Skin And Soft Tissue Lesions

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There is a wide range of benign skin lesions

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sebaceous cyst
lipoma
papilloma
keratoacanthoma
keratosis
ganglion
naevus (mole)

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Sebaceous cyst

Sebaceous cysts arise from sebaceous glands and consist of

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degenerating and disintegrating epithelial cells.

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Sebaceous cysts are situated

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within the skin itself - a small ‘punctum’ is generally seen. They are smooth and well circumscribed,

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Lipoma

Lipomas are composed of

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large, mature, fat cells.

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Lipomas are not usually painful,

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but a variant known as angiolipoma may be.

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Lipomas are situated subcutaneously, though occasionally they can lie

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deep in muscle and other tissues

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Previously infected sebaceous cysts can be very difficult to excise due to

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the amount of surrounding fibrosis

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Papilloma

Papillomas are usually slowly growing lesion(ssquamous carcinoma - this must be ruled out, particularly if

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the lesion is indurated around the base or bleeding.

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Keratoacanthoma

Keratoacanthoma is a rapidly growing lesion, growing over a period of a few weeks
It lies within the skin

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It is often ulcerated on the surface, exposing keratin-like material.

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Keratoacanthoma
it can be very difficult to differentiate this lesion from a well-differentiated squamous cell carcinoma (SCC). ___________________ is often the best guide

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The length of history

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Ganglion

A ganglion is a slowly enlarging lesion adjacent to

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a joint or tendon

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Ganglion
seen most commonly on the dorsal aspect of the wrist. Occasionally, a ganglion can be painful but this may be

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due to an associated arthropathy.

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Ganglion

Differential diagnosis includes:

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neuroma (especially if tender or painful).

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Naevus (mole)
It is clinically important to be able to detect early malignant change in a mole, though only about one-third of melanomas develop in

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pre-existing pigmented lesions.

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Naevus (mole)
The early signs of malignant change include:

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a change in size, shape or colour over a period of months
irregularity of the margin of the lesion.