Benign skin lesions

Question 1

What is a benign nevus?

Answer 1

plain old mole
except - on any palms or soles, any ugly ducklings = concerning

Question 2

what is a birthmark called?

Answer 2

congenital melanocytic nevus
the bigger it is, the higher risk for melanoma

Question 3

What is a spitz nevus?

Answer 3

red-pink, dome-shaped smooth papule, commonly on children. Excised.

Question 4

What’s a blue nevus?

Answer 4

blue in color often occuring in adolescence, biopsied due to color but maintain under observation

Question 5

What is a mongolian spot?

Answer 5

congenital dermal melanocytosis of extensive or sacral discoloration; blue-gray patches; monitor and consider abuse in children

Question 6

What should you consider regarding a port wine stain?

Answer 6

could be from associated underlying spinal cord malformation if covering back midline

consider glaucoma if involving eyelids or in trigem nerve area

Question 7

What is an infantile hemangioma?

Answer 7

strawberry mark on face, scalp, back or chest that mostly resolve unless needing IV propanolol

Question 8

What’s the guidelines for cafe au lait spot workup?

Answer 8

> 3 in caucasian
5 in african americans

Question 9

What are skin tags?

Answer 9

acrochordons that may be associated with colon polyps, evaluate for DM

Question 10

What’s a lipoma?

Answer 10

soft, mobile subq nodule on trunk/extremeties

Question 11

What is keratoderma?

Answer 11

hyperkeratosis of palms and soles. Treatment with keratolytics, mechanical debridement, retinoids

Question 12

What is seborrheic keratosis?

Answer 12

macular, papular, verrucous, “stuck on oval, velvety, warty lesions” scaly – biopsy if concerned, but simple reassurance and cosmetic removal

Question 13

What should a sudden appearance of multiple seborrheic keratosis lesions point to?

Answer 13

malignancy

Question 14

What is a dermatofibroma?

Answer 14

pink, tan or brown papule firm and dimples inwards on lower extremeties.
Multiple lesions = lupus or HIV, normal
Biopsy if painful, otherwise it’s fine

Question 15

How can you treat a keloid?

Answer 15

intralesional steroid/ topical steroid for pain

Question 16

What is an epidermal inclusion cyst?

Answer 16

face or trunk skin-colored to yellow-white papules with visible, pore-like opening. If in dermis there is redness and pain

Question 17

what in an epidermal inclusion cyst points to gardner or gorlin syndrome?

Answer 17

multiple

Question 18

How to manage epidermal inclusion cyst?

Answer 18

reasusrance and I&D. No abx needed

Question 19

What is milia?

Answer 19

small, superficial firm white cysts cause by keratin. Can express contents but overall reassurance

Question 20

What is xanthoma?

Answer 20

yellow-orange hue of papules and patches “pimples that were yellow” –> lab workup –> treat underlying cause

Question 21

What is xanthelasma?

Answer 21

yellow to orange maculesthin plaques around eyes, coming from xanthoma or hyperlipidemia. Treat with trichloroacetic acid or laser

Question 22

What does the sudden eruption of multiple cherry angiomas mean?

Answer 22

malignancy

Question 23

What does multiple spider angiomas mean?

Answer 23

hyperestrogenemia (pregnancy)

Question 24

What is a pyogenic granuloma?

Answer 24

rapid growth of friable, red papulic nodule which ulcerates, bleeds, on fingers, can be on lips, face or tongue. Can be caused by pregnancy or medications

Question 25

How do you manage a pyogenic granuloma?

Answer 25

reassurance, shave removal, recurrence is common

Question 26

What are corns and calluses?

Answer 26

keratotic lesions from repeated trauma - utilize symptomatic relief and reassurance. consider x-ray for relcacitrant lesions

Question 27

How do you differentiate warts from corns and calluses?

Answer 27

whether they have blood vessels

Question 28

What is ichthyosis vulgaris?

Answer 28

scaling favoring extensors from fine white scales to larger adherent scales (lower legs) with a genetic component of disorder and can be on trunk, scalp and forehead, too

Question 29

How do you treat ichthyosis vulgaris?

Answer 29

emollients, humidifiers, keratolytic agents, retinoids

Question 30

What is keratosis pilaris?

Answer 30

follicular papules, background erythema on lateral upper arms, thighs, and cheeks. risk factor is atopic dermatitis

Question 31

How do you manage keratosis pilaris?

Answer 31

reassurance, keratolytic agents, potentially topical retinoids