ANT SEG - Lumps and Bumps

What is the most likely diagnosis?

Squamous Papilloma 

What is the most likely diagnosis?

Seborrheic Keratosis 

What is the most likely diagnosis ?

Seborrheic Keratosis 

What is the most likely diagnosis ?

Verruca Vulargis 

What is the most likely diagnosis ?

Molluscum Contagiosum

What is the most likely diagnosis ?

Molluscum Contagiosum

What is the most likely diagnosis ?

Herpes Simplex Dermatitis 

What is the most likely diagnosis ?

Herpes Zoster Dermatitis 

What is the most likely diagnosis ?

Keratoacanthoma

What is the most likely diagnosis ?

Actinic Keratosis

What is the most likely diagnosis ?

Squamous Cell Carcinoma 

What is the most likely diagnosis ?

Basal Cell Carcinoma

What is the most likely diagnosis ?

Melanocytic Nevus 

What is the most likely diagnosis ?

Oculodermal Melanocytosis

What is the most likely diagnosis ?

Oculodermal Melanocytosis

What is the most likely diagnosis ?

Lentigo Maligna

What is the most likely diagnosis ?

Primary Malignant Melanoma

What is the most likely diagnosis ?

Sebaceous Gland Carcinoma

What is the most likely diagnosis ?

Eyelid Xanthelasma 

What is the most likely diagnosis ?

Sebaceous Cyst

What is the most likely diagnosis ?

Sudiferous Cyst

What is the most likely diagnosis ?

Eyelid Syringoma 

What is the most likely diagnosis ?

Neurofibroma

What is the most likely diagnosis ?

Capillary Hemangioma

What is the most likely diagnosis ?

Neurofibromatosis Type I

What is the most likely diagnosis ?

Nevus Flammeus 

What is the most likely diagnosis ?

Nevus Flammeus 

What is the most likely diagnosis ?

Kaposi Sarcoma 

What is the most likely diagnosis ?

Conjunctival Dermoid

What is the most likely diagnosis ?

Eyelid lymphoma

What is the most likely diagnosis ?

Pyogenic Granuloma

What is the most likely diagnosis ?

Goldenhar Syndrome 

What is the most likely diagnosis ?

Conjunctival Nevus 

What is the most likely diagnosis ?

Racial Melanosis 

What is the most likely diagnosis ?

Intraepithelial Neoplasia 

What is the most likely diagnosis ?

Primary Acquired Melanosis 

What is the most likely diagnosis ?

Primary Acquired Melanosis 

What is the most likely diagnosis ?

Malignant Melanoma

What is the most likely diagnosis ?

Malignant Melanoma

What is the most likely diagnosis ?

Squamous Cell Carcinoma

What is the most likely diagnosis ?

Conjunctival Lymphoma 

What is the most likely diagnosis ?

Brushfield Spots

What is the most likely diagnosis ?

Lisch Nodules

What is the most likely diagnosis ?

Iris Nevus 

What is the most likely diagnosis ?

Iris Cyst 

What is the most likely diagnosis ?

Iris Melanoma

What is the most likely diagnosis ?

Orbital Fat Prolapse 

What is the most likely diagnosis ?

Dermoid Cyst

• Flesh colored with cerebriform surface 

• Can be pigmented

what is the most likely diagnosis ?

Squamous Papilloma 

• Usually one (solitary) lesion 1-2 cm in diameter

• Button stuck to surface of the skin 

• Elevated with waxy surface 

• Sharp demarcation (well defined)

• Varying pigmentation

what is the most likely diagnosis ?

Seborrheic Keratosis 

• Multiple lesions

• Concomitant conjunctivitis

what is the most likely diagnosis ?

Verruca Vulargis

• Multiple pearly flesh colored lesion with a small central dimple

• Associated with chronic follicular conjunctivitis 

• Asymptomatic 

• Recurrence is rare

what is the most likely diagnosis ?

Molluscum Contagiosum

• Eyelid and periorbital erythematous base

• Prodromal facial and lid tingling last 24 hours 

what is the most likely diagnosis ?

Herpes Simplex Dermatitis 

Unilateral Causes pain along the trigeminal nerve During pre-eruptive patient can experience malaise, fever, headache, pain/burning/ itching what is the most likely diagnosis ?

