Skin tumors

Melanocytic Tumors
Lentigenes
Melanocytic Nevi
Malignant Melanoma
Cysts and Epidermal
Tumors
Cysts
Epidermal and Organoid Nevi
Benign Epidermal Tumors
Carcinoma insitu
Malignant Epidermal Tumors
Adnexal Tumors
Benign Tumors with Eccrine Differentiation
Benign Tumors with Apocrine Differentiation
Benign Tumors with Sebaceous Differentiation
Benign Tumors with Hair Follicle Differentiation
Malignant Adnexal Tumors
Soft Tissue Tumors

Connective Tissue Tumors

Tumors of Fat
Vascular Malformations and Tumors
Neural Tumors
Lentigenes
Lentigo Simplex
PUVA Lentigo
Solar Lentigo
Lentigo Simplex

Def: localized hyperpigmentation

secondary to increase in
melanocytes at the
dermoepidermal junction
 Clinical features :
sharply circumscribed,
uniformly pigmented tan to dark
brown macules, no relation to
sun exposure (unlike freckles)
Histology :
increased numbers of melanocytes at
demoepidermal junction, no nests

Diagnostic approach :
a biopsy is not needed
lentigenes are permanent lesions and
usually uniformly pigmented
(ephelides/freckles are paler, more
irregular and vary with sun exposure.
Therapy :
none needed; cryotherapy or
laser ablation
PUVA Lentigo

Def :
a number of flat small irregular
melanocytic lesions that persist
for months or years appear after
PUVA therapy
Solar Lentigo =
Seborrheic keratoses
Melanocytic Nevi
Congenital Melanocytic Nevus
Nevus Spilus
Aquired Melanocytic Nevus
Halo Nevus
Dysplastic Nevus
Spitz Nevus
Pigmented Spindel Cell Nevus
Congenital Dermal Melanosis
Blue Nevus
Congenital Melanocytic
Nevus = giant hairy
nevus
Def :
Melanocytic nevus present at birth

Clinical features :
Most congenital melanocytic nevi are
heavily pigmented, have papillomatous
surface and contain hairs.

*At birth, may be less heavily pigmented

and not have prominent hairs
Histology :
always junctional and dermal
component.

Diagnostic approach :
clinical examination,
dermatoscopy
Prognosis :
large risk of malignant melanoma

Therapy :
Goals : avoid malignant melanoma
& cosmetic improvement
*patients should be followed yearly.
Any new nodules are highly
suspicious and should be excised
Nevus Spilus
= speckled
lentiginous nevus
Def :
congenital lesion consisting of caf-au-
lait macule speckled with small
melanocytic nevi.

Clinical features :
irregular tan patch with numerous
small dark macules (lentigen) or
papules (melanocytic nevi)
Histology :
The background skin contains
increased melanin, while the darker
spots have increased melanocytes

Therapy :
small lesions can be excised
Aquired Melanocytic
Nevus
Def :
Benign proliferation of
melanocytes

Epidemiology : everyone has

melanocytic nevi
Clinical features :
- Average patient has 20-40 melanocytic
nevi

- Start as homogenous tan macules, gradually

darken but almost exceed 6mm papules and
nodules

- Color varies, ranging from skin-colored to tan

to red-brown to almost black
Diagnosis approach :
Careful clinical examination,
>lesions or atypical regular
follow-up instruct patient on
ABCDE rules

DD : Older nonpigmented nevi may

be mistaken for skin tags or
neurofibromas
Prognosis : >50 5 melanoma risk
>100 10 melanoma risk

Therapy :
Lesions that are likely to be
traumatized as well as those about
which the patient is either worried or
cosmetically bothered can be excised
Halo Nevus
= sutton nevus
Def : melanocytic nevus surrounded by
hypopigmentations
Clinical features :
papular melanocytic nevus
surrounded by white halo
Histology : dense lymphocytic infiltrate
that often obscures the residual
melanocytes
Therapy : excision
Dysplastic Nevus
Spitz Nevus
Pigmented Spindel Cell
Nevus
Congenital Dermal
Melanosis
Blue Nevus
Cysts