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Benign tumours—dermal structures and appendages
Any connective tissue or appendageal element of the skin may undergo benign (and malignant) proliferation. Common non-malignant dermal growths such as dermatofibroma, lipoma and keloid are discussed in Chapter 52 (p. 114).
Benign tumours of vascular and connective tissue
Benign dermal proliferations can be categorized according to the tissue involved. Occasionally variants can be malignant. The classification includes:
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Collagen and elastin : dermatofibroma (p. 114), keloid (p. 115), solar collagenosis and elastosis (p. 130), shagreen patch (p. 112), chondrodermatitis nodularis.
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Fat : lipoma (p. 115).
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Lymphatic : lymphangioma
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Multiple tissue elements (‘organoid’) : naevus sebaceus.
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Neural and muscular : neurofibroma (p. 112), leiomyoma.
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Vascular : haemangiomas (p. 146), pyogenic granuloma (p. 115), angiokeratoma (p. 112), cherry angioma.
Chondrodermatitis nodularis
Chondrodermatitis nodularis is not a neoplasm, but presents as a painful small nodule on the upper rim of the helix of the pinna, usually in elderly men ( Fig. 53.1 ). It is due to inflammation in the cartilage that may be a response to degenerate dermal collagen induced by pressure or chronic sun exposure. They can ulcerate and are often confused with basal cell carcinomas. Excision is curative.
Lymphangioma
Lymphangiomas are uncommon congenital malformations of the lymphatic system that present at birth or in childhood. They appear as congregates of small vesicles, variable in extent.
Naevus sebaceus
Naevus sebaceus is a congenital malformation of multiple skin components (including sebaceous glands) that presents as a papillomatous area on the scalp ( Fig. 53.2 ). Excision is required due to a tendency to metamorphose into a basal cell carcinoma.
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