raised red and well-defined
plaques with a rough surface
covered in scales of varying
thickness. The lesions are isolated
or multiple and their preferred site
is on exposed regions such as the
back of the hands or the face.
Keratoses; Scales
Sunlight, Ultraviolet Radiation
Basic Lesions:
Causes:
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alphabeticalpicturecausebasic lesion
Solar keratoses
(senile keratoses)
continued
The lesions are isolated or multiple
and their preferred site is on
exposed regions such as the back of
the hands or the face. Here one can
observe some characteristics of
skin-ageing caused by sunlight:
sallow skin, accentuated wrinkles,
etc. If left untreated, some cases of
solar keratosis develop into
squamous cell carcinoma.
Keratoses; Scales
Sunlight, Ultraviolet Radiation
Basic Lesions:
Causes:
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Actinic cheilitis
Relatively well-demarcated scaly
erythematous plaque, sometimes
encrusted and occurring essentially
on the lower lip. Under the
hyperkeratotic layer the epithelium
is atrophic and bleeds easily at the
slightest trauma. Actinic cheilitis
spreads slowly over time and can
degenerate into true squamous cell
carcinoma.
Erythematous Macule; Scales;
Crusts
Sunlight, Ultraviolet Radiation
Basic Lesions:
Causes:
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Leucoplakia – smoker's
keratosis (stomatitis nicotina)
Well-demarcated and more or less
rounded white or greyish plaques
on the lower lip or the buccal
mucosa. They occur more
frequently in men and are probably
promoted by smoking. Their natural
evolution is in the direction of
squamous cell carcinoma.
Achromic macules; Warts
Chemical Agents
Basic Lesions:
Causes:
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Bowen's disease
Slightly raised round or oval
discoid lesion with distinct borders,
varying in size, red or reddish
brown in colour and covered with a
crust of scales or with small crusts.
The current understanding of
Bowen's disease is that it is an
intraepidermal carcinoma (in situ).
Erythematous Macule; Scales;
Crusts
None specific
Basic Lesions:
Causes:
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alphabeticalpicturecausebasic lesion
Bowen's disease
continued
Erythematous Macule; Scales;
Crusts
None specific
Basic Lesions:
Causes:
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alphabeticalpicturecausebasic lesion
Eryhtroplasia of Queyrat
Mucosal site of Bowen's disease.
Red, well-demarcated, slightly
protuberant plaque, with a glazed
surface, on the glans penis.
Similar lesions are observed on the
vulval mucosa.
Erythematous Macule
None specific
Basic Lesions:
Causes:
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Bowenoid papulosis
Erythematous or brownish papules
on the glans and shaft of the penis,
the vulva, and sometimes the
perianal region.
Their histopathology is similar to
that of Bowen's disease. Human
papillomaviruses (16, 18, 33) are
the initial cause of this papulosis.
Epidermal Papules
None specific
Basic Lesions:
Causes:
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Radiodermatitis
Cicatricial atrophy, telangiectases,
and pigmentation abnormalities
form the classical picture of
radiodermatitis. At a further stage
ulcerations can appear. Basal cell
carcinoma or squamous cell
carcinoma are liable to develop
after several years.
Ulcers; Atrophy; Scars
X-rays
Basic Lesions:
Causes:
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alphabeticalpicturecausebasic lesion
Xeroderma pigmentosum
A hereditary disease with recessive
autosomal transmission. The
genetic basis of xeroderma
pigmentosum is an enzyme
deficiency resulting in disorders of
DNA repair after ultraviolet
irradiation. The condition is
characterized by extreme
photosensitivity and chronic
actinic lesions including skin
atrophy, freckles, and solar
keratosis. Some tumours can
develop early: keratoacanthoma,
basal cell or squamous cell
carcinoma, malignant melanoma.
Pigmented Macules; Nodules;
Keratoses; Atrophy
Sunlight, Ultraviolet Radiation
Basic Lesions:
Causes:
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Dubreuilh's melanosis
(Lentigo maligna melanoma,
melanosis circumscripta
precancerosa of Dubreuilh)
Polychromatic pigmented macule,
not raised and poorly defined. Its
colour varies from pale beige to
black. Dubreuilh's melanosis is
observed in old people, most
frequently on the face, less so on
the back of the hands and on the
legs. It spreads very slowly,
reaching a diameter of several
centimetres in about ten years.
Pigmented Macules
Sunlight, Ultraviolet Radiation
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Completed 1 May 2022

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