This document summarizes information about benign skin lesions. It discusses several common epidermal lesions including seborrheic keratosis, keratoacanthoma, verrucous nevus, and verruca vulgaris. It also covers various pigmented lesions such as nevus, congenital melanocytic nevus, blue nevus, and dysplastic nevi. Congenital melanocytic nevi are present at birth and can range in size from small to giant. Treatment options for congenital melanocytic nevi include serial excision, tissue expansion, skin grafts, and lasers depending on the size and location of the lesion. Blue nevi appear bluish due
1. The document discusses various types of flaps used in reconstructive surgery including local flaps, regional flaps, and free flaps.
2. Different types of local flaps are described such as rotation flaps, transposition flaps, and advancement flaps which allow redistribution of tissue near a defect.
3. Regional flaps like the pectoralis major flap provide tissue from a distance away but within the same anatomical region and rely on named vessels within a vascular pedicle.
This document discusses reconstruction of the thumb following various types of injuries or amputations. It begins by classifying different levels of thumb amputation and the general goals of reconstruction, which include regaining sensation, stability, strength, mobility and correct posture. Several reconstruction techniques are described for different amputation levels, such as secondary healing, flaps, phalangisation, osteoplastic reconstruction, pollicization, and toe transfers. Factors to consider for the choice of reconstruction include the level of amputation, remaining joints and digits, soft tissue coverage, and patient expectations and functional needs. The conclusion emphasizes that the best results are obtained with replantation when possible and tailoring the approach to the individual patient's post-tra
The document discusses various local flap options for reconstructing fingertip injuries. It describes the anatomy of the fingertip and goals of reconstruction which are to close wounds, maximize sensation, preserve length and function. Local flap options mentioned include volar V-Y flaps, bilateral V-Y flaps, cross-finger flaps, thenar flaps and lateral island flaps. Choice of flap depends on wound orientation and configuration.
Cutaneous manifestations of internal malignancy and paraneoplastic syndromes gamal sultan
cutaneous manifestations are extremely valuable marker because they may well be the presenting manifestation of an underlying neoplasm.
Increased clinician awareness could prove beneficial for the patient by promoting earlier screening and diagnosis, as well as increased intervention measures, thereby significantly affecting the chances of survival and/or improving the quality of life of the patient
The document discusses scar revision and scar formation. It describes that scars are remnants of healed wounds and can be caused by injuries, burns, or surgery. Scars are formed through the skin's wound healing process as collagen deposits in the dermis. Abnormal scars like hypertrophic scars and keloids form excess collagen and do not regress over time. The document outlines factors that influence scar formation and treatments for improving scars.
This document summarizes several viral diseases that affect the skin and mucous membranes. It discusses the characteristics of viruses and describes several families of DNA and RNA viruses that can cause skin infections. Specific viruses covered include herpes simplex virus types 1 and 2, varicella zoster virus, and human papillomavirus. For each virus, the document outlines the clinical presentation of primary and recurrent infections, common manifestations, treatment approaches, and potential complications.
An approach to wrist fractures as often seen in emergency rooms
presentation meant mainly to educate jnr drs in looking at x-rays of wrists and how to identify fractures and dislocations
1) Macrodactyly is an overgrowth of one or more fingers, most often the index finger. It can involve enlargement of skin, bone, nerves, and other tissues.
2) The cause is unknown but may involve abnormal nerve or blood supply. Recent evidence suggests a genetic mutation can cause abnormal growth regulation.
3) Treatment involves surgical procedures like debulking excess tissue or shortening the enlarged bones to improve appearance and function.
1. The document discusses various types of flaps used in reconstructive surgery including local flaps, regional flaps, and free flaps.
2. Different types of local flaps are described such as rotation flaps, transposition flaps, and advancement flaps which allow redistribution of tissue near a defect.
3. Regional flaps like the pectoralis major flap provide tissue from a distance away but within the same anatomical region and rely on named vessels within a vascular pedicle.
This document discusses reconstruction of the thumb following various types of injuries or amputations. It begins by classifying different levels of thumb amputation and the general goals of reconstruction, which include regaining sensation, stability, strength, mobility and correct posture. Several reconstruction techniques are described for different amputation levels, such as secondary healing, flaps, phalangisation, osteoplastic reconstruction, pollicization, and toe transfers. Factors to consider for the choice of reconstruction include the level of amputation, remaining joints and digits, soft tissue coverage, and patient expectations and functional needs. The conclusion emphasizes that the best results are obtained with replantation when possible and tailoring the approach to the individual patient's post-tra
The document discusses various local flap options for reconstructing fingertip injuries. It describes the anatomy of the fingertip and goals of reconstruction which are to close wounds, maximize sensation, preserve length and function. Local flap options mentioned include volar V-Y flaps, bilateral V-Y flaps, cross-finger flaps, thenar flaps and lateral island flaps. Choice of flap depends on wound orientation and configuration.
Cutaneous manifestations of internal malignancy and paraneoplastic syndromes gamal sultan
cutaneous manifestations are extremely valuable marker because they may well be the presenting manifestation of an underlying neoplasm.
Increased clinician awareness could prove beneficial for the patient by promoting earlier screening and diagnosis, as well as increased intervention measures, thereby significantly affecting the chances of survival and/or improving the quality of life of the patient
The document discusses scar revision and scar formation. It describes that scars are remnants of healed wounds and can be caused by injuries, burns, or surgery. Scars are formed through the skin's wound healing process as collagen deposits in the dermis. Abnormal scars like hypertrophic scars and keloids form excess collagen and do not regress over time. The document outlines factors that influence scar formation and treatments for improving scars.
This document summarizes several viral diseases that affect the skin and mucous membranes. It discusses the characteristics of viruses and describes several families of DNA and RNA viruses that can cause skin infections. Specific viruses covered include herpes simplex virus types 1 and 2, varicella zoster virus, and human papillomavirus. For each virus, the document outlines the clinical presentation of primary and recurrent infections, common manifestations, treatment approaches, and potential complications.
An approach to wrist fractures as often seen in emergency rooms
presentation meant mainly to educate jnr drs in looking at x-rays of wrists and how to identify fractures and dislocations
1) Macrodactyly is an overgrowth of one or more fingers, most often the index finger. It can involve enlargement of skin, bone, nerves, and other tissues.
2) The cause is unknown but may involve abnormal nerve or blood supply. Recent evidence suggests a genetic mutation can cause abnormal growth regulation.
3) Treatment involves surgical procedures like debulking excess tissue or shortening the enlarged bones to improve appearance and function.
Disease of the Peritoneum and RetroperitoneumCody Starnes
This document provides an overview of diseases of the peritoneum and retroperitoneum. It discusses the anatomy and physiology of the peritoneum, as well as various pathologies that can affect these areas such as peritonitis, spontaneous bacterial peritonitis (SBP), familial Mediterranean fever, tuberculosis, mesothelioma, pseudomyxoma peritonei, mesenteric panniculitis, and retroperitoneal fibrosis. It also reviews tumors that can arise from retroperitoneal organs and sources of retroperitoneal contamination. Management strategies are mentioned for several conditions.
