The most common skin lesions (benign)

Seborrheic Keratosis

Seborrheic Keratosis, sometimes called senile wart, is a non-cancerous condition that occurs as a light brown, black or tan growth on the surface of the skin. These are usually harmless but may sometimes get irritated or be aesthetically unappealing. They can be removed, if necessary.

Common characteristics:

·  These lesions are slightly elevated
·  They are waxy and scaly
·  They can appear in all areas of the body except for the palms and soles
·  They often occur later in life and usually in multiples
·  Many times, it has a stuck, “pasted on” appearance

Dermatosis papulosa nigra

Example picture of dermatosis papulosa nigra

Dermatosis paulosa nigra is a condition that occurs mainly in darker skin types and usually starts to form in adolescence. The lesions are small, darkly pigmented papules that are harmless and generally don’t require treatment.  

Common characteristics:

·  It appears mainly on cheeks and foreheads
·  It often occurs in multiples
·  This lesion has a smooth surface
·  It appears most likely in an old age

Stucco keratosis

Example picture of stucco keratosis

Stucco keratosis is another harmless skin condition among common skin lesions with the following characteristics:

·  It consists of small, white-gray papules
·  It appears mostly on the ankles or feet
·  Men are more likely to have it
·  It is more common among fair-skinned individuals

Skin tags (acrochordons)

Example pictures of skin tags

Skin tags or acrochordons are soft skin growths where a narrow papule sticks out of the skin from a short piece of flesh like a tag.

Common characteristics:

·  They are fleshy
·  They often occur on the eyelids, neck, groin or armpit
·  They can become irritated if twisted or rubbed a lot
·  They are harmless but can be removed for cosmetic reasons

Cherry angiomas

Cherry angiomas are red papules filled with blood vessels made up of capillaries at the surface of the skin.

Common characteristics:

·  They usually develop after the age of 40 and increase in number over time.
·  They occur in higher concentrations on the trunk of the body.
·  They may resemble melanoma when they bleed or clot.
·  They do not require treatment, unless for cosmetic reasons.

Dermatofibroma

Example picture of dermatofibroma

Dermatofibroma is a benign skin tumor that appears as a firm, round, brownish to red-purple growth usually found on the legs.

Common characteristics:

·  It feels like a hard lump under the skin
·  When squeezed, it dimples since the lesion is tethered to lower layers of the epidermis.
·  It initially has a red color, later changing to brown
·  It is dome-shaped
·  It usually has a darker peripheral rim
·  It is often a result of a prior injury

Solar lentigo

Solar lentigos, also known as “sun spots” or “age spots,” are marks on the skin from sun damage that are not cancerous. Although no treatment is required, patients are often at an increased risk for skin cancer and need to exercise precaution.

Sebaceous hyperplasia

Example picture of sebaceous hyperplasia

Sebaceous hyperplasia is a skin condition that occurs when sebaceous gland on the skin is enlarged.

Common characteristics:

·  It appears as small, skin-colored to yellow papules with a central indent
·  These papules often occur on the forehead and central face
·  They can often resemble basal cell carcinoma, but they rarely bleed or crust
·  Removal is not necessary, unless for cosmetic reasons

Epidermal inclusion cyst (EIC)

An epidermal inclusion cyst is a common skin cyst, sometimes called sebaceous cyst, even though it arises from hair follicles, not oil glands. The cyst contains a foul-smelling, cheese-like substance formed from degenerating keratinocytes.

They can become red and aggravated if the substance enters the dermis, an occurrence which is often mistaken for an infection. Asymptomatic cysts don’t require treatment. Excision can be used to remove a cyst if desired.

Milia or tiny epidermoid cysts

Example picture of milia or tiny epidermoid cysts

Milia or tiny epidermoid cysts is a condition where small 1-2 mm white to yellow papules occur underneath the surface of the skin.

Common characteristics:

·  These cysts can occur in all ages
·  They can be extracted without scarring
·  They are fixed and long-lasting
·  They often occur on the cheeks, eyelids, forehead, and genitalia.

Lipoma

Example picture of lipoma

Lipomas are collections of fat under the skin. These common skin lesions are soft and mobile benign tumors that usually stop growing when they reach a few centimeters in diameter. Treatment is surgical and considered elective.

