Benign skin tumors I.DVK FNUSA a LF MU • They grow expansively, so they can apply pressure to surrounding tissue, but they do not grow into it and destroy it • They keep structural and functional maturity • Epithelial • Adnexal • Seborrhoic keratosis • Syringoma Cylindroma Trichoepithelioma • • • Mesenchymal • • Fibroma • • Hemangioma • Lipoma • Keloidal scar • Dermatofibroma Vessel Hemangioma (capillare, cavernous senile, angiokeratoma) 1) Benign epithelial tu = • Seborrheic keratosis epithelioma (verruca seborrhoica, senile lentigo) - Is the most common benign skin tumor, almost every elderly person has several - Are most common on the: trunk (mostly back), head - They start as well-circumscribed skin-colored or tan maculas, then they slowly become darker, thicker and larger - Léser Trelát sign – is sudden eruption of numbers verrucas- can be the sign of malignant tumor of organs (gastrointestinal systema, hematopoetic sys.) - Theraphy – no therapy is needed, but patients usually desire removal for cosmetic reasons – curettage or cryotheraphy, excision Veruca seborrhoica 2) adnexal tumors = adenomas - This is large family of tumors with features of eccrine, apocrine, sebaceous, or hair follicle differentiation - All can be treated by excision 2) adnexal • Syringoma • Cylindroma • Pilomatrixom • Kerathoakanthoma • Syringoma - From the infundibulum of the sweat glands - 2 forms – usually periorbital, sometimes disseminated - Clinically – multiple tiny skin-colored papules around the eyes - Therapy – excision of solitary • Cylindroma - Epithelioma with apocrine differentiation - It appears in early adult age, gradually increasing during the time - Usually occurs on the scalp, at the begining few papules or nodules skincolored, or red, gradually increasing the number of nodules, so they can cover whole hair - described as „turban tumour“ - Therapy – surgical excision • Pilomatrixom - Epithelioma of the hair follicle - Common cystic childhood tumor - Usually on the scalp or cheek - Therapy - excision • Kerathoakanthoma - From supraglandular part of hair follicle - it is formed in sun-exposed parts of the body (face, neck, hands) in people around 60 years, or immunosuppressed people - fast-growing solitary semicircular nodule reaching up to 2 cm in diameter within a few weeks with bulging edges and a central crater filled with horn - On the edges there are many teleangiektasias - It could spontaneously regress with scar - Therapy - excision 3) Mezenchymal tumors • Histiocytoma, dermatofibroma • Keloid, hypertrofic scar • Fibroma molle • Angiofibroma • Leiomyoma • lipoma • Histiocytoma fibrosum, dermatofibroma - One of the most common skin tumors - Mainly appears at younger people on extremities, sometimes on trunk - It is reactive inflamation after bite of insect or injury - It looks like solitary flat lession or small nodule, red-brown - Therapy isn´t needed, but possible is excision • Keloid, hypertrofic scar - A keloid results when the reparative process extends beyond bounds of the original scar - Typical are – middle chest, following cardiac surgery or ear lobes after piercing - Blacks are more likely to develop keloids - Therapy – treatment is difficult, any manipulation may result in worsening, best results are obtained with shave excision, cryotherapy, interelesional corticosteroids combined with compression - Hypertrofic scar is confined to the side of the tissue damage Keloid • Skin tags (Fibroma molle) - Tinny skin colored or tan papules - Typicaly on neck, axillae or groin - More common in overweight and older individuals - Small lessions can be treated by cauter or excision • Angiofibrom - Proliferation of small vessels with perivascular fibrosis - Very often formed from intradermal nevii after regression of pigmentation - Variants: - - Fibrous papule of the nose – small solitary inconspicuous nasal papule - Tuberous sclerosis – facial papulos Therapy – excision (solitary), laser (multiple leasions) • Lipom - Bordered proliferation of subcutis fat tissue - They are solitary or multiple - They‘re located in subcutaneous mass like soft, elastic oval free movable against skin and the base - It doesn‘t resolve with weight loss - Unpainful (normally) - Therapy – all can be easily excised if they‘re functionally or cosmeticaly disturbing or painful 4) Vascular • Hemagioma capillare • Hem. Cavernosum • Hem. Senile • Granuloma pyogenicum • Angiokeratoma • Lymfangioma • Hemagioma capillare - This is the most common vascular lesion - The greatest risk factor is low birth weight, it is present after birth or in first months of life - The common localization is on head and neck, start as macule with telangiectasia and evolves into rubbery red tumor - During regression it develops a gray sheen and heals with scarring - 50% - have resolved by 5 years - 70% – by 7 years - Larger takes long to resolve and leave cosmetics defects • Hemagioma capillare - Complication includes: - ulceration - scarring - periorbital and periorificial risk of amblyopia sometimes interferes with eating or breathing - vascular problems risk of shunting and high output cardiac failure - agressive growth • Hemagioma capillare - Therapy - observation for low-risk lesion - Early cryotherapy may induce regression - Topical or systemic Beta-blockers - Topical or intralesional corticosteriods and excision or laser - High risk leasons: - Systematic corticosteroids or interferon alpha • Hemangioma senile - In older age on the trunk - Dark red papulas with sharp borders (1 - 6 mm) - Cosmetic problems - Therapy: - Coagulation - Laser and cryotherapy • Pyogenic granuloma - A reactive vascular proliferation in response to trauma - Charakterized by red nodule, that is usually brittle with a bloody surface - Therapy: - Chemical / electrical cauterization - Laser destruction Thank you for your attention