Benign Lesion - Lipoma, Cyst, Haemangiona, Xanthelasma, Comedones, Granuloma

Presentation

Lipoma

  • Asymptomatic. Slow growing
  • Dome or egg-shaped, soft, mobile sub-cutaneous nodule

 

Epidermoid (sebaceous) cyst

  • Smooth mobile flesh coloured nodule within and fixed to overlying skin
  • Presence of punctum helps confirm diagnosis

 

Spider haemangioma

  • Compressible central feeding blood vessel of variable size
  • May be associated with high levels of oestrogen e.g pregnancy, liver cirrhosis

Xanthelasma

  • Yellowish plaques nodules above and below the eyes

Giant comedones

  • Like a small cyst with punctum

 

Pyogenic granuloma

  • Rapidly growing vascular lesion often trauma site
Management

Lipoma

  • Symptomatic lesions may be removed in primary care, but treatment usually not indicated

Epidermal (sebaceous) cyst

  • Treatment not usually indicated. Symptomatic cysts may be removed in primary care

Spider haemangioma

  • No treatment as they may resolve spontaneously, especially in children

Xanthelasma

  • May be a sign of underlying hyperlipidaemia
  • Reassure patient, no treatment required

Giant comedones

  • Reassure patient, content often easily expressed

Pyogenic granuloma

  • Due to frequent bleeding, excision or curettage/cautery required (specimen to pathology)
Referral

Dermatology Referral Criteria

Referral of patients with benign tumours may be appropriate if there is:

  • Diagnostic doubt (particularly pyogenic granuloma, consider possibility of malignancy)
  • Lesion causing functional problems or significant disfiguration
  • Lesion prone to recurrent infection
  • Recurrent bleeding (pyogenic granuloma)

If benign skin lesion is diagnosed, it will not be removed in secondary care for cosmetic reasons alone

Patient Information