Common characteristics:

· They often appear on the trunk, arms, or thighs
· They tend to occur in multiples in early adulthood

What does a normal mole look like?

Types of skin moles and how to know if they’re safe

Skin cancer pictures

Images courtesy of the American Academy of Dermatology

What Are They, and How They’re Treated

Written by WebMD Editorial Contributors

• What Are the Types of Benign Skin Growths?
• What Are the Types of Malignant Skin Growths?
• What Are the Types of Precancerous Skin Neoplasms?
• What Are Skin Neoplasms of Uncertain Behavior?
• Conclusion

It can be alarming to find a growth on your skin, but don’t worry. Most growths, known as skin neoplasms, are harmless. However, some can be cancerous or precancerous, so make sure you get them looked at by a doctor. Your doctor may know exactly what kind of skin growth you have just by looking at it, or they may need to do a simple biopsy.

Benign neoplasms are not cancerous. Whether they need to be treated or not depends on their type and your symptoms. There are many different types of benign skin neoplasms, but they come in three major forms.‌

Flat and slightly raised lesions. These skin neoplasms are either macular, which is flat, or slightly papular, which is raised. Some of the most common of these are:

• Moles
• Cherry angiomas
• Dermatofibroma
• Actinic keratosis
• Sebaceous hyperplasia

Raised lesions. These skin neoplasms are raised bumps. Some common benign papular skin growths include: 

• Seborrheic keratosis
• Inverted follicular keratosis
• Keratoacanthosis
• Skin tags
• Pyogenic granuloma‌

Lesions beneath the skin. These are located underneath the epidermis, the upper layer of the skin. These can be lipomas or cysts.

Malignant skin neoplasms are cancerous. Early detection and treatment is important since almost all skin cancers can be cured by complete excision. There are several types of malignant skin growths.

Basal cell carcinoma. About 60% of malignant skin neoplasms are basal cell carcinomas. Usually found on skin that was exposed to many years of sun, basal cell carcinomas are a slow-growing neoplasm that invades tissue but doesn’t spread. While they can grow anywhere, they’re most often found on the face or other exposed areas.  

Squamous cell carcinoma. About 20% of malignant skin growths are squamous cell carcinomas. This type of neoplasm is often found in patients that were exposed to ultraviolet radiation, like tanning beds, or in people who have been treated with drugs to suppress their immune system. ‌

Squamous cell carcinoma doesn’t usually spread to other areas. However, squamous cell carcinomas that are more likely to metastasize are:

• Located on the lip or ear
• Come back after treatment
• Located at the site of a burn
• Deeply invasive‌

Malignant melanoma. Only about 1% of skin cancers are malignant melanoma. However, they are responsible for over 60% of skin cancer deaths. Malignant melanoma often metastasizes to other places, and it doesn’t respond well to treatment. Malignant melanoma is more common in areas that have been exposed to sunlight, but can occur anywhere. There are four types:

• Superficially-spreading melanoma, which has a slowly spreading irregular outline.
• Nodular melanoma, which looks like a shiny, black dome.
• Lentigo maligna melanoma, which has one or more hard black nodules.
• Acral lentiginous melanoma, which occurs on the palms of hands, under nails, on the soles of feet, and on moist surfaces that line body cavities.

Precancerous growths. Precancerous skin growths, also called actinic keratosis or solar keratosis, are growths that, if left untreated, may develop into squamous cell carcinoma. There is no way to know which growths will become cancerous. If they’re treated quickly enough, there’s no risk of cancer from them.

Bowen disease. Bowen disease is a rare precancerous disease that mostly affects older adults. Patients experience a red scaly patch that slowly grows over time. Sun exposure is also a risk factor. Even though it’s precancerous, the chance that it actually develops into cancer is less than 10% chance it will develop into cancer, and treatment is usually successful.

A skin neoplasm of uncertain behavior is a skin growth whose behavior can’t be predicted. This diagnosis is only reached after your doctor has conducted a biopsy and sent the sample to a pathologist for examination. There’s no way to know whether it will develop into cancer or not.

Many of these growths are natural and harmless, but as discussed, they may be cancerous. It’s important that you get any suspicious skin growths looked at by a doctor ⁠— early detection can save your life.

