follow @PCDSUKScalp
Common
- Pilar cyst (syn. trichilemmal cyst)
Uncommon / rare
- Naevus sebaceous (often present at birth / scalp, occasionally the face / smooth pink-yellow patch / become warty with age)
- Atypical fibroxanthoma (mainly males / sun-exposed areas, especially the head and neck / can ulcerate)
- Cylindroma (slow growing rubbery nodules)
Face
Common
- Sebaceous gland hyperplasia (multiple / 1-3 mm / white-yellow papules)
- Milia (multiple / small white papules)
- Xanthalasmata (eyelids and medial canthus / yellow papules and plaques / single to several)
- Fibrous papule of the face (nose most common site / solitary / skin-coloured papule)
- Solitary circumscribed neuroma (most commonly seen near muco-cutaneous junctions of face / solitary / firm skin-coloured papule)
Uncommon
- Dermoid cyst (often present at birth / head and neck)
- Appendageal tumours (more common on the face but can affect almost any part of the body)
- Angiofibroma (multiple / snout area / skin-coloured papules / tuberous sclerosis)
- Naevus of Ota (Asiatics / peri-orbital / blue-grey patch)
Ears
- Chondrodermatitis nodularis helicis (painful papule)
- Venous lake (blue / soft and compressible)
- Weathering nodules (skin-coloured papules running along rim of ear)
- Gouty tophi (small nodules / with time a white paste-like material drains)
- Angiolymphoid hyperplasia with eosinophilia (rare / around the ear most common site / clustered translucent papules)
Lips
- Venous lake (blue, soft and compressible)
- Mucocele (syn. mucous extravasation cyst; mucous retention cyst)
- Fordyce spots (vermilion border of the lips, oral mucosa / yellow-white spots)
- Mucosal melanocytic macules (brown)
- Leukoplakia (and other white patches in the mouth)
Trunk
Benign - common
- Epidermoid 'sebaceous' cyst (trunk and face)
- Keloid scar (smooth / firm / skin-coloured to red)
- Halo naevus (esp. back / circular white zone surrounding a mole)
- Atypical (dysplastic) naevus (scalp, trunk and buttocks)
- Vascular tumours
- Giant comedone (a large blackhead)
Benign - uncommon / rare
- Pilomatricoma (face and trunk / stony hard / deep-seated)
- Becker's naevus (shoulder to upper limb / large brown patch that develops course hair)
- Juvenile xanthogranuloma (infants and young children / smooth, tan-orange dome-shaped papules and nodules)
- Naevus of Ito (Asiatics / shoulder / blue-grey)
Malignant
Limbs
Common
- Dermatofibroma (fawn with darker rim / firm / dimples when pinched)
Uncommon / rare
- Pigmented spindle cell naevus of Reed (a dense black macule or papule)
- Clear cell acanthoma (most common site is lower legs / firm nodule with scaly rim)
- Rheumatoid nodules (ulnar border of forearm and knees / firm subcutaneous nodules)
- Tuberous xanthomata (knees and elbows / firm, painless, red-yellow papules and nodules)
- Cutaneous leiomyoma (painful lesions)
- Desmoplastic naevus (rare / most common site is upper arms / similar appearance to a dermatofibroma)
Hands
Common
- Ganglion (dorsal aspects of wrists most common site / soft subcutaneous swelling)
- Myxoid cyst (syn. mucous cyst / shiny tense papule in posterior nail fold / can ouze clear fluid / grooves can develop in nail plate)
- Pyogenic granuloma (red papule or nodule / eroded and bleeds easily)
- Fibrous tumours (digits and nails / smooth nodule, can be hyperkeratotic)
- Gouty tophi (small nodules / with time a white paste-like material drains)
Uncommon / rare
-
Zoonotic infections mainly affect the fingers, hands and other exposed sites, and are often tender:
- Orf (relatively common / mainly sheep and goats / a small, firm, red or red-blue papule enlarges to form a target-like nodule with a red centre, a white middle and a red periphery)
- Milker's nodule (relatively common / cows / small, red, flat-topped papule/s, which evolve into red-purple, firm nodules, 0.5-1.5 cm in diameter)
- Anthrax (rare / lesions have a necrotic centre with an outer rim of small bullae and non-pitting oedema)
- Rheumatoid nodules (dorsal aspects of hands / firm subcutaneous nodules)
- Tendon xanthomata (slowly enlarging subcutaneous nodules related to the tendons or ligaments)
- Palmar xanthomata (palmar creases / yellow macules and papules)
- Multicentric reticulohistiocytosis (rare / yellow-brown papules along sides of fingers)
Feet
Common
- Talon noir (black patch caused by trauma / heel most common site)
- Ganglion (dorsal aspects of feet and close to ankles / soft subcutaneous swelling)
- Stucco keratosis (multiple / mainly lower legs and feet / <1cm / white / rough)
- Piezogenic pedal papules (multiple skin coloured papules around heels)
- Fibrous tumours (digits and nails / smooth nodule or fleshy with a scaly surface)
Uncommon / rare
- Subungual exostosis (most commonly big toe / a firm nodule develops beneath the nail bed / the nodule usually grows over weeks-months, and develops a thick hyperkeratotic surface / nail plate separates from the bed)
- Rheumatoid nodules (firm subcutaneous nodules)
- Tendon xanthomata (slowly enlarging subcutaneous nodules related to the tendons or ligaments)
- Carcinoma cuniculatum syn. epithelioma cuniculatum, verrucous carcinoma (fungating, wart-like mass on sole of foot)
- Eccrine poroma and malignant eccrine poroma (sole of foot / moist, pink, elevated lesion)
Nails
- Refer to the chapter on Nail disorders
Genitalia
- Refer to the general dermatology table - Genital, oral and other mucosal membranes