Skin lesions - white / yellow / orange
White
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Milia (face most common site, especially the eyelids and cheeks. Can also occur in sites of skin injury / several to many / 1--2 mm diameter / white-yellow papules protruding from just under the skin surface)
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Epidermoid cyst syn. sebaceous cyst (mainly face, neck, shoulders and chest / single, occasionally several / appears white-yellow if close to skin surface / may have a central keratin-filled punctum attached to skin surface / a firm, elastic, dome-shaped protuberance / mobile over deeper structures)
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Atrophic scar eg acne
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Actinic keratosis (sun-exposed sites / single to several, occasionally many / 0.5-1 cm diameter / flat / rough adherent white scale)
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Stucco keratosis (mainly lower legs, forearms / several to many / small, less than 1 cm diameter / flat / rough white surface)
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Basal cell carcinoma - morphoeic type (central face most common site / slow growing / single / white-yellow / flat or slightly raised / waxy or scar-like appearance / firm)
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Halo naevus (usually young age / single to several / most commonly the back / circular white zone surrounding a regular mole)
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Melanoma with regression (single / two or more colours including white / irregular shape and colour distribution)
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Pilomatricoma (mainly children / single / usually head, neck, upper extremities / 3-30 mm in diameter / stony hard and deep-seated)
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Gouty tophi (most common sites are fingers and ears / single to several / tophi contain a white pasty material, which works its way towards the skin surface to drain)
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Calcification of the skin and subcutaneous tissues syn. calcinosis cutis. Examples include:
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Scrotal calcinosis (men aged 20-40 years / several / white-yellow / firm, subcutaneous nodules sitting within the scrotal skin)
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Dystrophic calcification (calcinosis at a site of tissue damage)
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Some cases of connective tissue disorders (eg the CREST syndrome - calcinosis, Raynaud's phenomenon, oesophageal dysfunction, sclerodactyly and telangiectasia)
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Leukoplakia (and other white patches on the lips or in the mouth)
Yellow
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Sebaceous gland lesions
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Naevus sebaceous (often present at birth / scalp, occasionally the face / single / pink-yellow / flat, or slightly raised and flat-topped / smooth initially, become warty with age)
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Sebaceous gland hyperplasia (common / face / can be single, often several / white-yellow / 1-3 mm diameter, raised)
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Sebaceous adenoma (face / single / yellow-tinged / 0.5-1 cm, raised)
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Sebaceous carcinoma (eyelids / single / yellow-orange with a translucent appearance / raised, sustained growth)
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Xanthomata
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Xanthelasmata (symmetrical distribution on eyelids, and medial canthus / single to several / yellow / circular or elongated / raised, flat-topped / soft and velvety)
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Eruptive xanthomata (most commonly buttocks, shoulders, arms and legs, but any site can be affected, although facial involvement is rare / often arise suddenly / yellow / grouped, small raised lesions)
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Plane xanthomata (can affect any site / several to many / yellow-orange / variable size / flat, or slightly raised and flat-topped)
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Palmar xanthomata (similar appearance to plane xanthomata, but found on the palmar creases of the hands)
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Fordyce spots (vermilion border of the lips, oral mucosa and genitalia / small, smooth, yellow-white spots)
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Mastocytoma (usually children / single to several / red-yellow / 1-5 cm diameter / become red and swollen within a few minutes of gentle rubbing)
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Keratoacanthoma (adults / rapid growth / single / yellow to skin-coloured / raised - can reach several cm in diameter)
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Multicentric reticulohistiocytosis (often middle-aged patients / extensor surfaces, especially of the hands and forearms / several to many / yellow-brown / small and raised / lesions on ears and nose may cause cartilage destruction / destructive symmetrical polyarthritis)
Orange
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Juvenile xanthogranuloma (infants and young children / 0.5 cm to several cm diameter / tan-orange / dome-shaped / smooth)
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Xanthoma disseminatum (mainly children and young adults / symmetrical involvement of face, trunk and proximal extremities, especially flexural sites / yellow-orange papules and nodules that become confluent, especially in the flexures, to form xanthomatous plaques)
The Cunliffe (TP) Diagnostic Skin Lesion Table - Copyright to the PCDS, all rights reserved.
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