Benign Skin Neoplasms

Question 1

Cherry angioma

Answer 1

primarily truncal, typically multiple, pretty smooth -

bright red, smooth-topped papules.

Treatment: superficial electrodesiccation, liquid nitrogen, shave biopsy, pulse dye laser -> other vascular lasers

Question 2

Infantile Hemangioma

Answer 2

Strawberry (capillary) hemangiomas = benign vascular proliferations and most common benign tumor of childhood. Eventually dissolve themselves.

Congenital syndromes: PHACES (posterior fossa malformations, hemangioma, arterial anomalies of the aortic branches, cardiac defects and coarctation of the aorta, eye anomalies and sternal defets)

stain with GLUT-1. (placenta associated vascular markers)

Question 3

Port wine stain

Answer 3

Vascular malformation -> do not resolve spontaneously. Grow in proportion to the individual.

Stains the face follows the distribution of the trigeminal nerve. May be a sign of occult spinal dysraphism.

SUCH AS Struge Weber syndrome -> capillary malformation in a V1 distribution.

Ectatic capillaries within the dermis, lined by flat epithelium

Question 4

Nevus sebaceus

Answer 4

Hamartoma commonly presents a papillomatous, yellow-orange linear plaque on the face or scalp. Lesions on scalp assocaited with alopcia. Rapid growth occurs at pubery.

Complication: epidermal nevus sndrome, epothelial neoplasms can occur

Question 5

Sebaceus hyperplasia

Answer 5

Common benign tumor of the oil gland. Increasing frequency after middle age. 1-6mm yellowish-white papule with central dell. May be component of Muir-Torre syndrome

Question 6

Acrochordons

Answer 6

Benign skin growth -> SKIN TAGS.

Question 7

Dermatofibroma

Answer 7

second most common fibrohistocytic tumor of the skin. Brown, firm papules usually range from 3mm to 10mm in size.

DIMPLE SIGN is characteristic. LARGE OR ENLARGING LESIONS may represent the malignant version, dermatofibrosarcoma protuberans.

Question 8

Seborrheic keratosis

Answer 8

Oval, slightly raised, light brown to black papules or plaques. Commonly on chest and back. 4th or 5th decade of life.

Subtypes: dermatosis papulose nigra - small pigmented on face w/ people V or VI

Stucco keratosis - multiple small hyperkeratotic papules found around ankles, feet, forearms.

Sign of Leser-Trelat - paraneoplastic syndrome reported to occur w/ onset of multiple seborrheic keratoses, associated w/ adenocarcinoma of the stomach

Question 9

Nevi

Answer 9

Like so many subtypes

Junctional nevi are at the dermal epidermal junction just above the basement membrane -> darkly pigmented flat or minimally elevated nevus.-> as nevi mature, nests of melanocytes gradually assimilate into the dermis (then they are compound nevi) and when nests are present at the dermal epidermal junction and within the dermis or as intradermal nevi.

Question 10

Blue nevus

Answer 10

dermal proliferation of melanocytes that produce abundant melanin -> congenital or acquired.

Question 11

Congenital nevi

Answer 11

may be solitary or multiple, may affect any cutaneous surface. There is a risk for melanoma with congenital nevi.

Question 12

Dysplastic nevi

Answer 12

irregular outline, variable pigmentation, indistrict borders, and can be larger than 6 mm in diameter.

Have “fried-egg” appearance. Increased risk of developing melanoma.

Show an increased number of melanocytes in the basal layer of the epidermis. Upper dermis usually shows fibrosis and contains a host response of lymphocytes.

Question 13

FAMM syndrome

Answer 13

Familiar atypical moles and melanoma

Occurence of malignant melanoma in 1 or more first or second degree relatives, the presence of numerous melanocytic nevi.

Germline mutations in 3 genes have been linked to subset of hereditary melanomas and FAMM.