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D6 Dermatology
Common Skin Lesions
Toronto Notes 2019
Skin tags are also known as...
• Acrochordons
• Fibroepithelial polyps
Fibrous Lesions
DERMATOFIBROMA
Clinical Presentation
• button-like,firmdermalpapuleornodule,skin-colouredtored-brown
• majorityareasymptomaticbutmaybepruriticand/ortender
• site:legs>arms>trunk
• dimplesign(Fitzpatrick’ssign):lateralcompressioncausesdimplingofthelesion
Pathophysiology
• benigntumourduetofibroblastproliferationinthedermis
Etiology
• unknown;maybeassociatedwithhistoryofminortrauma(e.g.shavingorinsectbites) • eruptivedermatofibromacanbeassociatedwithSLE
Epidemiology
• adults, F>M
Differential Diagnosis
• dermatofibrosarcomaprotuberans,malignantmelanoma,Kaposi’ssarcoma,bluenevus
Investigations
• biopsyifdiagnosisisuncertain
Management
• notreatmentrequired • excisionifbothersome
SKIN TAGS
Clinical Presentation
• small(1-10mm),soft,skin-colouredordarkerpedunculatedpapule,oftenpolypoid • sites:eyelids,neck,axillae,inframammary,andgroin
Pathophysiology
• benignoutgrowthofskin
Epidemiology
• middle-agedandelderly,F>M,obese,canincreaseinsizeandnumberduringpregnancy
Differential Diagnosis
• pedunculatedseborrheickeratosis,compoundordermalmelanocyticnevus,neurofibroma, fibroepithelioma of Pinkus (rare variant of BCC), nevus lipomatosis superficialis
Management
• excision, electrodessication, cryosurgery
Hyperkeratotic Lesions
SEBORRHEIC KERATOSIS
Clinical Presentation
• knownas‘wisdomspots,’‘agespots,’or‘barnaclesoflife’
• well-demarcatedwaxypapule/plaquewithclassic“stuckon”appearance
• rarelypruritic
• overtimelesionsappearmorewarty,greasyandpigmented
• sites:face,trunk,upperextremities(mayoccuratanysiteexceptpalmsorsoles)
Pathophysiology
• verycommonbenignepithelialtumourduetoproliferationofkeratinocytesandmelanocytes
Epidemiology
• unusual<30yrold
• M>F
• autosomaldominantinheritance
• Leser-Trelat:suddenappearanceofSKthatcanbeassociatedwithmalignancy,commonlygastric
adenocarcinomas