Benign skin
tumors are commonly seen by family physicians. The ability to properly diagnose and treat common benign
tumors and to distinguish them from malignant lesions is a vital skill for all family physicians. Any lesions for which the diagnosis is uncertain, based on the history and gross examination, should be biopsied for histopathologic examination to rule out
malignancy.
Lipomas are technically subcutaneous soft tissue
tumors, not skin
tumors, and controversy exists about whether
keratoacanthomas have malignant potential; however, both are discussed in this article because they are common
tumors evaluated by family physicians. Diagnosis usually is based on the appearance of the lesion and the patient's clinical history, although biopsy is sometimes required. Treatment includes excision,
cryotherapy,
curettage with or without electrodesiccation, and
pharmacotherapy, and is based on the type of
tumor and its location. Generally, excision is the treatment of choice for
lipomas,
dermatofibromas,
keratoacanthomas, pyogenic
granulomas, and
epidermoid cysts. Cherry angiomas and sebaceous
hyperplasia are often treated with
laser therapy and electrodesiccation. Common treatments for acrochordons and
seborrheic keratoses are
cryotherapy and shave excision. Referral is indicated if the family physician is not confident with the diagnostic evaluation or treatment of a lesion, or if a biopsy reveals
melanoma.