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Erma L. Benitez, M.D.
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Common Growths
Many common growths develop on people's skin. While the cause is often poorly understood, it is known that some are associated with aging, and others are inherited. Benign (non-cancerous) lesions are not life threatening, but people often have these lesions removed for cosmetic reasons. A lesion maybe removed for medical reasons if cancer is suspected. When a lesion bleeds or causes pain, inflammation, or irritation, it also is typically removed.

Dermatofibroma are pink, dull red, or darkly pigmented and resemble a mole (nevus). They are usually small, but can attain the size of a peach pit. Dermatofibromas are firm and pucker or dimple when pinched. They ocur most commonly on the legs of women and can be annoying since they are easily micked with shaving. Dermafibromas represent a scar-like reactive process that may be induced by a trauma, such as an insect bite. They can be removed surgically or flattened by freezing (cryosurgery).

Prurigo Nodularis
Prurigo nodularis is a thickened, rough, tumor-like, sometimes scaly lesion that often causes intense itching. It is not a true growth; it is an active process due to scratching. The exact cause of the intense itching remains unknown. Since it can be confused with squamous cell carcinoma, a type of skin cancer, a skin biopsy is sometimes necessary. Occasionally, prurigo nodularis is associated with an underlying medical condition such as eczema, kidney failure, or cancer. Treatment is difficult and may consist of cortisone injections placed directly into the growth, cortisone tapes, creams, ointments, freezing, anti-itch medication, or curettage (scraping).

Keratoacanthoma is a fast-growing, cone-shaped, flesh-colored lesion that is considered a variant of squamous cell carcinoma, a type of skin cancer, and is often confused with invasive squamous cell carcinoma. It destroys surrounding tissue and, in rare cases, metastasizes (spreads to other parts of the body). THese lesions usually develop on the extremities. Treatment consists of surgically removing the growth, which is sent to a laboratory for microscopic examination.

Pyogenic Granuloma
Pyogenic granuloma are small pink or red lesions formed by many blood vessels. With minor trauma, the lesions bleed easily. They may arise spontaneously or develop after an injury. These growths occur at any age and in both sexes, but are more common in children. Those which form during pregnancy in the gingiva (gums) usually disappear spontaneously after delivery. The most efficacious treatment is to surgically shave and cauterize them with an electric needle. Other treatment methods used are surgical removal and electrocautery, cryosurgery (freezing), and laser surgery.

Milia can be thought of as miniature epidermoid cysts. The frequently occur on the face as single or multiple pinpoint white lesions and are common in older women. The cause is unclear, but they may arise following injuries to the skin or surgery. The most effective treatment is extraction, which can be performed in a dermatologist's office.

Epidermoid and Pilar Cysts (Sebaceous Cysts)
A cyst is a benign growth that forms when an inner lining or sac fills with a cheesy material. Epidermoid cysts have a central opening from which a rancid material can be expressed. If they are located in the upper layers of the skin, they may have a yellow or white appearance and have prominent overlying blood vessels. Epidermoid cysts most commonly occur on the face, neck, and back. Pilar cysts are primarily located on the scalp. Inheritance may play a role in patients with multiple lesions. Epidermoid cysts may arise following surgery or injury to the skin. If a cyst enlarges rapidly and ruptures, a boil-like lesion results that usually requires treatment with an antibiotic and surgical removal of the sac. It is easier to remove the cyst when it is not inflamed. This may prevent the possibility of infection. If a cyst begins to enlarge rapidly, becomes inflamed, breaks down, or becomes painful, it should be examined by a dermatologist immediately.

Sebaceous Gland Hyperplasia
Appearing as small white or yellow lesions, sebaceous gland hyperplasia occurs on the faces of people with oily skin. The lesion may have prominent tiny blood vessels and can resemble basal cell carcinoma, a type of skin cancer; therefore, a skin biopsy may be performed. Treatment of sebaceous gland hyperplasia includes electrosurgery, cryosurgery (freezing), laser surgery, and photodynamic therapy (photoactive chemicals and a light source).

Digital Mucinous Pseudocyst
These lesions are bluish in color and extrude a clear, thick material when punctured. They most commonly occur in the skin overlying the base of the fingernail and may interfere with nail growth causing a nail groove to develop. These lesions are not true cysts, but represent a sticky, jelly-like substance accumulates. Treatment includes surgical removal and/or cortisone injections.

A lipoma is a fatty tumor that lies deep in the skin and appears as a soft lump. Occasionally, lipomas are tender to the touch but usually do not cause other symptoms. Malignant (cancerous) transformation rarely occurs. Lipomas may be small or quite large and develop in adults as single or multiple lesions. These tumors do not require treatment unless they become large and uncomfortable or exquisitely tender. Treatment consists of surgically removing the lipoma, or liposuction.

These lesions develop on the eyelids and are yellowish or whitish in color due to lipid (fat) deposits in the skin. They may occur in individuals with normal lipid levels, or they can be associated with a lipid-metabolism disorder, especially high choloesterol levels. People with xanthelasma should be evaluated for elevated or abnormal cholesterol and triglycerides. Treatment options include surgery, electrosurgery, cryosurgery (freezing), laser surgery, and the application of acids.