Benign Skin Lesions

Question 1

Identify this lesion

Answer 1

seborrheic keratosis

Question 2

What is the most common benign cutaneous lesion?

Answer 2

seborrheic keratosis

Question 3

Characteristics of a seborrheic keratosis

Answer 3

• smooth, verrucous, stuck-on appearance
• arise from epidermis
• milia like cysts on the surface
• can vary in color and have irregular borders

Question 4

Identify these two similar lesions

Answer 4

left: seborrheic keratosis
right: malignant melanoma

Question 5

What is the treatment for seborrheic keratosis

Answer 5

• watchful waiting
• cryotherapy, currettage, shave biopsy

Question 6

Characteristics of dermatosis papulosa nigra

Answer 6

• similar to SKs
• multiple brown/black dome shaped papules

Question 7

Identify this lesion

Answer 7

dermatosis papulosa nigra

Question 8

What is the treatment for dermatosis papulosa nigra

Answer 8

• monitor
• Refer to derm for: curettage, cryotherapy

Question 9

Identify this lesion

Answer 9

actinic keratosis

Question 10

characteristics of actinic keratoses

Answer 10

• rough scaly patch develops from years of sun exposure
• can become SCC

Question 11

treatment for AKs

Answer 11

• biopsy if uncertain diagnosis
• cryotherapy, curettage
• imiquod or fluorouracil
• sun protection

Question 12

Identify these lesions

Answer 12

solar lentigines (singular: solar lentigo)

Question 13

characteristics of solar lentigines

Answer 13

• aka liver spots
• small sharply circumscribed pigmented macule
• hyperplasia of the epidermis causing increased pigmentation of basal layer

Question 14

treatment for solar lentigines

Answer 14

refer to derm for laser or chemical peels

Question 15

What makes freckles unique to solar lentigines

Answer 15

Freckles
- appear during childhood
- darken with sun exposure
- fade with less sun
- genetic

Question 16

characteristics of cutaneous horns

Answer 16

• hard keratin projection
• occur in sun exposed areas
• can be benign or pre-malignant

Question 17

Identify this lesion

Answer 17

cutaneous horn

Question 18

Treatment for cutaneous horns

Answer 18

biopsy due to a concern for SCC at the base of the lesion

Question 19

What is the common name for acrochordons

Answer 19

skin tags

Question 20

Acrochordons characteristics

Answer 20

• skin colored pedunculated papules ranging in size from tiny to 1cm
• fleshy texture
• common in areas of friction

Question 21

Treatment for acrochordons

Answer 21

• snip excision (will bleed!)
• cryotherapy

Question 22

Identify these lesions

Answer 22

acrochordons

Question 23

Identify this lesion

Answer 23

Dermatofibroma

Question 24

characteristics of a dermatofibroma

Answer 24

• firm pink to brown papules that dimple when squeezed
• inflammatory rxn to bug bite/trauma

Question 25

treatment for dermatofibroma

Answer 25

- monitor - biopsy: excision/shave/punch

Question 26

characteristics of a hypertrophic scar

Answer 26

- confined to wound area - occurs in first 4 weeks after procedure - flattens over time

Question 27

characteristics of a keloid scar

Answer 27

- painful - extends outside of wound area - occur later than a hypertrophic scar - dont regress over time

Question 28

Treatment for hypertrophic and keloid scars

Answer 28

Refer to derm for - interalesional injections - surgical - cryotherapy - laser treatment

Question 29

Identify this lesion

Answer 29

keratoacanthoma

Question 30

characteristics of a keratoacanthoma

Answer 30

- benign epithelial tumor - well defined pink papule/nodule that develops umbilicated keratinous core - considered a variant of SCC so treated as SCC - grow rapidly over a few weeks

Question 31

treatment for keratoacanthomas

Answer 31

surgical excision

Question 32

What is this lesion

Answer 32

pyogenic granuloma

Question 33

characteristics of a pyogenic granuloma

Answer 33

- vesicular lesion that develops rapidly - painless - can bleed easily - can look like melanoma

Question 34

treatment for pyogenic granuloma

Answer 34

Refer to derm for - surgical - shave - curettage - excision

Question 35

Which of these is melanoma

Answer 35

left: melanoma right: pyogenic granuloma

Question 36

characteristics of an epidermal cyst

Answer 36

- firm, elevated, dermal lesion - smooth round mobile - narrow punctum/black dot

Question 37

Identify these lesions

Answer 37

epidermal cysts

Question 38

Treatment for epidermal cysts

Answer 38

refer for excision if larger and bothersome

Question 39

Identify this lesion

Answer 39

Pilar cyst (type of epidermal cyst) - no punctum

Question 40

characteristics of a lipoma

Answer 40

- benign subQ tumor - soft, round, mobile, superficial to muscle layer - fat cells clumped together in capsule/fibrous framework

Question 41

treatment for lipoma

Answer 41

refer for excision (derm or gen surg)

Question 42

Identify this lesion

Answer 42

lipoma

Question 43

Identify these lesions

Answer 43

sebaceous gland hyperplasia

Question 44

characteristics of sebaceous gland hyperplasia

Answer 44

- small benign tumors enlarged sebaceous glands - well defined yellow papules - waxy, central umbilication

Question 45

treatment for sebaceous gland hyperplasia

Answer 45

- electrocautery - shave excision if concerned for BCC - pulse dye laser - cryotherapy - topicals - accutane

Question 46

Identify these lesions

Answer 46

syringomas/syringomata

Question 47

characteristics of syringomas

Answer 47

- small sweat duct tumors - no malignancy potential - flat topped, skin colored papules - refer to derm for electrodessication, snip excision, curettage

Question 48

Identify these lesions

Answer 48

Milia (milium)

Question 49

what are the 3 types of angiomas

Answer 49

- cherry - spider - venous lake

Question 50

Identify this lesion

Answer 50

cherry angioma

Question 51

Identify this lesion

Answer 51

spider angioma (blanches with pressure)

Question 52

Identify this lesion

Answer 52

venous lake angioma (blanches with pressure)