Thumb reconstruction by microvascular methodsDr. Suiyibangbe
This document discusses microvascular reconstruction of the thumb using toe transfer techniques. It begins by outlining the importance of the thumb in hand function. Reconstruction of the thumb is challenging due to its unique position. Microsurgical toe transfer meets the requirements of providing stable, sensitive mobility. The great toe is well-suited anatomically and can be transferred with its vessels, nerves, tendons and skin. A thorough preoperative evaluation of the recipient site and donor toe is important for planning. The goals of reconstruction are to restore painless stability, sensibility and mobility. Careful surgical planning and technique along with postoperative therapy can achieve excellent results.
Dermatofibrosarcome Protuberence- Dr. Enja Amaranath Reddyapollobgslibrary
The document describes a case of a 37-year-old man presenting with a painless swelling in his left groin area that had been gradually increasing in size over 5 years. Examination found a nodular skin lesion measuring 10x4 cm. Excision and biopsy revealed dermatofibrosarcoma protuberans (DFSP), a rare type of soft tissue sarcoma. DFSP is a locally aggressive tumor characterized by infiltrative growth and a high recurrence rate if not sufficiently excised. Wide local excision is the primary treatment, with radiation or imatinib used for recurrent or advanced cases. Close long-term follow-up is important due to the risk of local recurrence within the first few years.
Investigations & management of varicose veinsKumar Ashwath
The document discusses various investigations and treatments for varicose veins. Key investigations include venous Doppler, duplex scan, and venography to evaluate the veins. Treatment options include elastic compression stockings, sclerotherapy injections to shrink small veins, foam sclerotherapy using ultrasound guidance, endovenous laser ablation (EVLA) using laser fibers, and radiofrequency ablation (RFA) using heated catheter to close veins. Surgery may involve ligating perforator veins in the calf. Non-invasive treatments are preferred initially, with surgery considered for recurrent ulcers or large symptomatic varicosities.
The document discusses tumors of the jaw, including odontogenic tumors. It defines benign and malignant tumors and provides examples of tumors that arise from different tissues. It then focuses specifically on odontogenic tumors, providing a classification system and examples such as ameloblastoma. The clinical features, diagnosis, and various treatment methods for ameloblastoma such as excision, curettage, resection, and reconstruction are summarized. Key factors that influence choice of treatment are also outlined.
1. Meek micrografting is a skin grafting technique introduced in 1958 that increases the surface area of a skin graft by cutting it into small strips or islands. This allows coverage of larger wounds with less donor skin.
2. The Meek technique involves harvesting a thin split-thickness skin graft and cutting it into small pieces or islands spaced 3mm apart. This can expand the surface area of the graft up to 9 times.
3. Meek micrografting is well-suited for major burns over 30% TBSA as it requires less donor skin than other techniques like mesh grafting. It also has higher success in infected or poorly vascularized wounds due to the low metabolic demands of
Macrodactyly is a congenital disease where the digits affected increase in size faster than can be
attributed to normal growth of unaffected digits. Its etiology is ambiguous and hereditary patterns do
not play a role. The abnormality develops in one or more toes and involves thickening of soft tissues,
bone and accumulation of fat. The accepted treatment is reduction of the fibro-fatty bulk via dissection
and ablation; the major aim being reconstruction of a pain-free functioning foot. Complications with
surgery include delayed wound healing and inadequate initial de-fatting which could require a more
proximal amputation.
Radial nerve palsy following humerus shaft fractures has controversial management. Spontaneous recovery occurs in over 70% of cases within 3-4 months. Early exploration is only clearly indicated for open fractures or nerve palsies associated with surgery. For secondary palsies, exploration does not improve recovery compared to nonsurgical management. Tendon transfers are considered if palsy persists after a year to restore function while further recovery remains possible.
This young man presented with scarring and papules & pustules on his face. 5 years ago he had a similar condition that responded well to antibiotics, but he did not continue treatment as recommended.
Q1. His initial condition was likely acne vulgaris.
Q2. Lesions should also be looked for on the chest, back, and shoulders.
Q3. There is an inherited predisposition to acne vulgaris. Regular treatment is important to prevent scarring.
This document discusses various types of vascular anomalies. It begins by providing historical context for how vascular anomalies were classified. It then summarizes the current biologic classification system introduced in 1982, which distinguishes between vascular tumors and malformations. For vascular tumors, it describes infantile hemangioma and its life cycle phases. It also discusses other types of vascular tumors like congenital hemangiomas and kaposiform hemangioendothelioma. For vascular malformations, it lists the main types classified by predominant vessel type. Diagnosis and management approaches are summarized for different vascular anomalies.
This document discusses malignant skin tumors including basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It describes the gross and microscopic features of each tumor type. Basal cell carcinoma appears as a nodular growth with central ulceration and invades locally. Microscopically it shows tumor cells resembling the basal layer growing downward in nests and strands. Squamous cell carcinoma presents as an elevated nodular or fungating mass. Microscopy shows downward proliferation of squamous cells invading the dermis. Malignant melanoma may be flat or nodular with irregular pigmentation and invades horizontally and downward, with tumor cells containing melanin granules.
This document discusses squamous cell carcinoma (SCC), a malignant skin tumor. It defines SCC as a cancer originating from keratinizing cells of the epidermis. The document then covers the epidemiology, pathology, spread/complications, clinical presentation, differential diagnosis, investigation, treatment, and prognosis of SCC. Key points include that SCC is the second most common skin cancer, affects sun-exposed skin of elderly males, and has varying malignancy depending on factors like depth of invasion and histological grade.
Basic Principles Of Local Flap In Plastic SurgeryShamendra Sahu
1) The document discusses principles of local flaps in plastic surgery, including definitions, classifications, and history. Local flaps are classified based on location, blood supply, movement, and tissue composition.
2) Key classifications include random pattern flaps which rely on subdermal plexus, and axial pattern flaps named after a source artery. Advancement, pivot, and interpolation flaps are classified by their movement.
3) The history outlines early descriptions of cutaneous territories and vascular anatomy from the 16th century to present. Delaying flaps was also described as enhancing vascularity through various mechanisms.
This document provides background information on lower limb amputations. It discusses the history of amputation dating back to ancient times and developments over centuries. It defines amputation, provides classifications, and outlines epidemiology, indications, investigations, surgical principles, complications and prognosis of lower limb amputations. The document discusses various types of foot, midfoot, hindfoot and above-knee amputations and their techniques.
This document provides information about syndactyly, including its definition, embryology, etiology, types, evaluation, management, surgical techniques, complications, and its association with certain genetic syndromes. Syndactyly is a fusion of soft tissue or skeletal elements of adjacent digits. It occurs when normal digital separation fails during development. Surgical correction aims to separate the digits and reconstruct the intervening skin and tissues. Timing, flap design, and postoperative care require consideration to optimize outcomes and prevent contractures. Syndactyly can be an isolated anomaly or part of genetic syndromes like Apert syndrome or Poland syndrome.
Pemphigus vulgaris is an autoimmune blistering disease that affects the skin and mucous membranes. It is caused by autoantibodies that attack desmoglein, a protein that binds epidermal cells together. This causes the epidermal cells to separate from each other (acantholysis) and form fragile blisters that rupture easily, leaving painful erosions. Pemphigus vulgaris is diagnosed through skin biopsy and detection of anti-desmoglein antibodies. Without treatment, it can be fatal due to infection; treatment involves high-dose corticosteroids and other immunosuppressants to control outbreaks and lessen side effects.
