Benign Skin Conditions and Skin Disorders


Chapter 23

Benign Skin Conditions and Skin Disorders



Common Benign Skin Lesions



1. Keratocanthoma (see Figure 23.1)


Benign tumor that behaves like a squamous cell carcinoma (SCC) and is difficult to differentiate histologically


Characterized by rapid growth with a central crater/keratin plug


Can spontaneously regress


Treatment recommendation: Excision



2. Actinic keratosis (AK; also known as solar keratosis, senile keratosis; see Figure 23.2)


Extremely common skin lesions reportedly affecting up to 12% of the population


Benign, premalignant lesion that can progress to SCC


Estimated rate of conversion to SCC is 13% to 20% over 10 years for lesions that are untreated.


More than 80% occur on sun-exposed/sun-damaged areas such as the head, neck, and upper extremities (e.g., dorsal hand/forearm).


Risk factors: Chronic sun exposure, increasing age, male gender, fair skin


Characterized by a rough, erythematous papule with a white to yellowish scale or plaque


Treatment: Cryosurgery, photodynamic therapy, medical treatment (e.g., topical or intralesional 5-fluorouracil [5FU], topical imiquimod)



3. Seborrheic keratosis (SK; also known as a senile wart) (see Figure 23.3)


Benign skin growth originating from the basal and squamous cells of the epidermis


Characterized by well-circumscribed, waxy lesions that are occasionally pigmented and have a “stuck-on” appearance


Must be differentiated from AK, basal cell carcinoma (BCC), and melanoma


Sudden appearance of multiple SKs can be a marker of internal malignancy.


Treatment: Laser therapy, cryotherapy, electrosurgery, and excision



4. Nevus sebaceous (“nevus sebaceous of Jadassohn”) (see Figure 23.4)


A benign hamartoma confined to the head and neck regions


Can have malignant degeneration into BCC


Characterized by a waxy, smooth or papillated, hairless, salmon-colored patch or thickening on the scalp that typically presents at birth


Treatment: Excision



5. Juvenile melanoma (“Spitz nevus”; see Figure 23.5)


Benign pigmented skin lesion typically found in children or young adults


Difficult to distinguish from melanoma clinically and histologically


Characterized by a red, pink, or brown papule or nodule with rapid growth


Treatment: Complete excision with negative margins; if any concern for melanoma, obtain appropriate margins based on depth.



6. Nevus of Ota (see Figure 23.6)


Benign blue nevus that is present within the dermatome of the first and second branches of the trigeminal nerve


Most commonly affects Asian females


Bimodal distribution: Early infancy and early adolescence


Caused by dermal proliferation of melanocytes


Treatment: Laser (e.g., Q-switched ruby, alexandrite); dermabrasion, peels, or cryotherapy have also been used.



7. Nevus of Ito


Often considered a subtype of nevus of Ota


Occurs in the acromiodeltoid region.


Treatment: Similar to nevus of Ota


8. Mongolian spot (also known as congenital dermal melanocytosis; see Figure 23.7)


A common benign proliferative disorder that affects the majority of Native American, Asian, and Hispanic infants


Caused by entrapment of melanocytes within the dermis during development


Characterized by multiple bluish-gray spots or a large patch covering the lumbosacral region


Lesions typically disappear by 10 years of age.


Treatment: Observation because most disappear without treatment; lasers for severe cases.



9. Blue nevus


Also caused by dermal melanocytosis


Characterized by a well-circumscribed, firm, blue-pigmented nodule/papule


Three subtypes: Common, cellular (can invade the subcutaneous tissue), and combined (combined with a pigmented nevus or a Spitz nevus)


Treatment: Biopsy for suspicious lesions; simple excision (see Figure 23.8)


Sep 2, 2016 | Posted by in Aesthetic plastic surgery | Comments Off on Benign Skin Conditions and Skin Disorders

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