Skin Growths

Common tumors/growths that are come across on the face and trunk are:

  • Benign:
    • Seborrhoeic keratosis
    • Dermatosis papillosa nigra
    • Skin tags (acrochordon)
    • Warts
    • Melanocytic naevi (moles)
    • Cherry angioma
    • Syringoma (Sweat gland tumor)
  • Malignant:
    • Basal cell carcinoma
    • Squamous cell carcinoma
    • Malignant melanoma

sebker1Seborrhoic Keratosis: It is a common, benign tumor of the top layer (epidermis) of the skin, seen after the age of 30 years. Tendency to develop seborrhoic keratosis can be familial. Sudden appearance of a large number of seborrhoic keratosis should arouse the suspicion of underlying systemic diseases like cancers.

Pic: Seborrhoic Keratosis Before Excision

They are commonly seen as brown to black raised lesions on the face, scalp and back with a stuck-on appearance. The surface of the lesion is uneven. It can produce symptoms like itching and pain when irritated.

It has to be differentiated from melanocytic nevi (mole) and wart (viral infection).

Treatment is for cosmetic reasons or when it becomes symptomatic. Treatment includes excision or curettage, cryo and cautery.

dpn1Dermatosis papillosa nigra: These are common, benign, epidermal tumors that may be a variant of seborrhoic keratosis, unique to black race. It is associated with a familial predisposition. They appear as brown to black, comedone like globoid lesions on the face and neck.

They usually begin at puberty or adolescence and slowly increase in size and number until the third to fifth decades.

Treatment is for cosmetic reasons and includes curettage and electrocautery.

acroch1Skin tags: These are common epidermal outgrowths seen as minute flakes or balls of skin. These appear after the age of 30 at the sites of wear and tear (axillae, groin, neck, eye lids)  and are especially associated with obesity. These lesions can get irritated by clothing or chains on the neck. These should not be mistaken with warts that have finger like projections and look fleshy, which are caused by viruses and hence contagious.

Pic: Skin Tag (Acrochordon) on the neck

Treatment is mainly for cosmetic reasons or when it gets strangulated or irritated.

In the presence of large number of skin tags, investigations for endocrinal disorders may be needed.

Syringoma:

syringpre3syringpre2

They are benign tumors of sweat glands and seen as skin coloured or pinkish, shiny, raised, flat lesions on the face (eyelids and centre of the cheeks), chest and neck. They appear in large numbers in patients with a familial tendency.

They first appear during adolescence and further increase during adult life. They become more prominent under humid conditions and are mistaken for acne vulgaris (pimples).

Treatment includes electrocautery, cryo and excision.[See Syringoma After Electrocautery]

melnevipre1Melanocytic nevi (Mole): It is a benign tumor of melanocytes (pigment producing cells of the skin). There are two types: those present at the time of birth (congenital) and those appearing later (acquired). Presence of a large number of nevi may be a familial trait. They appear at childhood, increase sharply at adolescence and then grow slowly during early adult life to reach a plateau by middle age.

Based on the site at which the proliferation of the cells occur, they are seen clinically as black spots or black, raised, dome shaped lesions.

Moles are most commonly seen on the face and the trunk and rarely on the palms and soles.
By their smooth and shiny surface, moles have to be differentiated from seborroic keratosis and warts. Whenever moles suddenly increase in size, ulcerate, bleed or become itchy, malignant transformation should be suspected and should be subjected for biopsy.

Treatment: Very early lesions can be treated by cryo. Treatment of choice is complete excision (punch or elliptical) and subjecting to histopathological examination.

Basal Cell Carcinoma:

bcc1

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