The document discusses various local flap options for reconstructing fingertip injuries. It describes the anatomy of the fingertip and goals of reconstruction which are to close wounds, maximize sensation, preserve length and function. Common local flaps include the volar V-Y flap, bilateral V-Y flaps, cross-finger flap, thenar flap and lateral island flaps. Choice depends on wound orientation and configuration.
Pattern of B and T cell infiltration
Define Cutaneous pseudolymphoma
Classification
Subtypes
Important entities with clinico-pathological features
Differential features from morphologically similar lesions
Pseudoclonality
The document describes the steps for examining an eyelid mass, including inspection and palpation to evaluate characteristics like shape, size, color, texture, and mobility. It then covers the anatomy and types of benign and malignant eyelid lesions. Common benign lesions include seborrheic keratosis, actinic keratosis, melanocytic nevi, dermoid cysts, and chalazia. Malignant lesions include basal cell carcinoma and melanoma. Surgical excision is a common treatment, while some lesions may be observed or treated with cryotherapy, laser, or radiation.
Basics of wounds, lumps, bumps, and rashes for gwep 2018SDGWEP
This document discusses the management of various skin lesions and defects. It provides information on diagnosing and treating common benign and malignant skin lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma. It also reviews options for reconstructing skin defects created by wide excision of malignant lesions, including the use of skin grafts versus flaps. Flaps are preferred when there is poor vascularity or reconstruction of facial structures is needed. Examples of specific flap techniques used for defects of the forehead and lower lip are described.
Disease of the Peritoneum and RetroperitoneumCody Starnes
This document provides an overview of diseases of the peritoneum and retroperitoneum. It discusses the anatomy and physiology of the peritoneum, as well as various pathologies that can affect these areas such as peritonitis, spontaneous bacterial peritonitis (SBP), familial Mediterranean fever, tuberculosis, mesothelioma, pseudomyxoma peritonei, mesenteric panniculitis, and retroperitoneal fibrosis. It also reviews tumors that can arise from retroperitoneal organs and sources of retroperitoneal contamination. Management strategies are mentioned for several conditions.
Thumb reconstruction by microvascular methodsDr. Suiyibangbe
This document discusses microvascular reconstruction of the thumb using toe transfer techniques. It begins by outlining the importance of the thumb in hand function. Reconstruction of the thumb is challenging due to its unique position. Microsurgical toe transfer meets the requirements of providing stable, sensitive mobility. The great toe is well-suited anatomically and can be transferred with its vessels, nerves, tendons and skin. A thorough preoperative evaluation of the recipient site and donor toe is important for planning. The goals of reconstruction are to restore painless stability, sensibility and mobility. Careful surgical planning and technique along with postoperative therapy can achieve excellent results.
Dermatofibrosarcome Protuberence- Dr. Enja Amaranath Reddyapollobgslibrary
The document describes a case of a 37-year-old man presenting with a painless swelling in his left groin area that had been gradually increasing in size over 5 years. Examination found a nodular skin lesion measuring 10x4 cm. Excision and biopsy revealed dermatofibrosarcoma protuberans (DFSP), a rare type of soft tissue sarcoma. DFSP is a locally aggressive tumor characterized by infiltrative growth and a high recurrence rate if not sufficiently excised. Wide local excision is the primary treatment, with radiation or imatinib used for recurrent or advanced cases. Close long-term follow-up is important due to the risk of local recurrence within the first few years.
Investigations & management of varicose veinsKumar Ashwath
The document discusses various investigations and treatments for varicose veins. Key investigations include venous Doppler, duplex scan, and venography to evaluate the veins. Treatment options include elastic compression stockings, sclerotherapy injections to shrink small veins, foam sclerotherapy using ultrasound guidance, endovenous laser ablation (EVLA) using laser fibers, and radiofrequency ablation (RFA) using heated catheter to close veins. Surgery may involve ligating perforator veins in the calf. Non-invasive treatments are preferred initially, with surgery considered for recurrent ulcers or large symptomatic varicosities.
The document discusses tumors of the jaw, including odontogenic tumors. It defines benign and malignant tumors and provides examples of tumors that arise from different tissues. It then focuses specifically on odontogenic tumors, providing a classification system and examples such as ameloblastoma. The clinical features, diagnosis, and various treatment methods for ameloblastoma such as excision, curettage, resection, and reconstruction are summarized. Key factors that influence choice of treatment are also outlined.
1. Meek micrografting is a skin grafting technique introduced in 1958 that increases the surface area of a skin graft by cutting it into small strips or islands. This allows coverage of larger wounds with less donor skin.
2. The Meek technique involves harvesting a thin split-thickness skin graft and cutting it into small pieces or islands spaced 3mm apart. This can expand the surface area of the graft up to 9 times.
3. Meek micrografting is well-suited for major burns over 30% TBSA as it requires less donor skin than other techniques like mesh grafting. It also has higher success in infected or poorly vascularized wounds due to the low metabolic demands of
Macrodactyly is a congenital disease where the digits affected increase in size faster than can be
attributed to normal growth of unaffected digits. Its etiology is ambiguous and hereditary patterns do
not play a role. The abnormality develops in one or more toes and involves thickening of soft tissues,
bone and accumulation of fat. The accepted treatment is reduction of the fibro-fatty bulk via dissection
and ablation; the major aim being reconstruction of a pain-free functioning foot. Complications with
surgery include delayed wound healing and inadequate initial de-fatting which could require a more
proximal amputation.
Radial nerve palsy following humerus shaft fractures has controversial management. Spontaneous recovery occurs in over 70% of cases within 3-4 months. Early exploration is only clearly indicated for open fractures or nerve palsies associated with surgery. For secondary palsies, exploration does not improve recovery compared to nonsurgical management. Tendon transfers are considered if palsy persists after a year to restore function while further recovery remains possible.
This young man presented with scarring and papules & pustules on his face. 5 years ago he had a similar condition that responded well to antibiotics, but he did not continue treatment as recommended.
Q1. His initial condition was likely acne vulgaris.
Q2. Lesions should also be looked for on the chest, back, and shoulders.
Q3. There is an inherited predisposition to acne vulgaris. Regular treatment is important to prevent scarring.
This document discusses various types of vascular anomalies. It begins by providing historical context for how vascular anomalies were classified. It then summarizes the current biologic classification system introduced in 1982, which distinguishes between vascular tumors and malformations. For vascular tumors, it describes infantile hemangioma and its life cycle phases. It also discusses other types of vascular tumors like congenital hemangiomas and kaposiform hemangioendothelioma. For vascular malformations, it lists the main types classified by predominant vessel type. Diagnosis and management approaches are summarized for different vascular anomalies.
This document discusses malignant skin tumors including basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It describes the gross and microscopic features of each tumor type. Basal cell carcinoma appears as a nodular growth with central ulceration and invades locally. Microscopically it shows tumor cells resembling the basal layer growing downward in nests and strands. Squamous cell carcinoma presents as an elevated nodular or fungating mass. Microscopy shows downward proliferation of squamous cells invading the dermis. Malignant melanoma may be flat or nodular with irregular pigmentation and invades horizontally and downward, with tumor cells containing melanin granules.
