Moles, Freckles, Skin Tags: Types, Causes, Treatments There are several skin lesions that are very common and benign (non-cancerous). These conditions include moles, freckles, skin tags , benign lentigines, and seborrheic keratoses. Moles and Your Skin Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Most moles appear in early childhood and during the first 25 years of a person's life. It is normal to have between 10-40 moles by adulthood. As the years pass, moles usually change slowly, becoming raised and/or changing color. Sometimes, hairs develop in the mole. Some moles may not change at all, while others may slowly disappear over time. What Causes a Mole? Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may darken after exposure to the sun, during the teen years, and during pregnancy .

Types of Moles Congenital nevi are moles that are present at birth. Congenital nevi occur in about one in 100 people. These moles are slightly more likely to develop into melanoma ( cancer ) than are moles that appear after birth. A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDEs of melanoma (see below). Dysplastic nevi are moles that are generally larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These nevi are somewhat more likely to become melanoma. In fact, people who have 10 or more dysplastic nevi have a 12 times higher chance of developing melanoma, a serious form of skin cancer . Any changes in a mole should be checked by a dermatologist to evaluate for skin cancer . How Do I Know if a Mole Is Cancer? The vast majority of moles are not dangerous. Moles that are more likely to be cancer are those that look different than other existing moles or those that first appear after age 25.

If you notice changes in a mole's color, height, size, or shape, you should have a dermatologist (skin doctor) evaluate it. You also should have moles checked if they bleed, ooze, itch, or become tender or painful. Continued Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of the skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, ears, legs, and back. If a mole does not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, talk to your dermatologist. The following ABCDEs are important characteristics to consider when examining moles. If a mole displays any of the signs listed below, have it checked immediately by a dermatologist. It could be cancerous. Asymmetry. One half of the mole does not match the other half. Border. The border or edges of the mole are ragged, blurred, or irregular. Color.

The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red. Diameter. The diameter of a mole is larger than the eraser of a pencil. Evolution. The mole is changing in size, shape, or color. Melanoma is a form of skin cancer. The most common location for melanoma in men is the chest and back and in women, it is the lower leg. Melanoma is the most common cancer in young women. How Are Moles Treated? If a dermatologist believes a mole needs to be evaluated further, he or she will do a biopsy by shaving or cutting out the entire spot so that it can be evaluated under the microscope. This is a simple procedure. (If the dermatologist thinks the mole might be cancerous, cutting through the mole will not cause the cancer to spread.) If the mole is found to be cancerous, the dermatologist will cut out the entire mole or scar from the biopsy site by cutting out the entire area and a rim of normal skin around it, and stitching the wound closed. Continued Skin Tag A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk.

Skin tags are not dangerous. They are usually found on the neck, chest, back, armpits, under the breasts , or in the groin area. Skin tags appear most often in women, especially with weight gain, and in elderly people. Skin tags usually don't cause any pain. However, they can become irritated if anything, such as clothing, jewelry, or skin rubs against them. How Are Skin Tags Treated? Your dermatologist can remove a skin tag by cutting it off with a scalpel or scissors, with cryosurgery (freezing it off), or with electrosurgery (burning it off with an electric current). Lentigo and Your Skin A lentigo (plural: lentigines) is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines are more common among whites, especially those with fair skin. What Causes Lentigines? Exposure to the sun seems to be the major cause of lentigines. Lentigines most often appear on parts of the body that get the most sun, including the face and hands. Some lentigines may be caused by genetics (family history) or by medical procedures such as radiation therapy .

How Are Lentigines Treated? Causes of freckles include genetics and exposure to the sun. Continued Do Freckles Need to Be Treated? Since freckles are almost always harmless, there is no need to treat them. As with many skin conditions, it's best to avoid the sun as much as possible, or use a broad-spectrum sunscreen with SPF 30. This is especially important because people who freckle easily (for example, lighter-skinned people) are more likely to develop skin cancer. If you feel that your freckles are a problem or you don't like the way they look, you can cover them up with makeup or consider certain types of laser treatment, liquid nitrogen treatment or chemical peels. Seborrheic Keratoses and Your Skin Seborrheic keratoses are brown or black growths usually found on the chest and back, as well as on the head. They originate from cells called keratinocytes. As they develop, seborrheic keratoses take on a warty appearance. They do not normally lead to skin cancer. What Causes Seborrheic Keratoses?

Skin Conditions: Moles, Skin Tags & More | Cleveland Clinic There are several skin lesions that are very common and almost always benign (non-cancerous). These conditions include moles , freckles, skin tags, benign lentigines, and seborrheic keratoses. What is a mole? Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Most moles appear in early childhood and during the first 20 years of a person's life. Some moles might not appear until later in life. It is normal to have between 10 to 40 moles by adulthood. As the years pass, moles usually change slowly, becoming raised and lighter in color. Often, hairs develop on the mole. Some moles will not change at all, while others will slowly disappear over time. What causes a mole? Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles might darken after exposure to the sun, during the teen years, and during pregnancy .

What should I look for when examining my moles? Most moles are benign. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 20. If you notice changes in a mole's color, height, size, or shape, you should have a dermatologist (skin doctor) evaluate it. You also should have moles checked if they bleed, ooze, itch, appear scaly, or become tender or painful. Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of your skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, and ears. If your moles do not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, talk to your dermatologist. The following ABCDEs are important signs of moles that could be cancerous.