Top Picks

Skin cancer: melanoma.

Skin cancer, as the most common oncological disease today, is a generalized concept for malignant neoplasms of the epidermis.

Modern oncology identifies three main malignant skin pathologies. Their names correspond to the names of the cells of the epidermis, which served as the primary source for their occurrence.

In particular:

• basal cell carcinoma that develops from the cells of the basal layer of the epidermis. Read more about this disease in the article “Basalioma. Skin cancer: basal cell carcinoma”;
• squamous cell carcinoma, developing from cells of the spiny layer of the epidermis;
• melanoma, which develops from pigment cells (melanocytes) of the basal layer of the epidermis.

Of these three types of skin cancer, melanoma is the least common, but the most dangerous form of cancer. It is prone to frequent relapses, metastasis and rapid growth within the tissue.

Description and characteristics of the disease

Melanoma is a malignant neoplasm of the skin that develops from the pigment cells of the basal layer of the stratified epithelium. Localized mainly in the skin, melanoma, however, can also occur on the mucous membranes of some organs. In addition, there are known cases of melanoma in the retina.

The main danger of this tumor lies in its uncontrolled growth and tendency to metastasize both by lymphogenous and hematogenous routes with the formation of new foci in almost all internal organs, including the brain. As a rule, melanoma mainly affects older people aged 70 to 86 years, but it can also develop in menopausal and postmenopausal women.

Risk factors and types of melanoma

As a rule, melanoma, although it seems to be a chaotically spreading disease, is based on structured paths of development, which allowed modern oncologists to identify a number of factors that provoke the formation of a tumor. In part, the factors that provoke the development of neoplasms include:

• excessive ultraviolet radiation, causing damage in the bonds of the DNA molecule of the pigment cell;
• genetic predisposition to develop the disease;
• moles, including multiple and atypical nevi;
• human genotype.

In addition, the rather rare xeroderma pigmentosa, characterized by an increased sensitivity of the body to ultraviolet radiation, may also be a risk factor.

The type of melanoma is usually determined by the type of development of the disease and its localization. To date, six main types of this tumor have been identified, the foci of which are localized exclusively in the skin. Among them, the most widespread is the so-called superficially spreading melanoma. This type of neoplasm occurs in 70% of cases and is characterized by horizontal tumor growth.

With timely diagnosis and qualified treatment, the prognosis is quite favorable: 98% of patients are cured after complete removal of the tumor.

Other types of cutaneous melanoma:

• nodular melanoma: occurs in 15% of cases, the most dangerous type of tumor, characterized by growth into the thickness of the skin;
• acrolentiginous melanoma: occurs in 10% of cases predominantly in dark-skinned people and is characterized by growth at the fingertips;
• lentiginous melanoma: occurs in 5% of cases, the most favorable of all types, develops, as a rule, against the background of a birthmark;
• achromatic melanoma: less than 5% of cases, characterized by the absence of pigment, and therefore problematic in diagnosis.

Diagnosis and treatment of diseases

ABCDE system
(enlarge)

Typically 70% cases, the diagnosis of melanoma is not difficult. The diagnosis is made by dermatoscopic examination of the neoplasm with a magnifying glass or dermatoscope. As a rule, a suspicious nevus is examined on the basis of the international ABCDE system. That is, on the basis of the asymmetry of the neoplasm, the unevenness of its border, the unevenness of its color, size and variability.

However, dermoscopy only provides a preliminary diagnosis; the final diagnosis is made by the doctor after a histological examination of the body of the neoplasm in the laboratory. As a rule, with a positive diagnosis, a decision is made to remove the tumor foci.

To date, there are a number of methods for treating neoplasms, with the highest possible positive result. However, focusing on the prognosis, one should not forget at what stage of the development of the disease the treatment began. In the case when melanoma treatment began at an early stage, the prognosis is invariably favorable, and when metastases to other organs have begun, the likelihood of death is very high.