This document discusses squamous cell carcinoma (SCC), a malignant skin tumor. It defines SCC as a cancer originating from keratinizing cells of the epidermis. The document then covers the epidemiology, pathology, spread/complications, clinical presentation, differential diagnosis, investigation, treatment, and prognosis of SCC. Key points include that SCC is the second most common skin cancer, affects sun-exposed skin of elderly males, and has varying malignancy depending on factors like depth of invasion and histological grade.
Basic Principles Of Local Flap In Plastic SurgeryShamendra Sahu
1) The document discusses principles of local flaps in plastic surgery, including definitions, classifications, and history. Local flaps are classified based on location, blood supply, movement, and tissue composition.
2) Key classifications include random pattern flaps which rely on subdermal plexus, and axial pattern flaps named after a source artery. Advancement, pivot, and interpolation flaps are classified by their movement.
3) The history outlines early descriptions of cutaneous territories and vascular anatomy from the 16th century to present. Delaying flaps was also described as enhancing vascularity through various mechanisms.
This document provides background information on lower limb amputations. It discusses the history of amputation dating back to ancient times and developments over centuries. It defines amputation, provides classifications, and outlines epidemiology, indications, investigations, surgical principles, complications and prognosis of lower limb amputations. The document discusses various types of foot, midfoot, hindfoot and above-knee amputations and their techniques.
This document provides information about syndactyly, including its definition, embryology, etiology, types, evaluation, management, surgical techniques, complications, and its association with certain genetic syndromes. Syndactyly is a fusion of soft tissue or skeletal elements of adjacent digits. It occurs when normal digital separation fails during development. Surgical correction aims to separate the digits and reconstruct the intervening skin and tissues. Timing, flap design, and postoperative care require consideration to optimize outcomes and prevent contractures. Syndactyly can be an isolated anomaly or part of genetic syndromes like Apert syndrome or Poland syndrome.
Pemphigus vulgaris is an autoimmune blistering disease that affects the skin and mucous membranes. It is caused by autoantibodies that attack desmoglein, a protein that binds epidermal cells together. This causes the epidermal cells to separate from each other (acantholysis) and form fragile blisters that rupture easily, leaving painful erosions. Pemphigus vulgaris is diagnosed through skin biopsy and detection of anti-desmoglein antibodies. Without treatment, it can be fatal due to infection; treatment involves high-dose corticosteroids and other immunosuppressants to control outbreaks and lessen side effects.
The document discusses various local flap options for reconstructing fingertip injuries. It describes the anatomy of the fingertip and goals of reconstruction which are to close wounds, maximize sensation, preserve length and function. Common local flaps include the volar V-Y flap, bilateral V-Y flaps, cross-finger flap, thenar flap and lateral island flaps. Choice depends on wound orientation and configuration.
Pattern of B and T cell infiltration
Define Cutaneous pseudolymphoma
Classification
Subtypes
Important entities with clinico-pathological features
Differential features from morphologically similar lesions
Pseudoclonality
The document describes the steps for examining an eyelid mass, including inspection and palpation to evaluate characteristics like shape, size, color, texture, and mobility. It then covers the anatomy and types of benign and malignant eyelid lesions. Common benign lesions include seborrheic keratosis, actinic keratosis, melanocytic nevi, dermoid cysts, and chalazia. Malignant lesions include basal cell carcinoma and melanoma. Surgical excision is a common treatment, while some lesions may be observed or treated with cryotherapy, laser, or radiation.
Basics of wounds, lumps, bumps, and rashes for gwep 2018SDGWEP
This document discusses the management of various skin lesions and defects. It provides information on diagnosing and treating common benign and malignant skin lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma. It also reviews options for reconstructing skin defects created by wide excision of malignant lesions, including the use of skin grafts versus flaps. Flaps are preferred when there is poor vascularity or reconstruction of facial structures is needed. Examples of specific flap techniques used for defects of the forehead and lower lip are described.
20181110 wound healing richard bodor_basics of wounds, lumps, bumps, and rash...SDGWEP
This document discusses the management of various skin lesions and defects. It provides information on diagnosing and treating common benign and malignant skin lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma. It also reviews options for reconstructing skin defects created by wide excision of malignant lesions, including the use of skin grafts versus flaps. Flaps are preferred when there is poor vascularity or reconstruction of facial structures is needed. The document concludes by discussing a case of excising a squamous cell carcinoma of the lower lip and reconstructing the defect using a free anterolateral thigh-tensor fasciae latae flap.
1. The document discusses various types of tumours that can occur on the eyelids and orbit, including both benign and malignant tumours.
2. Benign eyelid tumours include papillomas, naevi, haemangiomas, xanthelasma, keratoacanthomas, neurofibromas, and sebaceous adenomas. Premalignant tumours include actinic keratosis and xeroderma pigmentosa.
3. Malignant eyelid tumours consist of squamous cell carcinoma, basal cell carcinoma, malignant melanoma, and sebaceous gland carcinoma. Orbital tumours can be primary, secondary, or metastatic and include developmental tumours,
malignant skin lesions /BASIC MEDICAL KNWOLEDGE .pptMUJEEB REHMAN
This document provides information about three types of malignant skin diseases: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). BCC is the most common type of skin cancer, usually appearing as a pearly nodule on sun-exposed areas. SCC is the second most common, associated with cumulative sun exposure and chronic inflammation. MM is less common but more deadly, with risk factors including past skin cancers, dysplastic nevi, red hair, and sunburn history. Surgical excision is the main treatment for all three, with Mohs surgery used for minimizing recurrence of BCC. Prognosis depends on factors like tumor depth, location, and presence of immunosuppression.
The document provides a review course on ocular oncology covering tumors of the eyelids, conjunctiva, intraocular region, and orbit. It discusses the clinical presentation, classification, examples, investigations, and management including surgical and non-surgical options for various benign and malignant tumor types in these ocular regions. Key tumor types and management approaches are summarized for each anatomical region.
This document discusses various benign skin tumors, including seborrheic keratosis, melanocytic nevi (moles), dermatofibroma, pilar cysts, keratoacanthoma, and epidermal cysts. It provides details on the composition of skin and layers of the epidermis. For each tumor type, it describes clinical findings, characteristics, treatment options, and risk of malignancy when applicable, with a focus on seborrheic keratosis.
The document summarizes various tumors that can occur on the eyelid. It divides tumors into benign, pre-malignant, and malignant categories and lists examples of tumors that fall into each category. Some of the more common tumor types discussed include squamous cell papilloma, basal cell carcinoma, sebaceous gland adenoma and carcinoma, capillary hemangioma, and non-Hodgkin lymphoma. For each tumor, the summary provides details on clinical presentation and recommended treatment approaches.
This PPT is mainly oriented towards Bailey & Love - Topic on Skin & Sub-cutaneous tissue. Few common diseases has been added. Very useful to Final yr. MBBS Students
This document provides an overview of skin and soft tissue lesions, discussing:
1. The anatomy and functions of skin and soft tissue
2. Common congenital, traumatic, inflammatory, and neoplastic lesions including dermoid cysts, pilonidal cysts, wounds, burns, cellulitis, keloids, lipomas, and moles.
