DD- COMMON SKIN TUMORS (BENIGN) Flashcards
Typically arise in middle age
MOST common vascular tumor in adults
Generally no association with underlying disease
Usually on the trunk
Cherry HemangiomasSENILE CHERRY ANGIOMAS
Cherry Hemangiomas Treatment
Superficial electrodesiccation
Liquid nitrogen followed by curettage
Shave biopsy
Pulse dye laser- best for small lesions
The most common soft tissue tumor of infancy (10-12% of infants)
Benign endothelial cell neoplasm
Infantile Hemangioma
CAPILLARY HEMANGIOMA
other names:STRAWBERRY HEMANGIOMA, CAPILLARY HEMANGIOMA
Infantile Hemangioma- Complications
Ulceration Size- may obstruct vision or feeding Congenital syndromes (PHACES)
Infantile Hemangioma- Treatment Options
Observation
Local wound care
Pulsed dye laser
Topical, intralesional and systemic steroids
Beta-blockers
Stain with Glut-1, a placental antigen
More common in:
Girls
Premature infants
Infantile Hemangioma
STRAWBERRY HEMANGIOMA, CAPILLARY HEMANGIOMA
Vascular malformation Present at birth Persists into adulthood Often irregular vascular channels that do NOT stain with Glut-1 Somatic mutation in GNAQ
Port Wine Stain
CAPILLARY MALFORMATION
Port Wine Stain- Complications
Overgowth of an extremity covered by a large port wine stain
Varicose veins, venous stasis, edema, ulceration
Port Wine Stain Treatment
Pulsed dye laser
Why treat?
Persist into adulthood
Get worse with time
Dark purple, nodular, bleeding blebs
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
Infantile Hemangioma
Stain with Glut-1
nfantile Hemangioma
do NOT stain with Glut-1
Port Wine Stain
Hemangioma vs Port Wine gender
Hemangioma - girls
Port Wine- none
Klippel-Trenaunay syndrome
Port Wine on legs
may cause edema
Sturge Weber Syndrome
Port Wine on face
ocular and neurologic abnormalities including glaucoma, seizures and developmental delay
hamartoma
presents as a papillomatous yellow-orange plaque on face/scalp
Somatic mutations in HRAS and KRAS
Nevus Sebaceus
Nevus Sebaceus
enlargement of sebaceous glands
Nevus Sebaceus Treatment Options
Observation
Surgical excision
Common benign tumor of oil gland
Increasing frequency after middle age
Distribution- face>trunk>extremities
Sebaceous Hyperplasia
Sebaceous Gland HyperplasiaTreatment
No treatment
cosmetic issue only
Acrochordon
SKIN TAGS, FIBROEPITHELIAL POLYPS
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
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.
Lipoma
Lipoma Treatment options
No treatment
Surgical excision
Positive dimple (Fitzpatrick) sign
Complications- pain, pruritus
Distribution- legs
Typically solitary
Dermatofibroma
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.
Keloid Scar
Keloid Scar Rx
Topical steroids under occlusion
Intralesional steroids
Surgical excision: works best for ear keloids
Surgery +/- Radiation
Seborrheic Keratosis are called?
“Barnacles of Life”
Benign tumor of the hair follicle
Distribution- primarily head, neck, trunk
Seborrheic Keratosis
Clinical Variants
Dermatosis papulosa nigra
Stucco keratosis
Inflamed seborrheic keratosis
Sign of Leser-Trélat
Benign tumor of the hair follicle
Distribution- primarily head, neck, trunk
Seborrheic Keratosis
Seborrheic KeratosisTreatment
Moisturizers
Cryosurgery- treatment of choice
Infancy to adulthood
Any skin surface including mucous membranes
increased on sun-exposed skin
Nevocellular Nevi
Junctional Nevus are typically?
Flat macules
Compound Nevus are typically?
Papual/Nodule
Dark
on Trunk
Nevocellular Nevi
Treatment Options
Appropriate
Shave biopsy
Punch biopsy
Excision
Dysplastic Nevus
Acquired melanocytic proliferation
Round to oval to irregular
Variegation in color- tans, brown, black, reds
Margins- often indistinct
Neurofibromatosis Type 1:
Diagnosis requires 2 or more of the following criteria
- 6+ café au lait macules > 1.5 cm
- 2+ neurofibromas, or 1 plexiform neurofibroma
- Axillary or inguinal freckling
- Optic glioma
- 2+ more Lisch nodules
- osseous lesion or thinning of the long bone cortex
- FDR with the disorder
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
Café-au-Lait Spots
