lumps and bumps (benign)

+ pyogenic granuloma
- no sign of infection
- capillary hemangioma

+ glomus tumor
- AV shunts
- painful

+ lymphatic malformation (lymphangioma)
- frog-spawn

BENIGN CYSTS & PSEUDOCYSTS
+ epidermal inclusion cyst
-follicular infundibulum (cyst wall true epidermis, containing foul-smelling
macerated keratin substance
-presence might be linked to trauma
-MILIUM - small form of inclusion cyst
- TX: entire cyst with its lining should be removed surgically

+ trichilemmal cyst (pilar cyst)
- cystic content is made up of amorphous material, granular layer not obvious

+ digital myxoid cyst
- pseudocyst occuring over DIP

BENIGN TUMORS of EPIDERMIS and its APPENDAGES
+ seborrheic keratosis
= epidermis - scaling, well-marginated papule or plaque.
= thickened epidermis containing horned pseudocysts. benign squamoid and basaloid
proliferation. basal layer hyperproliferation.
= where? middle-aged old patients on head neck and trunk (sun-exposure)
= appearance? flesh-colored, smooth to warty crumbly texture, stuck-on
appearance.
= LESER TRELAT sign (massive appearance of seborrheic keratosis in old-age might
be a sign of GI malignancy ~% correlation unknown)
= STUCCO KERATOSIS (variation)
= DDX: lentigo maligna and lentigo maligna melanoma (shave biopsy), bcc,
hidroacanthoma simplex/eccrine poroma, fibroepithelioma of pinkus,
epidermal nevus (pigmented nevocellular nevus)
= TX: curettage

+ Keratoacanthoma
= Appearance: Epidermal shoulders (dome-shaped) and central keratotic plug.
= Distribution: Upper trunk and of 6 wks duration
= Histology: keratin plug, thin shoulder of normal epidermis, horn cyst, MNC
infiltrate
= DDX: squamous cell carcinoma

+ trichoepithelioma
= Appearance:

+ syringoma
= benign ademoa of the eccrine ducts
= Distribution: family history, women @ beginning of puberty
= disseminated syringoma on chest wall
= TX: laser removal

+ sebaceous hyperplasia
= cause: chronic sun exposure (photodermatitis)
= appearance: yellow papule, central umbilication, contains sebaceous material,
bv dilatation (telangiectasia)
= distribution: face

+ nevus sebaceous
= appearance: yellowish plaque lesions of characteristic orange color, hairless
= distribution: scalp
= note: 10% of pateitns can be expected to develop bcc in the lesion, therefore
excision is recommended at around puberty

+ epidermal nevus
= developmental (hamartomatous) disorder
= histology: hyperplasia of epidermal structures (epidermis and adnexa), no
nevocellular

+ Becker's nevus (variation of epidermal nevus)
= distribution: dermatone (t2 ~ t4, maybe c6-c8)
= appearance: dermatomal distribution on chest,
= tx: laser treatment

BENIGN DERMAL TUMORS
+dermatofibroma
= appearance: dome-shaped, slightly erythematous and tan nodule with a button-like,
firm appearance. "dimple sign". might be pigmented.

+hypertrophic scars
= appearance: broach raised scar developing at site of injury (no crossing over to normal skin

+keloid
= histology: epidermis atrophic,
= tx: combined cryotherapy and intralesional triamcinolone.
surgical excision, silicone cream nd silicone gel sheet.

+lipoma
= histology: normal epidermis, dermis impinged upon by an encapsulated tumor
contains large amounts of lipocytes and telangectasia
= appearance? soft swelling that moves around when pressed

+skin tag (soft fibroma, acrochondron, cutaneous papilloma)
= distribution: more common in females and in obses paeitnts, often in
intertriginous areas (axillae, inframammary, groin)
= TX; excision!

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NOTE: dermal nodules without specific activity is


CORNS and CALLUSES
= keratotic lesions resulting from repeated trauma
= HARD corns - dorsal aspects of the toes, SOFT corns - interdigital web
spaces
= salicylic acid, urea