Picture Quizzes –Benign and cancerous skin lesions

9. Pyogenic granuloma (lobular capillary hemangioma) is a benign, rapidly proliferating, solitary, polypoid, bright red papule or nodule, with a distinct rim of keratin. It often develops in areas of trauma (commonly head, neck, fingers, and upper trunk) and bleeds with little or no trauma. Pyogenic granuloma may also arise in pregnancy, particularly on the gingiva. Destruction with electrodessication is the mainstay of treatment.

10. Warts are caused by various subtypes of the human papillomavirus, which spread by direct or indirect contact. They present as skin-colored, hyperkeratotic papules with a rough, irregular surface. Treatment may be difficult, with frequent recurrences.

11. Cherry angiomas are very common, benign, asymptomatic, often widespread, bright red to violaceous, macules to dome-topped or polypoid papules. They are cutaneous vascular proliferations and typically present in the third or fourth decades of life.  

12. Molluscum contagiosum causes benign, asymptomatic, well-circumscribed, single or multiple, dome-shaped, umbilicated papules. Molluscum contagiosum is caused by the poxvirus molluscum contagiosum virus, which is transmitted through direct skin contact or indirect skin contact with fomites and often spreads by autoinoculation. The condition is usually a self-limited disease in healthy children and adults, but it may spread and become persistent in immunocompromised individuals.  

13. Angiokeratomas of Fordyce are benign, typically asymptomatic, blue-black or dark red, dome-shaped, scaly papules, located on the scrotum, shaft of penis, labia majora, inner thigh, or lower abdomen, mostly on adults. They do not require treatment unless bleeding becomes a problem.

14. Dermatofibroma is a common, benign, asymptomatic, well-circumscribed, solitary, cutaneous or subcutaneous papule or nodule. It most frequently develops on the lower legs of young adults. Dermatofibroma may represent a reactive neoplasm secondary to trauma. Multiple eruptive lesions may be observed in the setting of systemic lupus erythematosus, HIV, and other immunosuppressive states. The characteristic tethering of the overlying epidermis to the underlying lesion with lateral compression is called the dimple sign, and may be useful for diagnosis. Removal of the tumor is not required unless diagnostic uncertainty exists. It also may be treated for cosmetic reasons.

15. Chondrodermatitis nodularis helicis is a common, benign, painful condition of the helix or antihelix of the ear. The most common location is the apex of the helix in men and the antihelix in women. It typically presents with as a firm, well-demarcated, skin-colored to pink, scaly or crusted, tender papule or nodule, affecting mostly middle-aged or older men. The right ear is more commonly affected. Pressure and actinic damage play a role in the etiology of this condition. The treatment is to relieve pressure at the site of the lesion and decrease local inflammation that leads to pain.

16. Fibrous papule of the face is a common, benign, firm, dome-shaped, skin-colored to pink papule. It represents an angiofibroma. Most lesions are located on the nose and, less commonly, on the cheeks, chin, neck, and, rarely, on the lip or forehead. Removal of the tumor is not required unless diagnostic uncertainty or suspicion for an early skin cancer exists. It may be treated for cosmetic reasons.

17. Basal cell carcinoma (BCC) is the most common skin cancer. About 70% of all BCCs will arise on the head, with 25% on the trunk. It typically presents as a firm papule or nodule on sun-exposed areas. It may be well- or ill-circumscribed, waxy or scaly, translucent, skin-colored to pink or brown, with telangiectases and a variable degree of crusting or ulceration. Surgical excision is the treatment of choice, but other modalities may be considered depending on the subtype, tumor size, location, and staging.