Herpes Zoster Dermatitis 

• Elevated margins with central crater

• Usually solitary lesion 

• Multiple lesion= colon cancer (paraneoplastic syndrome)

• Rapid onset and growth 

what is the most likely diagnosis ?

Keratoacanthoma

what is the most likely diagnosis ?

• Multiple erythematous sessile (flat) plaques 

• Lesions range in diameter

• Pink in color and can be pigmented

what is the most likely diagnosis ?

Actinic Keratosis

• Prognosis varies with degree of differentiation, etiology, tumor size and depth 

• Lesions arising from actinic keratosis are more favorable prognosis 

• Fast growing

what is the most likely diagnosis ?

Squamous Cell Carcinoma 

• Painless but invasive lesions can cause pain 

• Occurs mainly in head and neck region 

• Hallmark signs → pearly, waxy, rolled, telangiectatic borders with central ulceration

what is the most likely diagnosis ?

Basal Cell Carcinoma

• May contain hair 

• Marginal nevus can extend onto the palpebral conjunctiva 

• Darkly pigmented lesion

what is the most likely diagnosis ?

Melanocytic Nevus 

Cutaneous lesion is flat, tan to gray Follows the first and second division of CN V

what is the most likely diagnosis ?

Oculodermal Melanocytosis

• Flat, Well-circumscribed, irregular, tan-brown lesion 

• Enlarges slowly over the years 

• Much later onset 

• Associated with primary acquired melanosis of the conjunctiva 

what is the most likely diagnosis ?

Lentigo Maligna

• Solitary nodule or diffuse eyelid thickening 

• Aggressive local behavior 

• Cardinal signs → madarosis, poliosis, thickening of lid margin

what is the most likely diagnosis ?

Sebaceous Gland Carcinoma

Usually bilateral Single or multi flare, yellow, placoid lesion that affect loose aspect of eyelid  Usually medial aspect of eyelids

what is the most likely diagnosis ?

Eyelid Xanthelasma 

Yellow dot can occur in meibomian glands of the upper tarsus and gland of zeis

what is the most likely diagnosis ?

Sebaceous Cyst

• Clear cystic translucent lesion near eyelid margin 

what is the most likely diagnosis ?

Sudiferous Cyst

Usually multiple and bilateral

what is the most likely diagnosis ?

Eyelid Syringoma 

• Causes an S-shaped curve of upper eyelids 

• Feels like ‘a bag of worms’ 

• stable , but can sometimes enlarge

• Possible proptosis

what is the most likely diagnosis ?

Neurofibroma 

• 2+ Neurofibromas or one plexiform neurofibroma 

• Optic Nerve Glioma 

• 2+ Lisch Nodules 

• 6+ macules 

• Freckling in axillary or inguinal region 

• Bony lesion 

what is the most likely diagnosis ?

Neurofibromatosis Type I

• Becomes more elevated after diagnosis 

• Stabilize after a year 

• Regresses completely by 7 yrs

• Lesion balances on pressure and can swell during crying

what is the most likely diagnosis ?

Capillary Hemangioma

• Follows cutaneous distribution of CN V

• Sharply demarcated pink-purish patch 

• Does not blanch with pressure 

• Frequently located on the face 

• Associated with soft tissue hypertrophy

what is the most likely diagnosis ?

Nevus Flammeus 

Presents as a red, purple, brown, or blue subcutaneous lesion

what is the most likely diagnosis ?

Kaposi Sarcoma 

Can be confined to eyelid, but usually associated with systemic lymphoma

what is the most likely diagnosis ?

Eyelid lymphoma

• Variable sized yellow-white limbal mass (usually infratemporal)

• Lined with squamous epithelium filled with sweat glands, fat and cilia

what is the most likely diagnosis ?

Conjunctival Dermoid

Macrostomia → wide mouth  Microtioa → underdeveloped pinna of the ear Pre-auricular and facial skin tags  Mental handicap  Hemiverterbrae → wedge-shaped vertebrae

what is the most likely diagnosis ?

