DD- COMMON SKIN TUMORS (BENIGN)

Question 1

Typically arise in middle age
MOST common vascular tumor in adults
Generally no association with underlying disease
Usually on the trunk

Answer 1

Cherry HemangiomasSENILE CHERRY ANGIOMAS

Question 2

Cherry Hemangiomas Treatment

Answer 2

Superficial electrodesiccation

Liquid nitrogen followed by curettage

Shave biopsy

Pulse dye laser- best for small lesions

Question 3

The most common soft tissue tumor of infancy (10-12% of infants)
Benign endothelial cell neoplasm

Answer 3

Infantile Hemangioma
CAPILLARY HEMANGIOMA

other names:STRAWBERRY HEMANGIOMA, CAPILLARY HEMANGIOMA

Question 4

Infantile Hemangioma- Complications

Answer 4

Ulceration 
Size- may obstruct vision or feeding 
Congenital syndromes (PHACES)

Question 5

Infantile Hemangioma- Treatment Options

Answer 5

Observation

Local wound care

Pulsed dye laser

Topical, intralesional and systemic steroids

Beta-blockers

Question 6

Stain with Glut-1, a placental antigen
More common in:
Girls
Premature infants

Answer 6

Infantile Hemangioma

STRAWBERRY HEMANGIOMA, CAPILLARY HEMANGIOMA

Question 7

Vascular malformation
Present at birth
Persists into adulthood
Often irregular vascular channels that do NOT stain with Glut-1
Somatic mutation in GNAQ

Answer 7

Port Wine Stain

CAPILLARY MALFORMATION

Question 8

Port Wine Stain- Complications

Answer 8

Overgowth of an extremity covered by a large port wine stain

Varicose veins, venous stasis, edema, ulceration

Question 9

Port Wine Stain Treatment

Answer 9

Pulsed dye laser

Why treat?
Persist into adulthood
Get worse with time
Dark purple, nodular, bleeding blebs

Question 10

Often only a precursor lesion is noted at birth, occasionally fully formed
Rapid proliferation in the first 1-3 months of life
Spontaneous involution over years

Answer 10

Infantile Hemangioma

Question 11

Stain with Glut-1

Answer 11

nfantile Hemangioma

Question 12

do NOT stain with Glut-1

Answer 12

Port Wine Stain

Question 13

Hemangioma vs Port Wine gender

Answer 13

Hemangioma - girls

Port Wine- none

Question 14

Klippel-Trenaunay syndrome

Answer 14

Port Wine on legs

may cause edema

Question 15

Sturge Weber Syndrome

Answer 15

Port Wine on face

ocular and neurologic abnormalities including glaucoma, seizures and developmental delay

Question 16

hamartoma
presents as a papillomatous yellow-orange plaque on face/scalp

Somatic mutations in HRAS and KRAS

Answer 16

Nevus Sebaceus

Question 17

Nevus Sebaceus

Answer 17

enlargement of sebaceous glands

Question 18

Nevus Sebaceus Treatment Options

Answer 18

Observation

Surgical excision

Question 19

Common benign tumor of oil gland
Increasing frequency after middle age

Distribution- face>trunk>extremities

Answer 19

Sebaceous Hyperplasia

Question 20

Sebaceous Gland HyperplasiaTreatment

Answer 20

No treatment

cosmetic issue only

Question 21

Acrochordon

SKIN TAGS, FIBROEPITHELIAL POLYPS

Answer 21

Common- ¼ of all adults have at least one
Solitary or multiple

Soft, flesh-colored tan to brown exophytic papule (1-4 mm) with narrow base

Question 22

benign tumor of adipose tissue.
It is the most common form of soft tissue tumor.
oft to the touch, usually movable, and are generally painless.

Answer 22

Lipoma

Question 23

Lipoma Treatment options

Answer 23

No treatment

Surgical excision

Question 24

Positive dimple (Fitzpatrick) sign
Complications- pain, pruritus
Distribution- legs
Typically solitary

Answer 24

Dermatofibroma

Question 25

It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1.

Answer 25

Keloid Scar

Question 26

Keloid Scar Rx

Answer 26

Topical steroids under occlusion
Intralesional steroids
Surgical excision: works best for ear keloids
Surgery +/- Radiation

Question 27

Seborrheic Keratosis are called?

Answer 27

“Barnacles of Life”

Benign tumor of the hair follicle
Distribution- primarily head, neck, trunk

Question 28

Seborrheic Keratosis

Clinical Variants

Answer 28

Dermatosis papulosa nigra
Stucco keratosis
Inflamed seborrheic keratosis
Sign of Leser-Trélat

Question 29

Benign tumor of the hair follicle

Distribution- primarily head, neck, trunk

Answer 29

Seborrheic Keratosis

Question 30

Seborrheic KeratosisTreatment

Answer 30

Moisturizers

Cryosurgery- treatment of choice

Question 31

Infancy to adulthood
Any skin surface including mucous membranes
increased on sun-exposed skin

Answer 31

Nevocellular Nevi

Question 32

Junctional Nevus are typically?

Answer 32

Flat macules

Question 33

Compound Nevus are typically?

Answer 33

Papual/Nodule
Dark
on Trunk

Question 34

Nevocellular Nevi

Treatment Options

Answer 34

Appropriate
Shave biopsy
Punch biopsy
Excision

Question 35

Dysplastic Nevus

Answer 35

Acquired melanocytic proliferation
Round to oval to irregular
Variegation in color- tans, brown, black, reds
Margins- often indistinct

Question 36

Neurofibromatosis Type 1:

Diagnosis requires 2 or more of the following criteria

Answer 36

1. 6+ café au lait macules > 1.5 cm
2. 2+ neurofibromas, or 1 plexiform neurofibroma
3. Axillary or inguinal freckling
4. Optic glioma
5. 2+ more Lisch nodules
6. osseous lesion or thinning of the long bone cortex
7. FDR with the disorder

Question 37

Subtle increase in number of melanocytes with increased melanin production
Congenital or early childhood
Distribution- trunk and proximal extremities
Typically solitary
Multiple lesions associated with NF

Answer 37

Café-au-Lait Spots