3. Descriptions of different types of benign and malignant neoplasms as well as pre-malignant skin lesions.
4. Guidelines for diagnosis and treatment of various skin and soft tissue conditions.
The document provides information about skin and soft tissue lesions. It discusses various types of congenital, traumatic, inflammatory, premalignant, benign and malignant lesions that can affect the skin and soft tissues. Examples include dermoid cysts, pilonidal cysts, wounds, burns, cellulitis, warts, moles, basal cell carcinoma and malignant melanoma. Treatment options vary depending on the specific lesion but may include excision, cryotherapy, skin grafting or chemotherapy.
More than 1 million skin cancer cases are diagnosed in the United States each year, with basal cell carcinoma making up about 80% of cases, squamous cell carcinoma making up about 16% of cases, and malignant melanoma making up about 4% of cases. Risk factors for skin cancer include sun exposure, older age, fair skin, and genetic factors. Common signs of skin cancer include changes to moles and lesions including asymmetry, irregular borders, varied color, diameter larger than 6mm, and evolving size or appearance. Diagnosis involves examination, biopsy, and sometimes imaging, while treatment involves surgical excision and may include lymph node assessment and other procedures depending on cancer type and stage. Prognosis depends on cancer type, thickness or
Squamous cell carcinoma is the second-most common
cancer of the skin (after basal cell carcinoma but more
common than melanoma). It usually occurs in areas exposed to the sun. Sunlight exposure and immunosuppression are risk factors for SCC of the skin, with chronic sun exposure being the strongest environmental risk factor
This document discusses squamous cell carcinoma (SCC), a type of non-melanoma skin cancer. It notes that SCC comprises about 20% of non-melanoma skin cancers. Risk factors for SCC include cumulative sun exposure, fair skin, genetic conditions, immunosuppression, arsenic exposure, and other skin damage or diseases. Actinic keratosis is a precancerous lesion that can progress to SCC. Diagnosis involves biopsy and imaging if needed to assess spread. Treatment depends on risk factors and location but commonly includes surgery, Mohs surgery, radiation, or a combination for more advanced cases.
Skin cancer Лекция - 2 дополненная перевод — копия 2.pptxSingh99882
This document provides information about skin cancer epidemiology and types. It notes that skin cancer is one of the most common cancers worldwide. The two most common types are basal cell carcinoma and squamous cell carcinoma, which usually form on sun-exposed areas. Melanoma is less common but more dangerous. Risk factors include fair skin, sun exposure, age, family history, and moles. The document describes characteristics, risk factors, diagnosis and treatment options for the different types of skin cancer. Prevention strategies include sun protection, sunscreen use, and treating precancerous lesions.
1. Viral infections like verruca vulgaris (wart) caused by human papillomavirus and moluscum contagiosum caused by poxvirus can infect the eyelid. Warts clinically appear as elevated papillary lesions and moluscum contagiosum appear as dome-shaped waxy nodules.
2. Degenerative diseases like xanthelasma and amyloidosis can affect the eyelid. Xanthelasma clinically appears as bilateral yellow plaques on the eyelids and amyloid deposits appear as multiple waxy nodules.
3. Various neoplasms can occur in the eyelid including seborrheic keratosis, basal cell carcinoma, squamous
Basal cell carcinoma and squamous cell carcinoma are the two most common types of skin cancer. Basal cell carcinoma is the most common human cancer, making up 25% of all cancers. It rarely metastasizes but can cause extensive damage locally. Risk factors include sun exposure, lighter skin, older age, immunosuppression, and genetic conditions. Treatment options include curettage and electrodesiccation, surgical excision with margin assessment, Mohs surgery, radiation therapy, and topical therapies like imiquimod for superficial lesions. Mohs surgery achieves the highest cure rates of over 99% for basal cell carcinoma.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
3. Introduction
The skin is the largest organ in the human body.
It serves as a mechanical and immunologic
barrier and is responsible
for thermoregulation and sensibility.
4. The skin is composed of two layers:
the thin epidermis and the thicker dermis.
Deep to the dermis is subcutaneous fat.
There are two types of human skin:
skin with hair and glabrous skin (without hair).
The latter is found on the palms and soles
and has a much thicker epidermis.
5. Embryology
A. Ectoderm: Epidermis, pilosebaceous glands, apocrine glands, eccrine sweat glands, nails
B. Mesoderm: Langerhans cells, macrophages,
mast cells, Merkel cells, fibroblasts, blood vessels,
lymph vessels, fat cells
C. Neuro-ectoderm: Melanocytes, nerves,
specialized sensory receptors
6. Anatomy
A. Epidermis
1. Cell types: Keratinocytes, melanocytes,
Langerhans cells, Merkel cells
2. Superficial to deep: Stratum corneum, lucidum,
granulosum, spinosum, basale
In glabrous skin, an additional layer (stratum lucidum)
Lies between the stratum comeum and
the stratum granulosum
B. Dermis
7. Anatomy
B. Dermis
1. Cell types: Collagen, elastin, ground substance
2. Nerves, blood vessels, lymphatics, muscle fibers, pilosebaceous/
apocrine/ eccrine glands
3. Two layers superficial to deep
a. Papillary —fibroblasts, mast cells, histiocytes,
Langerhans cells, lymphocytes
b. Reticular —thicker than papillary dermis
i. Extends to underlying fat
ii. Contains elastin with interspersed large collagen fibers
8. The skin appendages like hair follicles, sebaceous
glands, and apocrine and eccrine glands are also found
in the dermis.
Plastic surgeons
require a working knowledge of both benign and malignant
skin conditions; appropriate treatment can only be rendered
if the correct diagnosis is made.
11. Seborrheic Keratosis
This is a common benign, usually pigmented, neoplasm in elderly people,
arising from the basal layer of the epidermis and consisting of keratinocytes.
The etiology is unknown, and factors like virus infection,
genetics, and sun exposure can be related.
Usually seborrheic keratoses are not photoinduced.
These lesions occur in any body site (frequently in the face and upper trunk)
and are usually asymptomatic or associated with itching.
They are superficial verrucous plaques, smooth or rough, varying
from 1 mm to several centimeters in size and varying from
dirty yellow to dark brown.
The classic description is of a "stuck-on," waxy appearance.
12. Surgical excision or shave excision is appropriate if the
patient complains of cosmetic appearance.
Other treatment options include curettage, cryotherapy, or trichloroacetic acid (TCA).
There are times when the lesion is atypical and an excisional biopsy is indicated for diagnostic purposes
13. Keratoacanthoma
This is a common epithelial tumor related to sun exposure than may be better placed in the next
chapter on malignant lesions.
It is more comon in white phototypes and is usually found on the face or upper limbs.
Classically, it presents as a solitary papule that develops a crater-like central, keratotic core;‘
The history is one of rapid growth over a few weeks. Spontaneous regression is said to occur, but
most lesions are excised before it becomes clear if regression would have ever occurred.
The histology is similar to squamous cell carcinoma and many consider it a low-grade squamous
cell cancer.
Surgical excision is usually the treatment of choice.
