Picture Quizzes –Benign and cancerous skin lesions
Acrochordons (skin tags) are common, benign, skin colored or hyperpigmented, soft and often pedunculated papules, most commonly seen on the neck, axilla, and other skin folds (including the groin), particularly in obese individuals. They are usually asymptomatic but may become painful if irritated. The differential diagnoses include neurofibromas, melanocytic nevi, fibroepithelial tumors (Pinkus tumor), seborrheic keratosis, and warts. Acrochordons may be treated for cosmetic reasons or if symptomatic.
2. Neurofibromas are soft, pedunculated or broad-based, often asymptomatic, skin-colored papules. Cutaneous neurofibromas may exhibit a buttonhole sign, whereby they can be pushed deeper into the dermis. They may be treated for cosmetic reasons.
3. Lipomas are the most common subcutaneous soft-tissue tumor. Lipomas are well-circumscribed or ill-defined, soft or rubbery, non-compressible, slowly growing, mobile, subcutaneous nodules, most commonly presenting on the trunk, neck, and proximal extremities. They are usually asymptomatic unless they grow to compress an underlying nerve. They may be treated if symptomatic or for cosmetic reasons with surgical excision.
4. Sebaceous hyperplasias are common, benign, small, well-circumscribed, often umbilicated papules, mostly on the face, representing enlarged sebaceous glands. They may be treated for cosmetic reasons.
5. Syringomas are benign, small, asymptomatic, symmetrically distributed papules, derived from eccrine ducts. Syringomas are most commonly limited to the lower eyelids and cheeks. They may be treated for cosmetic reasons.
6. Xanthelasma are often symmetrical yellow papules and plaques that occur most commonly in the periorbital area, particularly the inner canthus of the eyelid and upper lid. Up to 50% of affected individuals may have associated dyslipidemia. The differential diagnoses include sebaceous hyperplasias and syringomas. Options available for the removal of xanthelasma palpebrarum include surgical excision, argon and carbon dioxide laser ablation, chemical cauterization, electrodesiccation, and cryotherapy.
7. Seborrheic keratoses are the most common benign tumor in adults. They present as well-circumscribed flat or verrucous papules that occur on anywhere except the palms, soles, and mucous membranes. Multiple lesions are seen with autosomal dominant inheritance or as part of the sign of Leser-Trelat, associated with malignancy. They are usually asymptomatic unless inflamed.
8. Epidermal inclusion or epidermoid cysts are common, benign, mobile, skin-colored, firm, round nodules, nearly always accompanied by a central pore or punctum. Discharge of a foul-smelling "cheese-like" material may be observed. They occur most frequently on the face, trunk, and neck. The lesions are usually asymptomatic unless they become inflamed or secondarily infected resulting in tenderness. They may be excised for cosmetic reasons or if recurrent inflammation develops.