Common benign skin lesions Flashcards
what is this lesion?
benign acquired nevi
compound nevi are common in
individuals with lighter skin phototypes
nevi on palms, soles, conjuctiva, and nail bed are more common in individuals of ______ and _______ descent
African and Asian
what is this lesion?
junctional nevi
describe junctional nevi
mole in junction (border) between the epidermis (outer) and the dermis (inner) layer
flat and macular
symmetry of color and shape
more common in younger individuals
what is this lesion?
compound nevi
describe compound nevi
pigmented
papule (elevated)
what is this lesion?
intradermal nevi
flesh colored papule
when should biospy be considered
new, changing, atypical appearing melanocytic lesion
what are the ABCDE’s for lesions
A- asymmetry
B- border (if irregular or indistinct)
C- color (pigmentation is not uniform, variegated, or different shades)
D- diameter (>6mm)
E- evolving (changes over time)
what is this lesion
congenital melanocytic nevuc (CMN)
describe congenital melanocytic nevus
flat and tan in color or elevated, can have variation in pigmentation
vary in size
mostly on trunk or extremities, less commonly on head and neck
earlier onset, larger with more heterogeneous morpholoy
how do you categorize CMN
size
small: <1.5cm
medium: >10-20cm
large: >30-40cm
giant: >60cm
greater size, more risk for malignancy
what is this a presentation of?
infantile hemangioma
describe infantile hemangioma
most common soft tissue tumour of infancy
benign endothelial cell neoplasm
early proliferation followed by gradual, spontaneous involution
absent at birth
F>M
premature/low weight infants
older mothers/chorionic villus sampling
growth pattern of hemangiomas
volumetric rather than centrifugal growth
80% of final size by end of early proliferative phase (mean=3.2mo)
what are signs of involution of infantile hemangiomas
color change from red to grey-purple and flattening of surface
what is this condition?
pericoular hemangioma
tx for hemangioma
small: spontaenous resolution
severe: non-selective beta blocker propranolol
what is this lesion?
vascular malformation (port wine stain)
describe vascular malformation
slow expansion
evident at birth
no predilections
what is sturge weber syndrom
combo of vascular malformation, trigeminal distribution, seizure
how to distinguish vascular malformation and hemangioma
sharp midline dermarcation
sequela of vascular malformation
hypertrophy of limb
soft tissue hypertrophy
what is this presentation?
milia
more common in pediatric
describe milia
small firm white papule containing keratin and representing small inclusion cysts
40-50% will have milia
resolve spontaneously within first 4 weeks of life
what is this a presentation of
miliaria
describe miliaria
occlusion of eccrine sweat ducts
small vesicles of retained sweat trapped under swollen stratum corneum
what is this a presentation of?
mastocytosis
excessive collections of otherwise normal mast cells
generalized form of childhood mastocytosis is called urticaria pigmentosa
frequently resolve for peds
can cause excessive histamine
what is this?
Darier’s sign
urtication of lesions of mastocytosis caused by the stroking or scratching
what is this lesion
halo nevi
describe halo nevi
<20 yr
no gender predilection
risk of overall increased # of melanocytic nevi
20% have vitiligo
what is this lesion?
mongolian spot
describe a mongolian spot
congenital dermal melanosis
blue-grey patch
lumbosacral distribution
asian descent
resolve spontaneously
what is this a presentation of?
alopecia areata
describe alopecia areata
non-scarring patterned alopecia
circular areas
organ-specific autoimmune disease involving T-cells
complete scalp hair loss: alopecia totalis
complete scalp and body hair loss: alopecia universalis
what is the pathognomonic feature of alopecia areata
exclamation point hair which narrows proximally as it exits the hair follicle
what is this a presentation of?
cherry hemangioma
describe cherry hemangioma
proliferation of dilated venules
increase in number with age
small cherry red papules or maules
what is this a presentation of?
venous lake
describe venous lake
dilation of venules
ear or lip
sun damage
95% in men
what is this a presentation of?
dermatofibroma
describe dermatofibroma
benign skin neoplasms compoased of collagen, macrophages (histiocytes), capillaries, fibroblasts
firm, skin colored or slightly pigmented papules or nodules, measuring 0.5-1cm in diameter
tender or pruritic
round/ovoid with well-defined border
why does dimple sign occur for dermatofibroma
epidermis is tethered to underlying fibrotic component
overlying skin does not slide over the underlying nodule
dimple sign - skin pucker inwards also known as Fitzpatrick sign
what is this a presentation of?
spider angioma
describe spider nevus/angioma
telangiectasia
central arteriole (body), radiating vessels (legs)
common in normal children
parturition or cessation of oral contraceptives
what is the diagnostic marker for spider angiomas?
classic refill pattern
refill radiating from the central vessel outward
what is this lesion?
seborrheic keratoses
describe seborrheic keratoses
common benign neoplasms
stuck on appearance
papules and plaques with well defined borders
familial trait (AD)
increased prevalence w age
can have verrucous-appearing papules or plaques
scaling when scratched
what is this lesion?
dermatosis papulosis nigra
SK on darker skin phototype
oriented in lines of skin relaxation (Langer lines)
what is this lesion?
achrochordon
skin tag
flesh-colored, pendunculated, fleshy papules
spontaneously fall off if blood supply becomes strangulated
increasing age, diabetes, obesity
achrochordons may occur on the _______
oral, anal, or vulvovaginal mucosa
what is this lesion?
fibrous papules of the nose
how to distinguish fibrous papule from other papular lesions (BCC, nevi, sebaceous hyperplasia?
look for single firm, dome shaped, flesh colored papule on nose or central face
lesions rarely occur on forehead, cheeks, chin, or neck
what is this lesion?
pyogenic granuloma
rapidly growing, benign, vascular growths
solitary red papule or nodule
ulcerates or bleeds easily
more common in children and women of child-bearing potential
drugs associated with pyogenic granuloma
isotretinoin, topical retinoids, indinavir, 5-fluorouracil, capecitabine, mitoxantrone, anti-epidermal growth factor inhibitors