Other potential treatment options are curettage, coagulation, and topical 5· fluorouracil
15. Verrucous Nevus
These are congenital lesions that pres ent as verrucous papules or plaques that are skin colored
or brown. A linear configuration is common and it can be found in any body site.
Malignant transformation is very rare. The treatment options due to cosmetic concerns are
surgical excision, laser, electrodissection, dermabrasion, cryotherapy,TCA, or topical retinoic acid
16. Verruca vulgaris
Caused by human papillomavirus (HPV) Scaly, rough appearance with a cap of friable keratotic
material Lesions arise from stratum granulosum
Treatment: Cryotherapy, chemical ablation, or excision
17. Pigmented Lesions
Nevus or Melanocytic Nevus
Congenital Melanocytic Nevus
Blue Nevus
Halo Nevus
Spitz Nevus
Nevus of Ota
Atypical Moles-Dysplastic Nevi
Solar Lentigo
Ephelides (Freckles)
18. Nevus or Melanocytic Nevus
Nevi are acquired lesions that present after birth and consist of a concentration of nevus cells
that are classified according to their location as junctional (at the epidermal-dermal junction),
intradermal, or compound (both in the dermis and at the junction).
Examples of melanocytic nevi: (A) junctional nevus, (B) intradermal nevus, (C) compound nevus, (D) dysplastic nevus
20. •Junctional nevi are frequently found on the palms and soles and tend to be uniform, macular,
and round with smooth and regular borders.
21. •Intradermal nevi are found on the face and are usually homogeneous, elevated, dome-shaped,
skin-colored lesions.
•Compound nevi are raised above the epidermal surface and may be round or oval.
•Nevi are rarely premalignant
22. Congenital Melanocytic Nevus
Congenital nevi are present at birth, usually singular and small.
They are classified in three types depending on the size: small, intermediate, and giant (>20 cm)
They have some potential to develop melanoma, although this risk is low except in the giant variety.
Except for size, the overall appearance of congenital melanocytic nevi and acquired nevi is similar.
Congenital nevi, however, may have dark, thick hair.
Histologically, congenital nevi are distinguished by the pres ence of nevomelanocytes in the epidermis
and in the dermis as sheets, nests, cords, or single cells.
The most common anatomic location for a giant CMN is the posterior trunk, followed in frequency by
the extremities and head and neck
23. Some interesting variants of CMN include the "kissing nevus,“
occurring on adjacent aspects of the upper and lower eyelids,
appearing as a single contiguous lesion when the eyelids are closed
24. The differential diagnosis for CMN includes other congenital pigmented lesions, such as
epidermal nevus, nevus sebaceous, cafe au lait spot, and Mongolian spot.
Features that should prompt biopsy, if not complete early exision, include those suggestive of
dysplasia or melanoma, such as ulceration, uneven pigmentation, bleeding, a change in shape,
focal growth, or pain
MANAGEMENT
The fundamental guiding principle in the management of CMN relates to achieving a balance between treatment goals,
namely, elimination (or at least reduction) of the risk of malignant transformation, preservation of function, and
cosmetic appearance.
Intervention, if performed, should be done early in life, as the risk of malignant transformation is greatest in the first
decade of life.
Chemical peds, lasers, curettage, have been reported as treatment for CMN
Excisional methods include primary excision and closure, serial excision, skin grafting, tissue expansion and skin
sbstitutes.
To address the malignant potential, only complete excision of the nevus can be recommended as a solution.
When the lesion can be excised in three stages or less, serial excision would be the recommended treatment of choice.
This method is tolerated better by patients and has many fewer complications compared with other techniques
In general, 6 months is allowed between successive excisions to allow for scar maturation and relaxation of the tissue.
25. The lesion was complet!lly excised in two stages, with each excision spaced 6 months apart
26. If the lesion cannot be treated in three stages or less, tissue expansion
is the preferred option
27. An alternative to tissue expansion is the use of skin grafts and skin substitutes.
These, however, have inferior aesthetic and functional outcomes compared with tissue
expansion and should be reserved for cases where tissue expansion is not possible in difficult
anatomical regions or has failed.
Back lesions are ideal for tissue expansion.
For lesions in the abdomen, a combined tissue expansion/abdominoplasty approach can be
used, providing additional tissue for coverage.
In the breast, care must be taken to avoid traumatizing the developing breast bud
reconstruction with tissue expanders can potentially lead to distortion of the breast mound or
nipple-areolar complex.
Breast asymmetry resulting from tissue expansion may require subsequent reconstruction with
implants
30. Tissue expansion is associated with more morbidity and a higher failure rate in the extremities.
In the proximal part of the arm and leg, expanded flaps originating in the back and groin may be
transposed to reconstruct defects.
For larger lesions distal to the knee or elbow may require other options such as skin grafting-
Expanded abdominal flaps may also be used
CMN in the forehead may also be treated with tissue expanders if less than two-thirds of the
forehead is involved. Otherwise,
reconstruction of the entire forehead with a single full-thickness skin graft is an option.
CMN in the nasal area may be reconstructed in continuity with forehead lesions using an
expanded forehead flap
Giant CMN in the cheek can be treated with expanded cervical or postauricular flaps
31. Blue Nevus
Blue nevi appear bluish because the nevus cells are deep in the dermis.
These lesions are usually benign but the literature suggests they can be malignant.
Appears during adolescence on Head, neck,
and dorsum of hands/feet.
Clinically, blue nevi are solitary, nodular lesions with
a smooth surface that tend to be blue or blue-gray
32. These lesions are generally treated conservatively unless there has been a change in their
appearance or the patient requests excision for cosmetic reasons.
The excision should include the subcutaneous component to ensure complete removal of deep
dermal melanocytes
Cutaneous metastasis of malignant melanoma can resemble blue nevus
33. Halo Nevus
When a melanocytic nevus is surrounded by a hypopigmented halo, it is termed a halo nevus.
These lesions tend to occur on the torso in older children and teenagers.
They are common, frequently multiple,
usually acquired and asymptomatic.
The central nevus tends to gradually disappear
leaving a macular area of non-pigmented skin.
34. This hypopigmented area may persist for years and may gradually return to a normal color.
When biopsies are performed there may be no trace of the original lesion.
The treatment is expectant. avoiding sun exposure at the hypopigmented areas unless there are
cosmetic concerns or the lesions have atypical features
35. Spitz Nevus
This is a common and usually acquired lesion predominantly in children and young adults but
can be found in older people as well.
Spitz nevi are usually firm, domedshaped, reddish or
dark brown nodules, frequently on the head and neck.
They are compound nevus variations,
which have distinctive histologic features
that make the differentiation from
malignant melanoma difficult.
36. The treatment is surgical excision.
There is controversy over whether an entity known as a malignant Spitz nevus exists or if these
lesions are malignant melanomas.
For these reasons, Spitz nevi require complete excision with margins to decrease recurrence risk
(range from 1 to 2 mm to 1 to 2 cm depending on concern for melanoma) with histologic
confirmation of clear margins
37. Nevus of Ota
Nevi of Ota are hamartomatous melanocytic Found in patients with Asian ancestry.
Appears at birth as large, blue-gray patch
lesions that occur on the face in the distribution of
the ophthalmic and
maxillary division of the trigeminal nerve.