Methods of treatment:

• surgical: a universal method for removing both primary tumor foci and its relapses, including resection of positive lymph nodes;
• immunotherapy;
• chemotherapy;
• radiotherapy;
• cryodestruction;
• laser vaporization

Laser vaporization of a tumor is an effective treatment for superficially spreading melanoma. In many ways, this method allows you to replace a potentially dangerous surgical intervention with a less traumatic, but no less effective solution to the problem. For these purposes, a new generation of laser equipment is used today using the energy of a carbon dioxide laser, which is used both in surgery and in dermatocosmetology. Read more about CO2 laser in the article “Carbon dioxide laser as the most common laser in cosmetology”.

Body neoplasm under the influence of laser radiation “evaporates” from the surface of the skin. At the same time, the features of the equipment allow you to control the depth of penetration of the laser beam. Thus, all cells with a damaged structure are destroyed. The same method is used to treat basal cell carcinoma (basalioma).

Skin neoplasms Kharkiv

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Wednesday, 02 February 2022

Any neoplasms are the result of uncontrolled division of cells that have not yet reached maturity, and therefore are not able to fully perform their functions. They occur due to the overgrowth of any tissue in the body. Skin lesions may arise from overgrown skin cells (epidermis), pigment cells (nevus, melanoma) or skin appendages (sebaceous glands, sweat glands).

Such neoplasms are called skin tumors and are divided into benign, precancerous and malignant. Benign neoplasms consist of cells in which the ability to differentiate them is not impaired. Cells retain their original functions and are similar in structure to normal cells, they grow slowly. At large sizes, benign formations can compress adjacent tissues, but never penetrate into them.

Precancerous skin diseases are dermatoses that can degenerate into cancer with a greater or lesser degree of probability. There are obligate precancers – dermatoses, which almost always transform into cancer. And optional – dermatoses, which are not always transformed into cancer.

Malignant tumors of the skin are a group of neoplasms formed from skin cells and connective tissue. Skin cancer is the most common type of cancer, and in most cases develops in areas of the skin that are exposed to insolation, and is inversely related to the content of melanin in the skin. Thus, people with fair skin, blond and red hair are most at risk of developing cancer. Also, malignant tumors of the skin can develop years after radiation therapy or exposure to carcinogens (for example, when arsenic is ingested).

An accurate diagnosis requires correct diagnosis.

Diagnosis and treatment

Dermoscopy is used to diagnose skin neoplasms. The doctor, using a special apparatus (dermatoscope), studies the formation and makes an assumption about the nature of its origin. This is a non-contact study aimed at recognizing benign formations from malignant ones.

Depending on the type of tumor, a decision is made about further treatment.

If the mass is benign and does not bother the patient, then it can be left and nothing can be done about it. If it is necessary to treat benign skin lesions, then most often this is the removal of the affected area with a small capture of healthy tissue. For non-pigmented benign formations, cryodestruction, radio wave method or laser ablation can be used.

If a malignant process is suspected, the removal of a skin lesion is carried out only surgically within healthy tissues.

Important!

If the lesion remains under observation, a photo of the lesion with dimensions should be taken and stored in the patient’s record so that any changes in size, color and shape can be assessed later.

After removal, any mass should be sent for histological examination. This means that a piece of the affected tissue is given for laboratory analysis to confirm the diagnosis.

Benign neoplasms of the skin

Types of benign neoplasms of the skin:

• A mole (nevus, birthmark) is a benign pigmented skin formation, usually small in size, but can reach gigantic sizes.
• Seborrheic keratoma is one of the most common tumors, especially in the elderly. A well-defined lesion, usually oval or round, flesh to grey-brown in color with scales on the surface.
• Hemangioma is a vascular tumor that develops from the cells of blood vessels. May be red to bluish black in color, flat or raised above the skin surface.
• Warts – a formation in the form of a small nodule, usually on a wide base (stalk). The reason is the human papillomavirus (HPV). Usually occur against the background of stress, reduced immunity, vegetative disorders.
• Papillomas are benign flesh-colored formations, often on a thin base (pedicle). Papillomas are not caused by the human papillomavirus (HPV), are not contagious, and do not require testing for HPV.
• Cutaneous horn is a dense cone-shaped formation that grows from the skin. It is a special form of keratosis. The size and shape of this formation varies widely, but most often it is several millimeters in length. Is a precancer. In this case, squamous cell carcinoma occurs at the base of the horn.
• Lymphangioma is a congenital tumor of the walls of the lymphatic vessels. They are located superficially or in body cavities and can reach large sizes. Outwardly, these are formations with a bumpy surface of a cyanotic or red-brown color.
• Atheroma – a tumor of the sebaceous gland, is formed due to blockage of the excretory duct. As a result, the secret accumulates in the cavity of the gland, becomes thick. It occurs on any part of the body, except for the skin of the palms and feet, since there are no sebaceous glands. When a secondary infection is attached, they can become inflamed and even abscess.
• Dermatofibroma – formation from connective tissue. Outwardly, it looks like a ball protruding above the surface of the skin.
• Schwanoma – a tumor of nerve sheath cells. Outwardly, it looks like a dense tubercle.
• Glomus tumor – a benign tumor, usually arising in the area of ​​the nail phalanges (in other words, it is called a glomangioma, or Barre-Mason’s tumor) – a small benign tumor originating from the neuromuscular node of the skin, which is called the “glomus”. Its feature is a very strong burning pain even with a light touch.

