B8. Benign tumours of the skin

From greek.doctor

Seborrheic keratosis

  • Most common benign skin tumor in elderly
  • Immature keratinocytes
  • Clinical features
    • Multiple darkly pigmented, soft papules/plaques
    • Greasy, wax-like
    • “Stuck-on” appearance
    • May be pruritic
    • May bleed easily
    • Increase in number and size with time
  • Treatment
    • No treatment necessary
    • Cryotherapy, laser, excision for cosmetic reasons

Keratoacanthoma

  • On sun-exposed skin
  • From pilosebaceous glands
  • Rapid growths for a few weeks -> then spontaneous resolution after months
  • Treatment
    • Excision
    • Radiotherapy

Dermatofibroma

  • Fibroblasts
  • Slowly growing
  • Skin-coloured or brownish nodules
  • Most commonly on lower extremities
  • Fitzpatrick sign – when squeezed the surface retracts inwards
    • Characteristic for dermatofibroma
  • Treatment only for cosmetic reasons

Lipoma

  • Slow growing
  • Round
  • Soft
  • “Rubbery”

Pyogenic granuloma

  • Benign vascular tumor
  • Soft, round, bright red tumor
  • Bleeds easily due to being vascular
  • Not actually "pyogenic"
  • Recurs after removal

Others

  • Epidermal origin
    • Sebaceous nevus
    • Apocrine nevus
  • Benign mesenchymal tumors
    • Acrochordon (skin tag)
    • Leiomyoma
  • Vascular tumors
    • Angioma
    • Haemangioma
  • Skin adnexal benign tumors – of accessory skin structures like glands, hair follicles
    • Syringoma
    • Hidradenoma
    • Trichoepithelioma
    • Dermal eccrine cylindroma
      • Solid, skin-coloured nodules
      • On head, neck, face
  • Other
    • Epidermoid cyst
    • Pigmented nevus
    • Neurofibroma
      • Neurofibromatosis