Benign Tumors Flashcards
What lesion is a benign squamous proliferation which is a very common tumor in the elderly? How does it appear?
Seborrheic keratosis
-Raised, pigmented plaque filled with horn cysts or pseudo-horn cysts (keratin proliferations plugged up invaginations in the skin)
What is the natural course of a seborrheic keratosis? Can they become malignant?
They appear typically on the extremities or face as a waxy “stuck-on” nummular lesion
They have no malignant potential
Why might you need to remove or biopsy a seborrheic keratosis?
Remove - if they are bothersome to the patient / too unsightly
Biopsy - if they are heavily pigmented they may resemble a melanoma
What is a lentigo histologically and what does it look like macroscopically?
Benign hyperplasia of melanocytes (a type of freckle)
Small pigmented spot on the skin with a clearly defined edge
What is lentigo simplex? Is it related to the sun?
Most common form of lentigos, arises in children and is not sunrelated
Often multiple lentigines can arise around the body
What is solar lentigo also called and what causes it? Where can they be found?
Lentigo senilis, or “liver spots”
- > associated with age and exposure to UV radiation
- > found photodistributed to hands, face, shoulders, arms, and forehead
Who gets sebaceous hyperplasia and how will it appear?
Middle-aged to elderly adults
Appears as fleshy to slightly yellow papules, sometimes with central punctum (sebaceous glands associated with hair follicles)
What are milia and how do they differ between young children and adults?
Small keratin-filled cysts which appear as tiny whitish papules (I have these!). Can be confused with stubborn whiteheads
Newborns - often resolve in several weeks
Adults - don’t resolve without intervention, usually comedo extractor
What is a dermatofibroma, who tends to get it, and what must it be differentiated from?
Common, benign, indolent dermal nodule which occurs on the legs of adults. Usually dome-shaped
-> can be pink but if it’s brown / black it may be confused with a melanoma
How does a dermatofibroma progress, and what does it look like under the microscope?
Lesions can be solitary or multiple, and they tend to persist indefinitely while remaining stable in size / appearance
Histology - looks like a scar (localized area of fibroblasts in the skin)
How can you commonly tell if something is a dermatofibroma clinically? What is the treatment?
If you pinch the skin around the sides of it, it will form a dimple
No treatment unless it is cosmetically bothersome, in which can it can be excised surgically
How is a hypertrophic scar vs a keloid determined?
Hypertrophic scar - Large, but confined to the border of the original wound
Keloid - extends beyond the borders of the original wound, tends to happen in ethnic groups with darker skin
What does a keloid look like under the microscope and how is it treated?
Looks like disorganized fibers of collagen and whorls of fibroblasts
Treated with repeat injections of steroids into the lesion to cause atrophy
Surgery is CONTRAINDICATED and will worsen the condition
What is an epidermoid cyst, what is it made of, and where is it found?
Mobile, firm, relatively superficial subcutaneous nodule with a punctum which appears as an open comedo (blackhead)
Made of keratin, much like milia, but larger.
Can be found anywhere on the skin
Do epidermoid cysts cause problems?
They are usually asymptomatic, but they may rupture, and the skin has an acute inflammatory reaction to the keratin released into the dermis making it seem like a bacterial infection
-> epidermoid cysts should be removed in surgery
