Differentiate between harmless growths, benign, and malignant neoplasms on the skin.
Angiomas
Also called cherry angiomas.
Present as red papules, commonly in patients over 30, especially on the trunk.
Harmless but may bleed or clot when traumatized.
Infantile Hemangiomas:
Subtype occurring in infants.
Proliferation of endothelial tissue, resulting in red (superficial) or blue-purple (deep) nodules.
Grow for about 0.5-2 years before involuting.
Treatment: Beta blockers like propranolol if large and disfiguring.
Acrochordons (Skin Tags)
Fleshy growths with their own blood supply.
Common in armpits, groin, eyes, or neck.
Can indicate insulin resistance.
Risk factors: Obesity, friction, genetics.
Treatment: Not necessary unless for cosmetic reasons.
Seborrheic Keratosis (SK)
Benign, superficial growths common after age 30.
Occur in multiples, often dark, pigmented, with a "stuck on" appearance.
Treatment: Not necessary but can be removed for cosmetic reasons.
Lesser Trelat Sign: Numerous SKs can indicate GI cancer.
Lipomas
Benign tumors of fat tissue.
Soft, movable, rubbery lumps under the skin.
Treatment: Not necessary but can be excised if desired.
Sebaceous Hyperplasia
Skin-colored umbilicated papules, often on the face. Presents with many(which is differential from BBC)
Result from sebaceous gland overgrowth. Mainly in men in 80’s, can be seen in women shortly after menopause, long term cysclosporin use
Treatment: Not necessary, but remove for cosmetic reasons such as cryo cauterization shaving or excision
-Differential diagnosis sebaceous adenoma, nevus sebaceous, lupus miliaris disseminatus faciei, and basal carcinoma
Pathology: based on clinical findings or dermoscopy (sebaceous gland and androgen hormone)not found on palms or soles of feet
Epidermal Inclusion Cysts (EIC)
Benign cysts filled with keratin, oil and dead skin.
Result from epidermis entering the dermis, often due to trauma.
Treatment: Not necessary unless ruptured or for cosmetic reasons. I&D for cosmetic do not require ABx
Milia
Small cysts similar to EICs, often on eyelids. Dead skin cells and keratin- Typically resolve in children but persist in adults. Pillor cyst found on head by hair follical do I&D
Dermatofibroma
Firm, scar-like growths with peripheral hyperpigmentation.
Benign, identified by the dimple sign.
Keloids
Overgrowth of scar tissue beyond the original injury.
More common in African-Americans and on earlobes.
Treatment: Steroid injections from growing.
Solar Lentigo (Suns pot/Liver spot)
Brown macules due to UV damage, benign but indicative of sun exposure.
-Treatment: use sunblock
Scaly plaques, gritty, texture premalignant, potential to progress to squamous cell carcinoma.
Treatment: Cryotherapy, 5-FU creams, photodynamics.
-can lead to SCC
Squamous Cell Carcinoma (SCC)
Higher mortality than BCC, originates in keratinocytes lower mortality than melenoma.
Risk factors: Fair skin, sun exposure, arsenic poisoning.
-loss of P53 can lead to SCC,pink red, hornlike, itchy
Treatment: Excision, curettage, MMS, 5-FU cream.
Nevi (Moles)
Congenital Nevi: Present at birth, low melanoma risk unless large, dome shapes, hair out of mole thick or alot of hair,no increase for cancer in smaller,larger then derm needed as it could be cancerous.
Acquired Nevi: Appear before age 20, evaluate using ABCDEs.
Melanoma
Cancer from melanocytes, can occur in skin, mouth, intestines, or eye.
Risk factors: UV exposure, fair skin, family history.