Benign Skin Lesions

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Benign skin lesions are non-cancerous skin growths that can be identified by the patient or discovered through routine skin checkups. The physical and histological characteristics of the lesion, as well as the patient’s characteristics and overall condition, must all be considered when accurately diagnosing a benign skin lesion and distinguishing it from a malignant condition.

List of benign skin lesions mentioned in the article:

Seborrheic keratosis (SK)​1​:

Seborrheic keratosis (SK) first appears in people in their twenties and affects nearly everyone in their eighties and beyond. These are flat-topped papules with a diameter of 1 cm to 2 cm, varying in color of brown to blackish brown. They occur mainly on the face, head and trunk. The surface of the papules is keratotic and often papillary, or granular surface that looks like clay attached to the skin, which means it has a greasy, wax-like, and “stuck-on” appearance. Treatment is only required if there are cosmetic problems or a suspicion of malignancy. The lesions do not go away on their own, and they do become more numerous as you get older. Cryotherapy, laser therapy, or surgical removal can be conducted if necessary.

Clear cell acanthoma:

Clear cell acanthoma is also a benign skin lesion which is a small tumor with a diameter of up to 2 cm that is usually single, elastic, firm, dome shaped, or bluntly elevated. It might be pedunculated, fungiform, or papillomatous. The surface is either velvety, grainy, or smooth. The color is normally rose pink, however in certain circumstances it can be brown to blackish brown. the answer of how clear cell acanthoma developed is unknown. It’s debatable if clear cell acanthoma is a true tumor or a reactive lesion that occurs as a result of inflammation.

Porokeratosis:

Porokeratosis is a raised keratotic eruption that appears round or oval on the extensor surfaces of the extremities, as well as the trunk and face. Atrophy develops in the lesion’s center, which becomes slightly concave. Porokeratosis appears as a blackish brown papule that grows centrifugally larger. It is asymptomatic, steadily progresses, and does not go away. It has the potential to worsen and progress to Bowen’s disease or squamous cell carcinoma. Porokeratosis is induced by epidermal clones that cause localized dyskeratosis. It may be triggered by sunlight, external injury or aging. Some cases are autosomal dominant. The most common treatments include excision, electrical coagulation, cryotherapy, dermabrasion, and retinoid administration. Porokeratosis is a chronic and hard to control condition.

Cherry angiomas​2​:

Multiple solitary cherry-red papules are disseminated on the skin. The largest lesion (located in the middle) features clearly visible septa.
Image Source: Courtesy of Dr. Gary M. White, MD

Cherry angiomas are a type of cutaneous vascular proliferation that can appear as a single or several spots on the upper trunk or arms. These benign skin lesion typically appear as round-to-oval, bright, red, dome-shaped papules and pinpoint macules measuring up to several millimeters in diameter. Treatment is not necessary unless bleeding occurs or for cosmetic reasons. If necessary, treatment options are electrocauterization, and vascular laser therapy.

Pyogenic granuloma:

Image Source: DermNet

Pyogenic granuloma is a benign proliferation of capillary blood vessels in the skin and oral cavity that develops over time. The name is a misnomer as it is a form of lobular capillary haemangioma, not due to infection. Pyrogenic granuloma is also known as granuloma gravidarum or pregnant tumor, when it occurs during pregnancy. Pyogenic granuloma of the skin appears as a painless red fleshy nodule with a diameter of 5-10mm that grows quickly over a few weeks. The skin is initially smooth, but it can ulcerate, crust over, or become verrucous. Pyogenic granuloma is often solitary, however it can erupt in numerous nodules and satellite lesions. The fingers and face are the most commonly affected areas. Causes may include minor trauma in oral cavity, certain medication such as,  oral retinoids, protease inhibitors (used in the treatment of HIV/AIDS), targeted cancer therapies, and immunosuppression, and there are other causes also.

Keloid scars:

Image source: IMPP

Keloid scars are benign skin lesions caused by an excess of fibroblast proliferation and collagen production as a tissue response to small skin injury. Patients with a family history of keloids and those with dark skin are more likely to develop keloid scars. They are Pruritus and painful brownish-red scar tissue of varying consistency (soft or hard) with claw-like appearance that extends beyond the original lesion’s boundaries. They commonly appear on the earlobes, face (especially the cheeks), upper extremities, chest, and neck. In up to 100% of cases, keloid scars return after surgical removal. Surgery alone may not be as effective as a combined treatment approach.

Warts: 

Source: “Verruca vulgaris on the first toe” by Mndno, Wikimedia Commons,

Warts are common, benign epidermal lesions, caused by human papillomavirus infection. They can take on a variety of morphologies and appear anywhere on the body. Examination is used to make a diagnosis. Warts are normally self-limiting, although they can be treated with destructive procedures like as excision, cautery, cryotherapy, and liquid nitrogen, as well as topical or injected agents. They are transmitted by direct skin contact and are skin colored or whitish in color. Warts can be treated with salicylic acid (daily application for a few weeks) or 5-fluorouracil cream or topical retinoic acid for flat warts. Surgical method includes cryotherapy with liquid nitrogen or surgical excision​3​.

Sources

  1. 1.
    Shimizu H. Shimizu’s Textbook of Dermatology Paperback. Hokkaido University Press Nakayama Shoten; 2007.
  2. 2.
    J K, H P, S.K A. Cherry Angiomas on the Scalp. karger. Published online 2009. doi: https://doi.org/10.1159/000251395
  3. 3.