December 1, 2015 - Benign Skin Lesions Flashcards
Seborrheic Keratosis
One of the most common tumors you will see.
Genetic pre-disposition.
Usually begin to appear in the 40’s and increase with age.
Appear “waxy” or “warty”
Treatment is usually none, unless unsightly.
Seborrheic Keratosis - Treatment
None unless unsightly.
If so, treatment is liquid nitrogen cryotherapy, electrodessication, curettage, or surgical excision.
Solar Lentigo
Found in 90% of people over 60 years old.
Incidence increases with age, but they may develop at any age.
Well-circumscribed in sun-exposed areas.
Treatment is to protect from sunlight, light cryotherapy, or intense pulse laser.
* Ensure not melanoma (ABCDE)
ABCDE’s
Used to help diagnose melanoma.
A - asymmetry
B - borders uneven
C - colour uneven
D - diameter greater than 6mm
E - evolution
If any of these are present, you may want to biopsy.
Halo Nevus
Usually asymptomatic
Central nevus may or may not involute with time
Repigmentation takes place over months or years and does not always occur
Common in kids
If a new halo nevus in an adult, biopsy it.
Blue Nevus
Early age of onset (8-15)
Well-defined homogenous blue-gray/blue-black color
Commonly found on head and neck, dorsal hands and feet, and presacral area
Spitz Nevus
Red or pigmented papule or nodule, usually in kids or young adults
Looks like melanoma on histology, but doesn’t behave like melanoma
Grows rapidly and may reach 1cm within 6 months, then settles down except for the colour
Treatment: requires complete excision
Pigmented Spindle Cell Nevus of Reed
(Variant of Spitz nevus)
Small, well-circumscribed dark brown to black papule
Characteristic starburst pattern
Requires complete excision
Congenital Nevi
Can be small, medium, or large.
Large/giant ones that are greater than 20cm have a 3-12% risk of developing into melanoma.
Intradermal Nevi
Raised soft fleshy papules of any colour.
Junctional Nevi
Flat well-defined macules with smoother borders and uniform colour.
Compound Nevi
Combination of raised (intradermal) and flat (junctional) lesions.
Benign.
Nevus Spilus
“Splash of paint”
Tan patch with superimposed speckles that develop over time.
Common on trunk and extremities
Reports of melanoma developing within these lesions, therefore it is important to follow them with serial imaging.
Atypical Nevi
Previously known as dysplastic nevi, but the association with melanoma is contraversial.
Clinically atypical doesn’t translate into hisopathologically atypical often.
Dermatofibroma
Very common tumor in adults
Most often affects the lower extremities
Has a positive dimple sign (when squeezed)
