Benign skin lesions

Question 1

warty, raised brown lesion with ‘stuck on’ appearance

Answer 1

seborrheic keratosis - also known as senile warts/basal cell papillomas

Question 2

pathophysiology of seborrheic keratosis

Answer 2

benign lesions caused by ageing not related to sun exposure

Question 3

treatment seborrheic keratosis

Answer 3

none required unless symptomatic/for cosmetic reasons - cryotherapy - curettage - topical tricholoracetic acid

Question 4

what are solar lentigines

Answer 4

small brown macules/patches (flat) due to sun exposure - resemble freckles but present all year round - also known as age spots/liver spots

Question 5

what causes freckles

Answer 5

increased melanin production not greater melanocyte numbers

• result of UVB exposure
• fade during winter

Question 6

what are melanocytic naevi

Answer 6

benign proliferations of melanocytes

• genetic
• sun exposure

Question 7

where are junctional naevi formed?

what is the appearance?

Answer 7

clusters of melanocytes at the dermo-epidermal junction

flat + brown

Question 8

where are compound naevi formed?

what is the appearance?

Answer 8

clusters of melanocytes in the dermis + at the dermo-epidermal junction

raised + brown

Question 9

where are intradermal naevi formed?

what is the appearance?

Answer 9

entirely dermal - no pigment from melanocytes

skin coloured + raised

Question 10

what is this lesion?

Answer 10

halo naevi

• • immune response to mole causing loss of surrounding pigment

Question 11

what is this lesion?

Answer 11

blue naevus

• melanocutes proliferate deep down in dermis instread of making it to basal layer of epidermis so they appear darker

Question 12

firm, red, brown papule following insect bite

Answer 12

dermatofibroma

• benign tumour of fibroblasts

Question 13

rapidly growing red lesion that bleeds easily, occurs post trauma

Answer 13

pyogenic granuloma

Question 14

what is a dermoid cyst?

Answer 14

benign teratoma - contains various tissue types e.g. epithelium, hair follicles, sebaceous glands

Question 15

appearance of dermoid cyst

Answer 15

smooth, skin coloured, rubbery lump

often found on head, neck, under tongue

Question 16

what is an epidermoid cyst

Answer 16

benign tumour of sqaumous epithelium which has penetrated into the dermis + filled with keratin

• unline dermoid cysts, does not contain hair follicles

Question 17

smooth, firm, mobile lump with central punctum

Answer 17

epidermoid cyst

Question 18

complications of epidermoid cysts

Answer 18

can become inflamed/ infected- cheesy discahrge of keratin through central punctum

Question 19

what are pilar cysts

Answer 19

varient of epidermoid cysts arising from hair follicle

usually found on scalp

Question 20

management of dermoid cyst

Answer 20

excision biopsy

Question 21

what is a lipoma

Answer 21

benign tumour of adipose tissue

Question 22

features of a lipoma

Answer 22

smooth, soft, painless lump

moveable

trunk, forearms, thighs, back of neck

Question 23

what is a acrochordon

Answer 23

skin tag

• pedunculated (on stalk) skin coloured papule
• skin folds
• may be result of friction
• cryotherapy if symptomatic/ unsightly

Question 24

what are campbell de morgan spots

Answer 24

abnormal proliferations of capillaries

non-blanching erythematous papular lesions

common with increasing age