Benign Tumours of the Skin

Question 1

What is seborrhoeic keratosis?

Answer 1

a benign growth of epidermal keratinocytes of unknown aetiology

they can be pink or light brown to almost black in colour

Question 2

Who tends to be affected by seborrhoeic keratoses?

Answer 2

Found in middle-aged and elderly people

Question 3

What does seborrhoeic keratoses look like?

Answer 3

It can range from one lesion to many (sometimes >100) present

it is asymptomatic and a sign of skin aging

Question 4

Where is usually affected by seborrhoeic keratoses?

Answer 4

usually on the face and trunk

Question 5

What are the clinical features of seborrhoeic keratoses?

Answer 5

• warty greasy papules or nodules
• well-defined borders
• variable colour from light pink to dark
• “stuck on” apperance

Question 6

What is the treatment for seborrhoeic keratoses?

Answer 6

usually no treatment is required

may be removed if they catch on clothing or for cosmetic reasons

Question 7

What is a lipoma and what causes it?

Answer 7

A lipoma is a fatty tumour located just below the skin

It is caused by adipose tissue proliferation but aetiology is not fully understood

Question 8

Who tends to be affected by lipoma?

Answer 8

it usually occur in middle-aged people

solitary lipomas are more common in women and multiple are more common in men

Question 9

What is thought to cause lipoma?

Answer 9

The aetiology is unknown but it is possible that genetics or physical trauma have a role

It is unclear whether the trauma causes a lipoma to form, or the lipoma is discovered as a result of medical attention to that area of the body

Question 10

What are the clinical features of lipoma?

Answer 10

• slow-growing (takes years)
• soft, smooth, mobile subcutaenous nodule

Question 11

What is the treatment for lipoma?

Answer 11

Usually no treatment is required

It may be surgically removed if it is impacting on nearby muscles

Question 12

What is a potential complication of lipoma?

Answer 12

liposarcoma but this is very rare

Question 13

What are alternative names for epidermoid cysts?

Answer 13

• follicular infundibular cyst
• epidermal cyst
• keratin cyst

Question 14

What is an epidermoid cyst?

Answer 14

a benign cyst derived from the infundibulum or upper portion of a hair follicle

it is encapsulated in a thin layer of epidermis-like epithelium

they are typically filled with keratin and lipid-rich debris

Question 15

Who tends to be affected by epidermoid cysts and in which locations?

Answer 15

they usually occur in adults

males are affected 2x more often than females

common affected sites are the face, neck and trunk

Question 16

What causes epidermoid cysts?

What symptoms do they present with?

Answer 16

they are caused by epidermal cell proliferation

they are usually asymptomatic

Question 17

What are the clinical features of epidermoid cysts?

Answer 17

• they can be skin-coloured or yellow
• firm, round nodules
• may have a central punctum
• may have offensive smelling keratinous contents

Question 18

What is the treatment for epidermois cysts?

Answer 18

usually no treatment is required

antibiotics are given if infection occurs

Question 19

What is a dermatofibroma?

Answer 19

a benign fibrous nodule usually found on the skin of the lower legs

it involves overgrowth of fibrous tissue situated in the dermis

Question 20

Who tends to be affected by a dermatofibroma?

Where do they usually occur?

Answer 20

affects all ages but is more common in females

common on the lower legs, often from after an insect bite

eruptions of dermatofibromas may occur in immunosuppressed people

Question 21

What causes dermatofibromas and how do they present?

Answer 21

caused by fibroblast proliferation

it is often asymptomatic but may be itchy and/or painful

Question 22

What are the clinical features of dermatofibromas?

Answer 22

• firm, fibrous, dermal nodules or papules
• usually <1cm diameter
• pale centre
• the skin dimples upon compression

Question 23

What is an alternative name for Campbell de Morgan spots?

Answer 23

cherry angiomas

Question 24

What is an angioma (or haemangioma)?

Answer 24

a benign vascular skin lesion

it is due to proliferating endothelial cells that line the inside of the blood vessel

Question 25

What do Campbell de Morgan spots look like?

Answer 25

an asymptomatic firm red, blue or purple papule that is 0.1-1cm in diameter

when thrombosed it can appear black in colour

Question 26

Where are Campbell de Morgan spots found?

Who tends to be affected?

Answer 26

They are common on the mid-trunk

The number of spots increases with age from around the age of 40

75% of people over 75 years have them but they can also occur in young people

Question 27

What causes Campbell de Morgan spots?

Answer 27

the aetiology is unknown

they are caused by endothelial cell proliferation and subsequent blood vessel overgrowth

Question 28

What are the clinical features of Campbell de Morgan spots?

Answer 28

• red / purple / black papules or macules

Question 29

What is the treatment for Campbell de Morgan spots?

Answer 29

Usually no treatment is required but they may be removed for cosmetic reasons

Question 30

What is a fibroendothelial polyp?

Answer 30

a skin tag

this is very common benign skin lesion that is usually found in intertriginous areas of the skin

(where two skin areas may touch or rub together)

Question 31

Who is affected by fibroendothelial polyps?

Answer 31

They are very common and can affect anyone but will develop with age

They are commonly found in skin folds e.g. axillae

Question 32

What causes a fibroepithelial polyp?

Answer 32

The aetiology is not fully understood but some factors involved are thought to be:

• skin irritation
• insulin resistance
• HPV
• high levels of growth factor hormones

Question 33

What are the clinical features of fibroepithelial polyps?

Answer 33

• usually skin-coloured
• vary in size
• may be removed for cosmetic reasons