Benign and Malignant Skin Neoplasms CMI PDF

Benign Neoplasms in Practice: -​ Nevi -​ Seborrheic Keratosis -​ Solar lentigo -​ Verruca -​ Epidermal inclusion cyst -​ Cherry hemangioma -​ Acrochordon (skin tag) -​ Sebaceous hyperplasia -​ Dermatofibroma -​ Milia -​ Syringoma -​ Stucco keratosis -​ Fibrous...

Benign Neoplasms in Practice: -​ Nevi -​ Seborrheic Keratosis -​ Solar lentigo -​ Verruca -​ Epidermal inclusion cyst -​ Cherry hemangioma -​ Acrochordon (skin tag) -​ Sebaceous hyperplasia -​ Dermatofibroma -​ Milia -​ Syringoma -​ Stucco keratosis -​ Fibrous papule -​ Keloid and hypertrophic scar -​ Lipoma Epidermis: -​ Squamous cells- constantly shed (best cancer) -​ Basal cell- constantly dividing (medium cancer) -​ Melanocytes- produce pigment, in deepest layer (worst cancer) 1.​ Nevi -​ Melanocytic nevus -​ Benign -​ Even color, distribution -​ If starts to look diff from other mole → biopsy it -​ Background- congenital or acquired, composed of melanocytes -​ Presentation- commonly 40, male, sun, sunburns -​ Clinical- friable, non-healing wound, bleeds, pearly border -​ Nodular -​ Head and neck -​ Pearly papule/nodule, smooth, rolled borders, translucent -​ DD- dermal nevus, amelanotic melanoma -​ Superficial -​ Scaling -​ Erythematous, pink plaques with well demarcated borders, scaling bleeds when scratched -​ DD- eczema -​ Pigmented -​ Increased melanization -​ Brown, blue, black color, smooth with translucence, can be eroded -​ DD- nodular melanoma -​ Ulcerating -​ Crusted with ulceration, rolled border similar to nodular -​ DD- amelanotic melanoma, SCC -​ morpheaform​ -​ Aggressive growth -​ Ivory white appearance, may resemble scar, can progress to nodular or invasive -​ DD- scar– biopsy -​ Treatment- surgical excision -​ Morpheaform- MOHS, excision -​ Superficial- topical imiquimod, 5 FU -​ Prognosis- if left untreated could invade muscle and bone Malignant melanoma: -​ Skin, eyes, scalp, feet, nose, mouth -​ Most common on back -​ Early detection key -​ Risk doubles with more than 5 sunburns -​ Patho- proliferation of melanocytes occurs after DNA mutation -​ Risk- genetic, fair skin, Uv/sun damage, blistering sunburns, increased number of nevi/freckles, weakened immune system -​ DD- blue nevi, pigmented BCC, seborrheic keratosis, hemangioma, irritated nevus, lentigo, amelanotic -​ Superficial spreading- most common type -​ 60-70% -​ Trunk of men and legs of women -​ Begins as nevus or brown papule -​ Nodular- second most common -​ 15-30% -​ Diagnosed 6th decade -​ Blue, black, red nodule, ulceration, bleeding -​ Lentigo maligna- most common on sun damage -​ 15% -​ Face, nose, cheek -​ Slowly enlarging, asymmetric brown or black patch -​ Acral lentiginous -​ Palms, soles, nails -​ 5-10% -​ Fair skin, >3mm in width -​ Dx in late stage