Goldenhar Syndrome 

• Consist of granulation tissue, proliferation of small blood vessels and inflammatory cells 

• Usually presents a few weeks after physical insult 

• Rapidly growing pink fleshy conjunctival mass

what is the most likely diagnosis ?

Pyogenic Granuloma 

• Solitary lesion

• Flat or slightly elevated 

• Mobile over underlying sclera 

• Stable size and pigmentation over time 

• Can contain cystic components

what is the most likely diagnosis ?

Conjunctival Nevus 

• Bilateral diffuse flat pigmentation of conjunctiva 

• Pigmented epithelium moves freely over the underlying episclera 

• Appears during the first few years of life and becomes static by early adulthood 

• Bilateral but can be unilateral 

• Usually concentrated around the limbus 

• Small cyst can be present within pigmentation 

what is the most likely diagnosis ?

Racial Melanosis 

Unilateral  Fleshy sessile lesion near limbus or intrapalpebral fissure

what is the most likely diagnosis ?

Intraepithelial Neoplasia 

• Gradual onset in middle age 

• Unilateral patches on the conjunctiva and peripheral cornea 

• Solitary

• Diffuse or multifocal 

what is the most likely diagnosis ?

Primary Acquired Melanosis 

Usually located on bulbar conjunctiva near the limbus

what is the most likely diagnosis ?

Malignant Melanoma

• Large conjunctival feeder vessels usually present 

• Locally invasive 

what is the most likely diagnosis ?

Squamous Cell Carcinoma

Diffuse, slightly elevated, fleshy pink mass Occurs in fornices or bulbar conjunctiva

what is the most likely diagnosis ?

Conjunctival Lymphoma 

Bilateral Small whitish peripheral iris speckles arranged in a concentric ring

what is the most likely diagnosis ?

Brushfield Spots

Pigmented aggregation of melanocytes and spindle cells in the superficial iris stroma

what is the most likely diagnosis ?

Lisch Nodules

• Flat or variable elevated pigmented lesion

what is the most likely diagnosis ?

Iris Nevus 

• Benign

• Arises from POSTERIOR surface of iris pigment epithelium 

• Usually asymptomatic and non-progressive

what is the most likely diagnosis ?

Iris Cyst 

• Elevated with feeder vessels

• Pigmented or Amelanotic 

• Arises from the ANTERIOR surface of the iris pigmented epithelium

what is the most likely diagnosis ?

Iris Melanoma

Soft yellow mass in supratemporal conjunctival fornix

what is the most likely diagnosis ?

Orbital Fat Prolapse 

• Firm, non-moveable subcutaneous mass

• Filled with hair follicles, sebaceous glands and sweat glands

what is the most likely diagnosis ?

Dermoid Cyst

Which finding are characteristic of Squamous Papilloma ?

gradual onset, slow growth and can occur at any age but increases in frequency in older age

Which finding are characteristic of Seborrheic Keratosis?

pigmented lesion due to melanocytes, presents on hair bearing areas, and can be part of paraneoplastic syndrome

Which finding are characteristic of Verruca Vulargis?

squamous papilloma caused by HPV and most common in children and youn adults

Which finding are characteristic of Molluscum Contagiosum?

Poxvirus infection of the skin, transmission in children is due to direct contact, transmission in adults is an STD, severe bilateral involvement suspect immunocompromised state

Which finding are characteristic of Herpes Simplex Dermatitis ?

Usually due to primary infection and self-limiting but can resolve quicker with medication

Which finding are characteristic of Herpes Zoster Dermatitis ?

Unilateral infection caused by a virus and occurs in elderly and immunocompromised individuals

Which finding are characteristic of Keratoacanthoma?

Develops on hair bearing sun exposed skin, mostly occurs on face, onset age is >40 and falls within the spectrum of squamous cell carcinoma

Which finding are characteristic of Actinic Keratosis?

Caused by proliferation of atypical keratinocytes, mainly effects light skinned individuals, presents on face rarely eyelids and caused by gradual damage of UV exposure

Which finding are characteristic of Squamous Cell Carcinoma of Epidermis?

Fast growing, can extend into orbit and brain via neuronal invasion and recurrence is possible

what bengn tumor of the epidermis is a strong indication for cancer in the GI tract ?

Seborrheic Keratosis