How are benign skin lesions differentiated from malignant lesions?

Updated: Jan 30, 2020
  • Author: Ginard I Henry, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Answer

Answer

Initially, benign lesions must be differentiated from malignant lesions. This is best done by being familiar with characteristics of common malignant lesions. The clinician should try to categorize any skin lesion as one of the following: most likely benign, most likely malignant, or unclear. The last 2 categories should be biopsied. Once the benign nature of the lesions is assumed, the diagnosis must be made accurately in order to assess any future malignant potential. A critical caveat is that all benign lesions must be watched by the patient and examined by a clinician should any changes occur.

See the images below of benign skin lesions.

Papular benign skin lesion: Acrochordon (skin tag) Papular benign skin lesion: Acrochordon (skin tag).
Papular benign skin lesion: Pyogenic granuloma. Papular benign skin lesion: Pyogenic granuloma.
Papular lesions: Keloids developed from back acne. Papular lesions: Keloids developed from back acne.
Macular benign skin lesions: Seborrheic keratoses Macular benign skin lesions: Seborrheic keratoses of back and trunk.
Macular benign skin lesions: Seborrheic keratoses Macular benign skin lesions: Seborrheic keratoses of the face.
Macular benign skin lesion: Nevus sebaceous of Jad Macular benign skin lesion: Nevus sebaceous of Jadassohn.
Subepidermal lesion: Keratinous cyst (epidermal in Subepidermal lesion: Keratinous cyst (epidermal inclusion cyst).
Subepidermal benign lesion: Lipoma of posterior ne Subepidermal benign lesion: Lipoma of posterior neck.
Benign pigmented lesion: Dermatosis papulosa nigra Benign pigmented lesion: Dermatosis papulosa nigra.
Psoriasis. Psoriasis.
Necrobiosis lipoidica diabeticorum. Necrobiosis lipoidica diabeticorum.
Pyoderma gangrenosum. Pyoderma gangrenosum.

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