What’s This Thing on My Skin?

Feb 21

“Your skin is like a garden. Over time, there are wildflowers and weeds.”

One of the best ways to find skin cancer early is by doing a self-exam and looking for “ugly ducklings.” Luckily, most of what we find on our skin is benign. Nonetheless, when in doubt, seek an evaluation by a board-certified dermatologist who can make a definitive diagnosis and provide cosmetic treatment options if desired.

So, what’s that thing on your skin? Read on.

Seborrheic Keratosis

Some of the most common issues we see are these benign growths made out of the epidermis. They are often well-demarcated, rough, and have a sticker-like or “stuck-on” appearance. Seborrheic keratosis can vary greatly in shape, size, and color. The “garden” varieties are tan to brown, wart-like, and distributed mainly on the trunk and creases. The less common versions include ones that are flat with accentuation of the skin line; small, white, and rough ones on the ankles called stucco keratosis; and small, waxy, and brown ones on the face and neck of darker-skinned individuals called dermatosis papulosa nigra. Almost everyone over the age of 50 has at least a few seborrheic keratoses, which is why we call them “signs of wisdom.”

Cherry Angioma

As the name suggests, cherry angiomas are red like cherries and made of the benign growth of blood vessels. They often start to appear in early to mid-adulthood. They can vary in size from a pinpoint to 3-4 mm. Cherry angioma can sometimes appear purple or even black, which can resemble a nodular melanoma. When in doubt, always seek an evaluation from your dermatologist. Features of a cherry angioma are easily recognized by a dermatologist equipped with a dermatoscope.

Sebaceous Hyperplasia

The hallmarks of enlarged or hypertrophic oil glands are small, skin-colored-to-yellow bumps with central dells, located mainly on the face of middle-aged to older adults. Sebaceous hyperplasia can be surrounded by “broken blood vessels,” mimicking the appearance of basal cell carcinoma. Therefore, if any lesion enlarges or bleeds easily, a biopsy may be warranted.

Milia

These 1-3 mm, white-to-yellow, superficial bumps are tiny cysts usually found on the face. They can affect patients of all ages. Milia occurs when the sloughed-off skin becomes trapped in the dermis. Therefore, they often occur after procedures that are abrasive or traumatic, such as dermabrasion, chemical peels, and blistering disorders. Milia are easily treated by our nurses with a tiny incision in the skin and a comedone extractor.

Skin Tags

The fancy names for these small, soft, fleshy, skin-colored-to-brown hanging extra pieces of skin are acrochordon or fibroepithelial polyps. They are most commonly found in areas of friction such as the neck, armpits, and groin. Although they are benign and usually asymptomatic, skin tags can sometimes become red, tender, or even black—necrotic due to trauma from clothing or twisting. Increased number of skin tags are associated not only with age, but pregnancy, diabetes, and obesity.

Dermatofibroma

Dermatofibromas are firm, skin-colored-to-pink-to-hyperpigmented, round-to-oval “scars” under the skin found often on the extremities. They are commonly reported at sites of trauma and insect bites. Their etiology, however, is unknown. Once present, they are usually asymptomatic and stable in appearance. Treatment requires surgical removal which has the potential to replace one spontaneous scar with another man-made scar.