Skin malignancies

Skin malignancies are tumors that arise from the epithelium.

At the same time, skin cancer refers to tumors that are fairly easy to visualize, so early detection and timely treatment are possible, and, as a result, the most favorable prognosis. Distinguish between basal cell and squamous cell skin cancer.

• Basal cell skin cancer (basalioma) is one of the most common skin cancers. Most basaliomas are small, shiny, firm macules, almost clear to pink nodules with telangiectasias, ulceration, and crusting on the surface of the mass, but there may be large plaques with bleeding. It does not metastasize, but without treatment (removal, radiation therapy) it can reach large sizes, be complicated by decay and bleeding, and degenerate into squamous cell carcinoma.
• Squamous cell skin cancer is the second most common form of skin cancer. The clinical picture is highly variable, but squamous cell skin cancer should be suspected in any non-healing mass in an exposed area of ​​the skin. The tumor may manifest as a red spot or plaque with scales on the surface and transform into a nodule. In some cases, the tumor tissue may be below the level of the surrounding skin, ulcerate and grow into the underlying tissues. Squamous cell carcinoma, which occurs in the superficial layers of the epidermis, if left untreated, can spread to other organs. It metastasizes mainly by the lymphogenous route.
• Sometimes there is cancer from the appendages of the skin – hair follicles, sebaceous and sweat glands.
• Melanoma is a tumor that develops from melanocytes (pigment-forming skin cells). It is the most aggressive and often recurrent skin tumor that metastasizes to the blood or lymphatic vessels. It has very variable clinical manifestations. It may appear as a dark spot on the skin, or as a red or blue-white nodule. A particular danger is in spontaneously regressing melanoma, which gradually disappears from the surface of the skin and subsequently manifests itself in the form of metastases in organs and lymph nodes. In the vast majority, this is a tumor of the skin, but it also happens on the retina, on the mucous membranes and meninges. Most melanomas often develop on intact skin, but sometimes in moles, which is why it is so important to monitor their appearance and consult a doctor if you notice the growth or discoloration of one of the nevi.
• Dermatofibrosarcoma bulging (Darier-Ferrand’s tumor) is a malignant tumor arising from connective tissue. Visually, it is a large brown knot that rises above the surface of the skin. It grows slowly, metastases are rare. Often recurs with incorrectly chosen tactics of surgical intervention and postoperative treatment.
• Kaposi’s sarcoma is a malignant tumor from the group of sarcomas. This is a multifocal vascular tumor that is caused by the herpes virus type 8. It can be associated with HIV, and also occurs iatrogenically (after organ transplantation).
• Lipoma is the most common soft tissue tumor that consists of fat cells surrounded by a thin fibrous capsule. In the people, such a neoplasm is called a wen. Lipoma on external signs is little different from liposarcoma, hygroma, subcutaneous cyst, hematoma, parasitic invasion, inflammation or the consequences of trauma. Therefore, it is important that any neoplasms are examined by a doctor.

Skin cancer often develops as a result of previous diseases. All precancerous diseases can be divided into obligate (those that necessarily degenerate into cancer) and optional.

Obligate precancers include Bowen’s disease (squamous cell carcinoma in situ), Keyr’s erythroplasia, xeroderma pigmentosum, Paget’s disease.