38. They are much more common in women. The sclera is involved in
two-thirds of cases.t The treatment consists of laser therapy using the Q-switched ruby,
(Nd:YAG) or alexandrite laser
40. Atypical Moles-Dysplastic Nevi
Dysplastic nevi are melanocytic nevi that have the clinical features of melanoma:
asymmetry, border irregularity, color variability, and diameter greater than 6 mm .
Appear after puberty on trunk.
When patients present with many atypical moles,
they are at higher risk for melanoma.
Patients who present with many atypical
moles and a strong family history of malignant melanoma
are at much higher risk for melanoma and must have at
least annual full body examinations for their entire lives
41. It is difficult for even an experienced dermatologist to know when to recommend excisional
biopsy. The best indication for biopsy is a change in clinical appearance.
The ideal surveillance involves total body photographs, which are compared annually with the
patient's current condition in order to determine if any lesions have changed over time and
Sunscreen and avoidance of sunburning/tanning
The treatment is excisional biopsy with margins to prevent recurrence
42. Solar Lentigo
Solar lentigo occur on sun-exposed areas of the face, arms,
and dorsum of hands, especially in lighter skinned white people
with light eye color.
These acquired lesions are pigmented macules
that can be small or large, with a tendency to confluence
and range in size from 0.2 to 2 cm.
They become more numerous with advancing age.
43. Treatment is not required. A biopsy is taken to exclude melanoma from any lentigo that develops
a highly irregular border, a localized increase in pigmentation, or localized thickening.
Bleaching agents like hydroquinone are not particularly effective.
Topical tretinoin, microdermabrasion, or cryotherapy can be used.
44. Ephelides (Freckles)
These are small, less than 3 mm, red or light brown macules that appear on sun-exposed areas
predominantly in fair skinned people with red or blond hair, but can appear in darker skinned
individuals as well.
There is no increase in the number of melanocytes, but rather an increase in the amount of melanin
in the skin. They are common in childhood; however, they can be seen at any age.
They are usually confined to the face, arms,
and back. The number varies from a few spots on the
face to hundreds of confluent macules on the face and arms.
Treatment is not required, but sunscreen is recommended.
Bleaching agents such as hydroquinone,
peels, and intense pulsed light (IPL) can be used for
cosmetic reasons
46. Actinic Keratosis
Actinic keratosis may be the most common of the premalignant skin conditions.
*Approximately 5% to 20% will develop into squamous cell carcinoma
Caused by sun exposure in people with Fitzpatrick skin types I, II, and III,
they are macules or papules with a scaly surface, generally between 1 mm and 2 cm in diameter.
47. Most commonly located on sunlight-exposed areas (scalp, ears, face, and hands).
Actinic chelitis (aggressive form involving lips).
These lesions frequently require biopsy to rule out a carcinoma.
Multiple lesions are usually treated with 5-fluorouracil or the immune stimulator imiquimod
(Aldara)
48. Leukoplakia
Leukoplakia is white intraoral plaque Cannot be wiped away and is the most common
precancerous lesion of the oral cavity.
Associated with chronic inflammation/irritation (Alcohol or tobacco). These lesions do not
frequently become squamous cell cancer but must be followed and biopsied if they persist or
undergo a change in appearance with Remove the irritant
49. Cutaneous Horn
Cutaneous horn is considered a premalignant lesion. They are usually yellowish brown
protuberant "horns" and are found on the face and ears.
Histologically, they are characterized by a compact proliferation of keratin.
The treatment is surgical excision.
50. Bowen's Disease
Bowen's disease is squamous carcinoma in situ of the skin. This tumor presents as a slowly
growing, red lesion with a scaly surface and irregular borders.
Ulceration or bleeding may be a sign of invasive malignancy. The treatment of choice is surgical
excision, but cryotherapy, curettage, cauterization, topical agents like 5-fluorouracil, and
topical photosensitizer can also be considered
51. Adnexal tumors
Excised for aesthetic reasons
May be classified as nevus, adenoma, or epithelioma
May include sebaceous glands, hair follicles, apocrine, or eccrine sweat glands
52. HAIR FOLLICLE TUMORS
Located in lower dermis and subcutaneous fat
Trichofolliculoma
Trichoepithelioma
Trichilemmoma
53. Trichofolliculoma
This is a rare hamartoma of the pilosebaceous follicle. They are typically solitary, small, raised
nodules with two or three hairs, usually white, protruding together in a tuft.
They frequently appear on the face and scalp. Malignant change is not typical but has been
reported in a single case with perineural invasion.
The treatment recommended is surgical excision.
54. Trichoepithelioma
Trichoepitheliomas are hamartomas of the hair follicle typically found in the center of the face.
They tend to be small, skin-colored or slightly pink papules that are usually distributed
symmetrically on the cheeks, eyelids, and the nasolabial region.
Treatment is not required; excision may be contemplated for cosmetic reasons. Other options
include electrodissection and curettage or cryotherapy. Recurrence is common.
55. Trichilemmoma
Smooth papule Found on scalp or other hair-bearing regions Glycogen-rich epithelial cells
surrounded by sheaths of cells resembling hair follicles on histology
Cowden disease (multiple hamartoma syndrome) should be suspected if patients have multiple
such tumors
Treatment: Laser therapy (CO2), electrodessication with curettage, or simple excision due to
similar appearance with BCC
58. Syringomas
This is a benign tumor that usually presents as firm, skin-colored to yellowish dermal papules on
the lower eyelids, predominantly in females. Syringomas can be sporadic or familial and are
frequently associated with Down's syndrome.
The treatment is punch or surgical excision for
cosmetic reasons only.
Electrodissection, curettage, and
carbon dioxideLaser can be considered
59. Eccrine Poroma
An eccrine poroma is a solitary, firm, skin-colored or erythematous papule, usually on the sole or
palm in adults.
Ulceration and bleeding may occur at points of pressure.
May resemble amelanotic melanoma
and pyogenic granuloma
The treatment is surgical excision
60. Cylindroma
Cylindromas can be solitary or multiple. The multiple lesion type has a genetic component.
They are classically found on the scalp as numerous small papules or large nodules with
smooth surfaces.
Sometimes they cover the entire scalp like
a turban explaining the name turban tumor.
They are usually benign, but malignant
development has been reported.
Treatment options include surgical excision,
and carbon dioxide laser
61. Eccrine hidrocystoma
Dilated and obstructed sweat ducts histologically
Translucent vesicles Appears on lower eyelids and upper cheeks
Swell in heat/humidity; regress in cooler/dry climate
Treatment: Puncture to release pressure
62. Clear Cell Hidradenoma
Clear cell hidradenoma is an eccrine sweat gland tumor.
It occurs as a slow growing usually solitary nodule. Classically, it is a firm nodule, 0.2 to 5 cm in
size . Some of these tumors discharge serous material, whereas others tend to ulcerate. Lesions
may occur on any body part, but are most frequently found on the arms, thigh, and scalp.
They can develop malignant tumors. The treatment is surgical excision
64. Apocrine Cystadenoma
This lesion results from a cystic dilatation of an apocrine secretory gland. It is generally a solitary,
nodular lesion on the face that tends to be skin colored to bluish.
The treatment is surgical excision.
