Boulder Dermatology: Benign Skin Growths and Pigmentation Disorders

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BENIGN SKIN GROWTHS AND PIGMENTATION DISORDERS

Abnormal skin growths and abnormal pigmentation of the skin may be present at birth, or develop later in life. Although harmless in most cases, they should be monitored for any changes that may indicate the development of cancerous skin cells. A few of the many types of skin growths and pigmentation disorders that may require the care of a dermatologist are:

BIRTHMARKS

What are birthmarks?

Birthmarks are areas of discolored and/or raised skin that are apparent at birth or within a few weeks of birth. Birthmarks are made up of malformed pigment cells or blood vessels. About 10 in every 100 babies have vascular birthmarks (birthmarks made up of blood vessels). Although the cause of birthmarks is not known, most of them are benign (non-cancerous) and do not require treatment. Babies with birthmarks should be examined and diagnosed by a dermatologist.

The following are the most common types of vascular birthmarks:

• flat, unelevated stains (known as "angel’s kisses" or "stork bites") - These are the most common type of vascular birthmark, characterized by pink to red marks that may appear anywhere on the body. Some of these disappear after about age 2, but others may last into adulthood.

• hemangioma - a common vascular birthmark that becomes visible within the first few weeks of life and continues to grow rapidly for about six to nine months. Then, they gradually lose this red color and also shrink.

• port-wine stains - a port-wine stain, also called a nevus flammeus, is a flat, pink, red, or purple mark that appears at birth, often on the face, arms, and legs, and continues to grow as the child grows. Port-wine stains do not go away and often require treatment if located on the eyelid or forehead. Port-wine stains involving the face may cause eye problems.

OTHER BENIGN SKIN GROWTHS

As a person grows older and is exposed to sunlight and the environment, the skin changes. For example, a person may have freckles and moles that multiply or darken over time. The following chart describes the different types you might encounter:

Skin Growth	Characteristics
dermatofibromas	Small, firm, red or brown bumps caused by an accumulation of fibroblasts (soft tissue cells under the skin). They often occur on the legs and may itch.
dermoid cyst	A benign tumor which is made up of hairs, sweat glands, and sebaceous glands. Some internal dermoid tumors may even contain cartilage, bone fragments, and teeth.
freckles	Darkened, flat spots that typically appear only on sun-exposed areas of the skin. Freckles are common in people with blond or red hair.
keloids	Smooth, firm, raised, fibrous growths on the skin that form in wound sites. Keloids are more common in African-Americans.
lipomas	Round or oval lumps under the skin caused by fatty deposits. Lipomas are more common in women and tend to appear on the forearms, torso, and back of the neck.
moles (nevi)	Small skin marks caused by pigment-producing cells in the skin. Moles can be flat or raised, smooth or rough, and some contain hair. Most moles are dark brown or black, but some are skin-colored or yellowish. Moles can change over time and often respond to hormonal changes.
atypical moles (dysplastic nevi)	Larger than normal moles (more than a half inch across), atypical moles are not always round. Atypical moles can be tan to dark brown, on a pink background. These types of moles may occur anywhere on the body.
pyogenic granulomas	Red, brown, or bluish-black, raised marks caused by excessive growth of capillaries (small blood vessels) and swelling. Pyogenic granulomas usually form after an injury to the skin.

PIGMENTATION DISORDERS

What are skin pigment disorders?

Skin color is determined by a pigment (melanin) made by specialized cells in the skin (melanocytes). The amount and type of melanin determines a person's skin color. Melanin gives color to the skin, hair, and iris of the eyes. Levels of melanin depend on race and amount of sunlight exposure. Sun exposure increases melanin production. In addition, hormonal changes can affect melanin production. The following chart describes various skin pigment disorders.

Pigment Disorder	Characteristics
albinism	This rare, inherited disorder is characterized by a total or partial lack of melanin in the skin, compared to the pigmentation of siblings and parents. Albinos (people with albinism) have white hair, pale skin, and pink eyes. Vision is often affected.
pigment loss after skin damage	Sometimes following an ulcer, blister, burn, or infection, the skin does not replace some of the pigment in that area.
vitiligo	Smooth, white patches in the skin. Vitiligo is caused by the loss of pigment-producing cells in the skin (melanocytes). The white patches are very sensitive to the sun.