1. discrete lesion(s)rash papular (raised >5mm) macule or plaque pigmented near-flesh colored red vascular appearing Common Benign Skin Lesion Algorithm Skin Anomaly Color? raised or flat? sub-epidermal appears to be below skin?

2. Papular Lesions pedunculated Skin tag (acrochordon) hyperkeratotic, fast growing Central keratin plug Keratocanthoma friable, red granulation tissue Pyogenic granuloma Keloid history of surgical scar, acne, skin piercing or minor trauma; fast growing, more prevalent in darker- skin persons ±itching, burning Neurofibroma Flesh-colored nodule that can be invaginated with finger

3. Pigmented Lesions Nevus* Melanoma* Dermatosis papulosa nigra multiple dark colored lesions, dark-skinned patient irregular border color variegation * links to eMedicine articles for more information dark brown lesion, rough, fissured surface Seborrheic wart brown to dark brown lesion usually solitary, history of insect bite, ‘dimple sign’ Dermatofibroma

4. Sub-epidermal lesions Epidermal Inclusion Cyst Lipoma Dermoid cyst firm, well-circumscribed mass central plugged pore compressible, soft, non-tender, ± well defined present from birth mobile, flesh colored may increase in size suddenly if infected Schwannoma flesh colored, painless mass, firm with variable size