65. Chondroid Syringoma
This tumor is a firm intradermal nodule usually found on the head and neck that is composed of
both sweat gland elements and cartilaginous elements.
It is rare and there can be malignant degeneration. Surgical excision is recommended
67. Sebaceous Nevus
Sebaceous nevi are common tumors of childhood.
Two-thirds are present at birth; the remaining one-third develop in infancy or early childhood.
The lesions are usually solitary, oval to linear, yellowish in color, varying from O.5 cm to several
centimeters, and frequently present on the scalp.
68. Surgical excision is recommended before adolescence because of the potential for development
of BCC and other malignant tumors.
*After puberty, 10% to 15% degenerate into BCC
The rare nevus sebaceous of Jadassohn syndrome consists of the triad of a linear sebaceous
nevus, convulsions, and mental
retardation
69. Sebaceous Epithelioma
This lesion looks like a BCCA, but tends to be more yellowish because of the sebaceous cellular
elements. It is most frequently located on the scalp and face.
70. Sebaceous Hyperplasia
This is a small tumor composed of sebaceous glands that is commonly located on the forehead,
cheeks, lower eyelids, or nose. lt begins as a pale yellow and slightly elevated papule and can
become dome shaped, and sometimes umbilicated. May be covered with telengiectasia
Sebaceous hyperplasia does not have any relationship with solar exposure. Treatment options
are electrodissection. curettage, cryosurgery, or surgical excision
71. Rhinophyma
Rhinophyma is a localized telangiectatic enlargement of the nose, most often in men.
Histologically, it is characterized by sebaceous gland hyperplasia, fibrous infiltration, and lymphedema.
Rhinophyma is considered a glandular form of acne rosacea. The reported incidence of occult cancer in
the setting of rhinophyma varies from 15% to 30%. BCCA is the most common malignant neoplasm.
Treatment options include surgical excision with reconstruction using a forehead flap.
73. Epidermal Cyst (or Sebaceous Cyst)
This is the most common type of cyst and occurs because of proliferation of surface epidermal
cells within the dermis.
Epidermal cysts are rare in children but common in adults. They are generally round, protruding,
smoothsurfaced
masses, varying in size from a few millimeters to several centimeters. Commonly found on face,
neck, and trunk.
74. Epidermal cysts grow slowly and are not symptomatic unless they become infected.
Once infected, rupture is common. The only effective treatment is surgical excision.
If infected, a course of antibiotics is recommended in an effort to prevent rupture and drainage
so that excision can be accomplished. Staphylococcus aureus is the most common pathogen.
The entire capsule must be removed to avoid recurrence
75. Dermoid cyst
Appears at birth or early childhood Clinical presentation: Similar to epidermal inclusion cysts.
Lined with epidermal skin appendages
Anatomic location: Most commonly found along supraorbital ridge, lateral brow, or nasal midline
Treatment: Excision
Midline nasal mass differential diagnosis
i. Dermoid cyst, glioma,
meningocele/encephalocele
ii. CT or MRI prior to excision to determine
intracranial extension
76. Milium
A milium (plural: milia) is a superficial, white epidermal cyst that appears immediately beneath
the epidermis. They are most common on the eyelids and cheek and often appear along a
healing upper blepharoplasty incision.
The treatment is unroofing and removal of the central kernel with a 11 blade or needle.
77. Pilar Cyst
A pilar cyst is similar to an epidermal (sebaceous) cyst and is a common scalp lesion containing
keratin. The treatment of choice is surgical excision. Like epidermal cysts, if they present
in an inflamed, infected state, they may require drainage
78. Smooth muscle tumor
Leiomyoma
Abnormal proliferation of smooth muscle - May become symptomatic with pain on exposure to
cold/pressure.
Appears as firm, pale intradermal nodules with brown hue.
Local recurrence may occur - Malignant degeneration to leiomyosarcoma is rare.
79. FIBROUS TUMORS
Dermatofibroma
This lesion is a myofibroblast proliferation, characterized by a firm, skin-colored or reddish
brown sessile papule or nodule,more commonly in women.
They vary in number from 1 to 10 and can be found anywhere on the extremities and trunk.
They tend to remain stable for years as discrete solitary lesions.
Treatment options include surgical excision for cosmetic reasons only, cryotherapy
80. Angiofibroma
Pale, firm papule. May have telengiectasia or erythema Most commonly on lower third of face
Treatment: Simple excision for cosmesis.
May be associated with tuberous sclerosis if multiple.
81. Lipoma
May be present at any age Painless, soft, flesh-colored nodule
Commonly found in the trunk and extremities
Treatment: Simple excision
82. Neurofibroma
May appear at any age Soft, compressible, flesh-colored or pink nodules;
button-hole sign (can be pushed deeper into dermis). Composed of Schwann cells and
endoneurial fibroblasts
Treatment: Excision
Multiple neurofibromas may be associated
with neurofibromatosis type I or II
Editor's Notes
A 7-mon.th-old female is shown with a giant congenital
pigmented nevus involving the tomo and buttocks region.
At least 3 months should elapse between reinsertion of tissue expanders to allow adherence of
the previously advanced skin flaps>
A 3-year-old boy who presented with a giant congenital pigmented nevus with cin:umferential involvement of the left forearm and
hand. A. The lower abdomen is expanded in preparation to resurface the extremity with an abdominal flap. B. The expander is removed and the
neVU9 excised cin:wnferentially from the forearm and hand to the level of the distal metacarpals. C. The foreann is tunneled through the expanded
flap iD. the lower abdominal wall and bolsn:rs applied to help contour the abdomiD.al flap around the ciJ:aunferena: of the forearm. The fingers
are left free di&tal to the metac:arpal heads. D. An expanded full-thiclm.ess skin graft is harvested from the lowc.r abdomen to resurface the palmar
aspect of the hand following a second-staged serial expansion. E. The uppc:.r extremity is shown 1 year following resurfacing with the e:xpanded
abdominal Sap. F. The donor sin: for the abdominal Sap and full-thickness skin graft to the palm is shown 1 year postoperatively.
A. A 1.5-yea.r~ld body is shown with a giant congenital
pigmented nevus, involvinl the right frontxltemporal and parietal
scalp. The nevus occ:upies approximately one-third of the total
scalp surface area, with a hyperpigmented region within the center.
B. Tissue expanders are placed superior and posterior to the area
of involvement in the frontoparietal sca.lp and in the occipital sca.lp.
C. The tissue expanders are shown following maximum inflation.
D. The nevus has been markedly reduced aftu first-stage expansion,
but recontouring of the expander bed deformities of the underlying
skull and advancement of the expanded scalp. E. A second set
of expanders is placed in the frontoparietal and occipital scalps to
address the residual nevus. F. The patient is shown 6 weeks following
second-slllge scalp expansion, with complete excision of the giant congenital
pigmented nevus and restxlration of the frontal and temporal
hair line. Rtldundant tissue of the scalp is allowed to contract over 1
year before considering further excision so as to preserve hair follicles
A 24 year old male patient with a nevus of Ota on his right cheek. A, At baseline and B, Significant improvement after eight treatment sessions using Modified Jessner's peel and Nd:YAG laser
Amazing Solar Lentigo results for this patient after 1 treatment using our medical grade Fotona Q-Switch KTP laser.