1. SKIN TUMORS (except malignant melanoma)
dory

2. Benign tumors Malignant tumors
grow slowly
do not invade surrounding tissue
can have large dimension and produce „mass efect“ = compression of vital organs such as blood vessels
do not metastasize
grow fast
invade surrounding tissue
(regardless of size)
can metastasize (spread to non-adjacent tissues)

3. Diagnosis Clinical findings
Dermatoskopic examination (can increase accuracy by 20 – 80 %)
Biopsy + histological examination (confirmation)

4. Therapy depends on a few factors: the type of tumor, the size, the site and whether the patient will be able to undergo an operation
Surgical excision
Liquid nitrogen
Phototherapy - actinotherapy, photodynamic therapy
Imiguimod (immune response modifier)
Laserotherapy

5. Epidermal Tumors BENIGN Seborrheic Keratosis Clear Cell Acanthoma
PREmalignant
Actinic Keratosis
Bowen Disease
Paget Disease
Erythroplasia of Queyrat
Leukoplakie
Lentigo Maligna
MALIGNANT
Basal Cell Carcinoma
Squamous Cell Carcinoma
Malignant Melanoma
Carcinoma Cutis Carcinoides

6. Benign Epithelial Tumors (from keratinocytes)
Seborrheic Keratosis (senile wart, seborrheic verruca) They appear in various colors, from light tan to black, are round or oval, slightly elevated with rough surface, and range in size from small to more than 2 cm across. It can sometimes imitates malignant melanoma.
Diagnosis: clinical findings, dermatoskopy, histology (if needed)
THERAPY (cosmetic reasons usually):
exkochleation, excision or laserotherapy

7. Benign Epithelial Tumors (from keratinocytes)
Clear Cell Acanthoma (Degos acanthoma, Pale cell acanthoma)
It usually presents as a moist solitary firm, brown-red, well-circumscribed, 5 mm to 2 cm nodule, on the lower extremities of middle-aged to elderly individuals.
It is characterized by slow growth, and may persist for years.

8. PREmalignant Epithelial Tumors
Actinic Keratosis - scaly lesion on chronically sunlight-exposed skin, that usually appear in elderly persons and may evolve into spinalioma
Bowen disease - squamous cell ca in situ is slowly growning psoriasiform plaque in older adult.
Paget disease - dermatitis-like change involving nipple and adjacent skin of the brest as a manifestation of an underlying carcinoma of the breast.

9. PREmalignant Epithelial Tumors
Erythroplasia of Queyrat
is squamous cell ca in situ on mucosal or transitional surfaces, usually on genitals of elderly men.
Leukoplakia is a solitary lesion on the oral mucosa, asymptomatic, white, hyperkeratotic spot.

10. Malignant Epithelial Tumors
Basal Cell Carcinoma (Basalioma, Basal Cell Epithelioma)
- very common
usually on chronically sunlight-exposed skin, more in elderly people
Superficial BCC (the most common)
Nodular BBC
Pigmented BBC
Sclerosing BBC
Ulcerated BBC (old term „ulcus rodens“ means „destructive“, old term „ulcus terebrans“ means boring through → it can destroy underlying structures)

11. Malignant Epithelial Tumors
Squamous Cell Carcinoma
- common tumor
usually arises from actinic keratosis, carcinoma in situ, chronic ulcer … or can develops de novo
it develops anywhere on skin, often on chronically sunlight-exposed skin, usually appear in older people (back, extremities, face, scalp…)

12. Malignant Epithelial Tumors
Papillomatosis Cutis Carcinoides
- unfrequent
- unilateral or bilateral, large cauliflower-like vegetating masses develop over the shins or insteps, can reach a size of 15 cm, tumors slowly expand

13. Mesenchymal Tumors BENIGN Soft Fibroma Fibroma Durum Keloid MALIGNANT
Lipoma
Leiomyoma
Neurofibroma
fibroangioma, angiolipoma, lipofibroma…
MALIGNANT
Dermatofibrosarcoma Protuberans
Malignant Fibrous Histiocytoma
Fibrosarcoma (lipo-, leiomyo-…)

14. Benign Mesenchymal Tumors (fibrous tumors)
Dermatofibroma (fibroma durum, histiocytoma…) firm pigmented nodule usually on the legs.
Soft Fibroma (Fibroma Molle, Skin Tag, Acrochordon) - harmless pedunculated outpouching of skin.
Keloid - usually develops after injury or operation, but can develops spontaneously (belongs to tumors), thick firm nodules extend beyond the boundaries of the original wound, the growths can be several cm thick, extremely hard, with smooth, mirror-like surface.

15. Benign Mesenchymal Tumors Tumors of Muscle Tissue
Lipoma – from fat tissue, one of the most common tumors
Leiomyoma - can arise from the smooth muscle of the hair (arrector pili), nipple, scrotum (dartos) and blood vessels
Neurofibroma - cutaneous neural tumor from nerve sheath

16. Malignant Mesenchymal Tumors (fibrous tumors)
Malignant Fibrous Histiocytoma is the most common soft tissue sarcoma in adult.
Dermatofibrosarcoma Protuberans is an uncommon tumor, usually involving the shoulder girdle region of young to middle-aged adults.

17. Vascular Tumors BENIGN Hemangiomas Pyogenic Granuloma Lymphangioma
MALIGNANT
Sarcoma Kaposi
Lymphangiosarcoma

18. Adnexal Tumors BENIGN Trichoepitelioma Pilomatricoma Trichoblastoma
Keratoacanthoma
Syringoma
Cylindroma
Sebaceous Hyperplasia
MALIGNANT (uncommon)
carcinomas
(trichilemmal, sweat or sebaceous glands…)

19. Benign Adnexal Tumors (Hair Follicle Tumors)
Keratoakanthoma - quickly growing tumor, mimics a squamous cell carcinoma but regresses spontaneously in most cases.
Trichoepithelioma (superficial trichoblastoma) Tumor also containing hair germs, but often with multiple lesions .
Trichoblastoma (giant trichoepithelioma) uncommon tumor containing follicular germinative cells, any area of the body may be involved
Pilomatricoma (pilomatrixoma, Malherbe tumor…) tumor with features of follicle matrix, typically in childhood.

20. Benign Adnexal Tumors (from glands)
Syringoma - from sweat glands, the most common adnexal tumor, they typically occur below the eyes of young women.
Eccrine poroma – from sweat glands
Sebaceous Hyperplasia – from sebaceous gland, very often, discrete skin-colored papule