Family MedicineAcademyWritten AKTNotesDermatologyBenign growths
Dermatology
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Melanocyte proliferations from childhood/early adult life; genetics and UV influence number. About 20% of melanomas arise in a pre-existing naevus.
Features: Symmetrical, smooth border, flat or raised; colour varies.
Management: Excise only if symptomatic.
Advice: Advise monitoring and sun protection.
Referral: Urgent referral if melanoma suspected; routine dermoscopic review for atypical naevi.
Benign epidermal lesions after age about 40.
Features: Greasy stuck-on warty surface.
Management: Reassure; remove with cryotherapy or curettage if the patient wants.
Referral: Urgent referral if diagnosis uncertain.
Rapidly growing tumour with a volcano-like crater and central keratin plug; often resolves in about 3 months.
Features: Hard to distinguish from SCC clinically.
Red flags: Treat as suspected SCC - urgent 2WW.
Common firm fibrous papule/nodule on a limb after minor trauma.
Features: Pinch dimple sign. No malignant potential.
Management: No treatment unless the patient requests excision.
Rapid vascular nodule after trauma or in pregnancy; bleeds easily; common on head, neck, hands.
Management: Removal: curettage, cryotherapy, and other options.
Red flags: Urgent review if bleeding continues after treatment or the lesion fails to shrink (for example within 2 weeks of salt treatment) to exclude amelanotic melanoma.
Age-related capillary proliferations; 1-3 mm red non-blanching papules; not on mucosa.
Management: No treatment needed.
Painful ear-cartilage nodule from pressure or poor blood supply.
Features: Small skin-coloured nodule, often with scale over a tiny ulcer. Clinical diagnosis; biopsy if SCC/BCC cannot be excluded.
Management: First step: pressure relief (pillow, foam). Options: cryotherapy, steroid injection, excision.
Clinical figure
Clinical examples: DermNet NZ - chondrodermatitis nodularis helicis
Open on DermNet NZ