Skin Tumors

.Benign Tumors
.Precancerous Tumors
•Malignant Tumors

•Pseudo-tumors
•True tumors

•
 Tumor Origin :
Keratinocytes
Melanocytes
Vascular : Endothelial, Blood Components
Fibroblasts
Metastatic
 Benign Tumors

•Cytology is benign : homogenous cells

Atypical cells (-)
Polymorphic cells (-)
Normal mitoses
•No invasion
•No metastasis
 Hypertrophic Scar

•Pseudo tumor, excessive healing responses

•Loss of tissue should beyond base membrane
•Infection may cause more extensive loss tissue

•Clinical manifestations:
•< 3 months
•redness scar, elevated , capillary +
•Spontaneous flattening < 6 months
•Steroid + pressure dressing
 KELOID
•Excessive healing response
•Failure of remodeling, prolonged inflammation
•predispositions:
females, young adults, mongoloid, Negros

•deltoid, pectoral, sternal, earlobes (tension skin)

similar with HS but with pseudopodia.
•Therapy :
• intra-lesion TA
•Combined with excision
•Laser
 Pyogenic Granulomas
•Unknown, bacterial infection? Bacteri-
•HP: similar with hemangioma , plus leucocytes infiltrations
•CM:

•Soft dome shape papules

•Easy bleeding
•Single
•Erosive surface or glossy

DD: Nodular melanoma

TH: excision
cryosurgery
chemosurgery
electrosurgery
Nevus : All Of Birth Marks
Growth Anomali Of Immature Melanocytes In Skin
Melanocytic nevi= pigmented nevi= moles

junction dermal compound

GIANT PIGMENTED HAIRY NEVI

= Melanocytic nevi
 Cellular Blue Nevi

Dermal Melanocytoma
It Can develop to be melanoma
Melanotic nevi:
Melanin accumulation in mid and lower dermal,
may persist since neonatal
Mongolian spot
nevus ota/ito

Nevus of ota
 Seborrheic Keratoses
Senile seborrheic warts
basal Cell papilloma
• keratinocytes hyper-proliferation
• A wrong name,
•Seborrhea areas and lower limb
•CM: early : flat papules, brownish yellow
late : verrucous, oily crust/scales, darker.
.HP: Proliferation of epidermal cells, basaloid, keratin pseudocyst,
.DD: melanocytic nevi
pigmented basalioma
verucca vulgaris
TX : electrosurgery,laser,cryosurgeryi
Malignancy (-)
 SYRINGIOMA (HIDRADENOMA)

•Benign tumor of ecrine glands

•Adult females, malignancy -

CM :
•1-5 mm nodules
•Multiples
•Skin colour
•Around orbital areas
(localized)
•Whole of the body (generalized)

Laser, Electrosurgery
Sebaceus Nevi of Jadhason
•Scalp And Face
CM :
•since born, prominent in puberty
•Patch to flat plaques, papillomatosis,
well boder, Yellowish, glossy, soft or
elastic in palpation
•Milia like lesion
•HP :
•proliferation of mature sebaceus
gland PA
•Hair follicle abortive
•Hidro-cyctic degeneration of
apocrine and ecrine gland
•Prog:
•30% developed to basalioma
sometimes : SCC
TH :
Excision
PRECANCEROUS LESIONS
•INSITU MALIGNANCY
•MALIGNANT CYTOLOGICALLY
•NO INVASION
•NO METASTASES

•Actinic keratoses
•Arsenic keratoses
•Bowen diseases
•Erythroplasia of Querat
•Paget diseases
•etc
Actinic Keratoses

•Ultraviolet radiation
•Light color skin peoples
•Sign of photoaging
•Sun exposed areas
•Basalioma and SCC
 CM
•Plaque covered by adherent scales
•Bleeding if removed
•Telengectasias
•Prominence Skin wrinkles
•and skin elastosis

TH:
Topically 5 FU
Wide Excision
Arsenic keratoses

•Arsen
•Farmers: pesticides, insecticides
•Contact areas
•SCC

Observe: scales and borders

Cutaneous Horn

•Sun exposed areas

•SCC in situ
 BOWEN Disease
Inflammatory Pre Cancer

•Multiple : immunosuppresive
•Internal malignancy
•SCC
 Paget Diseases
Intraductal Carcinoma
Apocrine Glands
Mammary Glands
non Mammary Glands

•Mammary
•Extra mammary Itchy
Erosion
Adherent crust

Itchy
No respon steroid
Nipple erosion
Nipple destruction
exzematous
Paget cells
Erythroplasia Queyrat

Indurative patch
Adherent scale

•SCC
•Uncircumcised peoples
•Personal hygiene
•Chronic trauma
•Hot climates
•genital herpes
PAPULOSIS BOWENOID

•HPV 16, 18, 33

•SCC in situ
•Sex-partners
Giant Condyloma

•HPV 6
•Sex-partner
•uncircumcised >>
MALIGNANT SKIN TUMORS
1. Squamous Cell Ca •Tumor origin : keratinocytes
CM •Invasive and potensial metastases
•Elderly

TH : wide excision
ionizing radiation
2. Basal cell carcinoma=basalioma

Malignant tumor originated from basal cells

Sun-exposed
Local destruction, almost never metastases
Clinical types

Superficial

NODULO ULCERATIVE
Noduler

PIGMENTED
Rodent ulcers
Exsicion
Radiation
5-FU Topical

Terapi:
A Year Later
basalioma
 3. Malignant melanoma
Arising from melanocytes
Highly metastases

Clinical manifestation:
•Lentigo malignant melanoma
•Noduler melanoma
•Superficial spreading melanoma
•Acral lentiginous melanoma

Aceal lentiginous melanoma

Most common in Indonesia

TH: initial stages : excision +1.5-3 cm from margin
chemotherapy for metastases
Radiation palliative : bone and brain metastases
GBU
thanks!