SM_254a: Benign Skin Neoplasms

Question 1

This is ____

Answer 1

This is seborrheic keratosis

Question 2

Describe seborrheic keratosis

Answer 2

Seborrheic keratosis

• Benign superficial (epidermal) growth
• Common after age 30
• Can arise on all body surfaces except palms and soles
• Stuck-on quality (like a glob of wax smushed to the skin)
• Tan or brown or sometimes black
• Crumbles, flakes, or lifts off, revealing superficial waxy character if picked at
• Often multiple
• Individual lesions do not go away

Question 3

Image on the left is normal, while imagine on the right is ____

Answer 3

Image on the left is normal, while imagine on the right is seborrheic keratosis

(hyperproliferation of keratinocytes)

Question 4

This patient has ____

Answer 4

This patient has solar lentigo

Question 5

Describe solar lentigo

Answer 5

Solar lentigo

• Sun spot / age spot / liver spot
• Results from sun damage: common on sun damaged skin
• Flat light brown macules
• Not cancerous or precancerous
• No treatment required
• Prevention is sun protection
• Excessive amount reflects history of UV exposure: can identify people at risk for skin cancer

Question 6

Solar lentigo involves increased ____ but not an increase in the number of ____

Answer 6

Solar lentigo involves increased melanin but not an increase in the number of melanocyte cells

Question 7

____ spots that are ____, ____, and ____ are likely melanoma rather than solar lentigo

Answer 7

Ugly duckling spots that are different in color (darker, multiple, variegated), have a diameter of > 6 mm, and are evolving are likely melanoma rather than solar lentigo

Question 8

These are ____

Answer 8

These are skin tags

Question 9

Describe skin tags (acrochordons)

Answer 9

Skin tags (acrochordons)

• Soft fleshy papules that arise in axiallae, neck, groin, and eyelids
• Skin colored to brown
• Often pedunculated (connected to skin with small stalk)

Question 10

This is a _____

Answer 10

This is a skin tag

(polypoid growth protruding out of skin, soft and fleshy because composed of dermis in addition to epidermis)

Question 11

This is a ____

Answer 11

This is a dermatofibroma

Question 12

Describe dermatofibromas

Answer 12

Dermatofibromas

• Single small round firm papule 0.5 - 1 cm
• Pink, reddish brown, sometimes hyperpigmented
• Dimple sign
• Most common on lower extremities
• Initiated by injuries to skin such as insect bites or inflammed hair follicles
• Scar

Question 13

___ sign is indicative of dermatofibroma

Answer 13

Dimple sign is indicative of dermatofibroma

Question 14

This is a _____

Answer 14

This is a keloid

Question 15

Describe keloids

Answer 15

Keloids

• Firm, hyperpigmented, pink or red plaque or nodule
• Often shiny or smooth surface
• Usually at site of previously known tissue trauma (cut, laceration, burn, sometimes acne, piercing)
• Excess scar tissue gone out of control
• Lesions can be tender or itchy

Question 16

In keloids, there is an imbalance in collagen ____ and ____ leading to ____ and ____

Answer 16

In keloids, there is an imbalance in collagen production and degradation leading to excessive collagen production and less degradation

(allows scar to form in all directions)

Question 17

Keloids can be treated with ____ to flatten out the scar and reduce itch/pain

Answer 17

Keloids can be treated with intralesional steroid injection to flatten out the scar and reduce itch/pain

Question 18

This is a ____

Answer 18

This is a cherry angioma

Question 19

Describe cherry angiomas

Answer 19

Cherry angiomas

• Shiny bright red papules
• Location common on trunk but can be anywhere (face, scalp)
• Likely genetic
• Common to have multiple spots
• Can increase in number during pregnancy

Question 20

This is a ____

Answer 20

This is a cherry angioma

Question 21

This is a ____

Answer 21

This is a pyogenic granuloma

Question 22

Describe pyogenic granulomas

Answer 22

Pyogenic granulomas

• Eruptive, small, solitary, sessile, or pedunculated vascular (red) raised papule
• Bleeds easily with trauma
• Relative quick onset

Question 23

This is a ____

Answer 23

This is a pyogenic granuloma

Question 24

This is an ____

Answer 24

This is an epidermal inclusion cyst

Question 25

Describe epidermal inclusion cysts

Answer 25

Epidermal inclusion cysts * Mobile subcutaneous nodule, often with overlying punctum * Arise from hair follicles * Debirs (dead skin cells, oil, etc) collects within a sack: may discharge foul smelling cheesy white material * Benign and require no treatment * If rupture due to trauma, create abscess (sterile) -\> incision and drainage * Can be surgically removed if cause discomfort

Question 26

This is an \_\_\_\_

Answer 26

This is an epidermal inclusion cyst (keratinocytic lining, filled with dead keratinocytes and sebaceous material)

Question 27

This is a \_\_\_\_

Answer 27

This is a lipoma

Question 28

Lipoma is a \_\_\_\_

Answer 28

Lipoma is a soft, poorly defined, rubber painless subcutaneous nodule

Question 29

This is \_\_\_\_

Answer 29

This is sebaceous hyperplasia

Question 30

Describe sebaceous hyperplasia

Answer 30

Sebaceous hyperplasia * Cream colored or yellowish papule with central depression * Located on face * Usually multiple in number * Age of onset is in 40s

Question 31

This is \_\_\_\_

Answer 31

This is sebaceous hyperplasia

Question 32

This is a \_\_\_\_

Answer 32

This is a hemangioma

Question 33

Describe hemangioma

Answer 33

Hemangioma * Strawberry hemangioma * Most common benign tumor of childhood * Present at birth or within first few weeks of life * Common location: head and neck but can happen anywhere * Raised, soft, easily compressed * Evolution: growth within the 1st year, then slowly disappear spontaneously * Most gone by age 7

Question 34

Stem cells within hemangioma tissue differentiate into \_\_\_\_, which ____ then \_\_\_\_

Answer 34

Stem cells within hemangioma tissue differentiate into mature blood vessels, which proliferate than involute

Question 35

This patient has \_\_\_\_

Answer 35

This patient has solar lentigo

Question 36

This is a \_\_\_\_

Answer 36

This is a pyogenic granuloma

Question 37

This is firm and discharges material once in a while. It is \_\_\_\_

Answer 37

This is firm and discharges material once in a while. It is an epidermal inclusion cyst

Question 38

This is a \_\_\_\_

Answer 38

This is a keloid (raised plaque or nodule, shiny in appearance)

Question 39

This is \_\_\_\_

Answer 39

This is seborrheic keratosis

Question 40

This patient has \_\_\_\_

Answer 40

This patient has cherry angiomas