29- SubQ, Sweat G,Hair, Epith Tumors Flashcards
Sharply circumscribed yellow orange hamartoma
Solitary, congenital, linear
Scalp-most common location
Lesions persist through life
Nevus sebaceous
Neoplasms that have been described as arising from nevus sebaceous
Trichoblastoma
Syringocystadenoma papilliferum
Treatment for nevus sebaceous
Surgical removal
Small cream colored/yellowish umbilicated papules
Occurs after age 40
Favors forehead, infraorbital and temples
Sebaceous hyperplasia
Prominent sebaceous hyperplasia occurs in 15% of patients taking this drug
Cyclosporine
Treatment for sebaceous hyperplasia
Purely for cosmetic reasons
Electrosurgery
Laser
PDT
Sebaceous carcinoma is a rare tumor that usually occur on
Eyelid or around the eye
This syndrome is now recognized as a subset of the Lynch syndrome/ hereditary nonpolyposis colorectal CA syndrome (HNCCS)
Sebaceous tumor + internal malignancy
Muir-Torre Syndrome (MTS)
Most common malignancy associated with MTS and Lynch syndrome
Colonic adenocarcinoma
Small papules, yellow, brown or pink
Demonstrates sweat duct differentiation
Frequently occurs on eyelids and upper cheeks
Syringoma
Treatment for syringoma
Very light electrodessication
Shave removal
CO2 laser
Translucent cystic papules that may have a bluish tint
Eccrine or apocrine differentiation
Solitary, more common in women
Most often periocularly (face or scalp area)
Hidrocystoma
Benign slow growing slightly protruding soft sessile reddish tumor that usually occurs on the sole or side of the foot
Bleed on slight trauma
Cup shaped shallow depression from which the tumor grows
Poroma
Most common form of sweat duct carcinoma
Malignant acrospiroma
Solitary deep seated nodule covered with normal appearing skin
Usually occurs in ventral surface of the body (esp upper half)
15-35 years old
May mets to regional lymph nodes or hema
Spiradenoma
This condition may occur with spiradenoma together in the same patient
Cylindroma
Firm, rubberlike pink-blue tumor that usually occurs on the face and scalp as a solitary lesion
Cylindroma
Very slow growing plaque or nodule
Head and neck- favor midface and periorbital area, predilection for left side
Upper lip more often than lower
Long term sun exposure msy play a role
Perineural invasion common
Microcystic adnexal carcinoma
Sclerosing sweat duct carcinoma
Derived from hair matrix cells, bimodal age distribution (1st and 6th decades)
Single lesion on face neck or proximal upper extremity
Asymptomatic, deeply seated firm nodule covered by normal or pink skin
Overlying epidermal atrophy common
Pilomatricoma
Small dome shaped nodule with a small wisp of fine vellus hairs that protrude through a central pore
Highly structured tumor of the pilosebaceous unit
Trichofolliculoma
Autosomal dominant
Familial cylindroma or multiple familial trichoepithelioma
Multiple cystic and solid papules on the face
Often symmetrical
Small round smooth shiny slightly translucent firm papules or nodules
Brooke-Spiegler syndrome
Firm slightly indented (central dell sign) with a raised annular border
skin colored dermal tumor
Affects young women
Focal calcifications, horn cysts and central dell favor this dx
Desmoplastic trichoepithelioma
Benign neoplasm of follicular germinative cells
Asymptomatic nodules in the deep dermis or subcutaneous tissue, may be pigmented
Scalp most common site, occur in adult
Arise in organoid nevi and represent majority of basaloid neoplasms described as BCC in nevus sebaceus
Trichoblastoma
Benign neoplasm that differentiates towards cells of outer root sheath
Small solitary papule on the face (nose and cheeks)
Trichilemmoma
Multiple trichilemmoma may be a marker for this autosomal dominant condition
Cowden syndrome
Mucocutaneous diagnostic criteria for Cowden syndrome include
TAP the Cow
Trichilemmoma
Acral keratoses
Papillomatous papules
Mucosal lesions
Mucosal lesions in Cowden Syndrome occur in 80% of patients and usually involve
Buccal
Gingival
Malignancies associated with Cowden Syndrome
Breast
Endometrial
Thyroid
Cowden Syndrome is caused by a mutation in this tumor suppressor gene
PTEN
Smooth compressible cystic mass
Shiny, freely movable
Usually from plugging of follicular orifice, pasty contents cheesy consistency and with pungent odor, may rupture
Usually on face neck and trunk
Epidermal inclusion cyst
Treatment for epidermal inclusion cyst
Surgical excision
“Daughter cysts” must be removed- enucleation and scraping with curette
Remove cyst lining- 20%TCA
Similar to an epidermoid cyst clinically except that about 90% occur on the scalp
Women over age 60 are predominantly affected and it’s more mobile and firmer than epidermoid cysts
Pilar cyst (trichilemmal cyst)
This is a large and exophytic neoplasm confined almost exclusively to the scalp and back of the neck.
Up to 25cm in size, more common in women age 65
proliferating pilar cyst
This occurs in the midline sacral region at the upper end of the cleft of the buttocks
becomes symptomatic during adolescence due to inflammation
Often occurs with nodulocystic acne, dissecting cellulitis and hidradenitis suppurativa
Pilonidal cyst
Keratinous cysts 1-4mm
White, can occur congenitally (resolve in weeks)
Can also occur due to trauma (chemical peels, dermabrasion, laser), long term use of occlusive moisturizer or topical steroids
Milia
Treatment for milia
Incision and expression of contents :
Blade 11
Cutting tip hypodermic needle
Comedo extractor