If a mole displays any of the signs listed below, have it checked immediately by a dermatologist: Asymmetry: One half of the mole does not match the other half. Border: The border or edges of the mole are ragged, blurred, or irregular. Color: The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red. Diameter: The diameter of a mole is larger than the eraser of a pencil. Elevation/Evolution: A mole appears elevated, or raised from the skin. Are the moles changing over time? Melanoma is a form of skin cancer. The most common location for melanoma in men is the back; in women, it is the lower leg. Melanoma is the most common cancer in women ages 25 to 29. What are the different types of moles? Congenital nevi are moles that appear at birth. Congenital nevi occur in about one in 100 people. These moles might be more likely to develop into melanoma than are moles that appear after birth. If the mole is more than eight inches in diameter, it poses more risk of becoming cancerous.

Dysplastic nevi are moles that are larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These moles tend to be hereditary. People with dysplastic nevi might have more than 100 moles and have a greater chance of developing malignant (cancerous) melanoma. Any changes in the mole should be checked by a dermatologist to detect skin cancer. How are moles treated? If a dermatologist believes the mole needs to be evaluated further or removed entirely, he or she will first take a biopsy (small tissue sample of the mole) to examine thin sections of the tissue under a microscope. This is a simple procedure. (If the dermatologist thinks the mole might be cancerous, cutting through the mole will not cause the cancer to spread.) If the mole is found to be cancerous, the dermatologist will remove the entire mole by cutting out the entire mole and a rim of normal skin around it, and stitching the wound closed. What is a skin tag? A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags are benign and are not dangerous.

They are usually found on the neck, chest, back, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in middle-aged and elderly people. Skin tags usually don’t cause any pain. However, they can become irritated if anything such as clothing or jewelry rubs on them. How are skin tags treated? Your dermatologist can remove a skin tag by cutting it off with a scalpel or scissors, with cryotherapy (freezing it off), or with electrosurgery (burning with an electric current). What is a lentigo? A lentigo (plural: lentigines) is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines are more common among Caucasian patients, especially those with fair skin, but can occur in anyone. What are the causes of lentigines? Exposure to the sun seems to be the major cause of lentigines. Lentigines most often appear on parts of the body that get the most sun, including the face and hands. Some lentigines might be caused by genetics (family history) or by medical procedures such as radiation therapy . How are lentigines treated?

There are several methods for treating lentigines: Cryotherapy (freezing it off) Creams that are applied to the skin (These include retinoids and bleaching agents.) Can lentigines be prevented? The best way to prevent lentigines is to stay out of the sun as much as possible. Use sunscreen when outdoors, and avoid using a tanning bed to get a suntan. What are freckles? Freckles are small brown spots usually found on the face and arms. Freckles are extremely common and are not a health threat. They are more often seen in the summer, especially among lighter-skinned people and people with light or red hair. However, freckles can occur in anyone, and appear as darker brown spots in people with darker skin. Both men and women get freckles at an equal rate. What causes freckles? Causes of freckles include genetics, diseases (such as xeroderma pigmentosum, a rare disease that causes an increased sensitivity to ultraviolet light, such as the sun), and exposure to the sun. What is the treatment for freckles? Since freckles are almost always harmless, there really is no need to treat them.

As with many skin conditions, it’s best to avoid the sun as much as possible, or use a sunscreen. This is especially important because people who freckle easily (such as lighter-skinned people) are more likely to develop skin cancer. If you feel that your freckles are a problem or you don’t like the way they look, you can cover them up with makeup. What are seborrheic keratoses? Seborrheic keratoses are brown or black growths usually found on the chest and back, as well as on the head. They originate from cells called keratinocytes. As they develop, seborrheic keratoses take on a warty appearance. What causes seborrheic keratoses? The cause of seborrheic keratoses is unknown. They are seen more often as people get older. They do not lead to skin cancer. How are seborrheic keratoses treated? Seborrheic keratoses are benign and are not contagious. Therefore, they don’t need to be treated.

If you decide to have seborrheic keratoses removed because you don’t like the way they look, or because they are chronically irritated by clothing, methods for removing them include cutting them off, cryotherapy, and electrosurgery. Can seborrheic keratoses be prevented? Seborrheic keratoses can’t be prevented. References: National Institute on Aging. AgePage: skin care and aging . Accessed 2/24/2016. Woodhouse JG, Tomecki KJ. Common benign growths. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010:section 3. © Copyright 1995-2016 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/23/2014...#12014 Spot the difference!

| DermNet New Zealand Home » Topics A–Z » Melanoma. Spot the difference! Spot the difference! Author: Vanessa Ngan, Staff Writer; Copy Editor: Clare Morrison; Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, October 2013. About Melanoma is sponsored by the New Zealand Dermatological Society Incorporated. The first sign of a melanoma is usually an unusual or funny-looking mole or freckle. Look out for: Change in the colour, shape or size of a spot A spot that is itchy, painful or tender One that stands out from other spots – an “ugly duckling” If you find an “ugly duckling” on your skin, see your doctor right away. Melanomas stand out from other spots Superficial spreading melanoma Nodular melanoma Moles and freckles Most moles, spots, freckles and bumps on the skin are harmless, but this is not always the case: About 75% of melanoma are new spots that appear in normal skin – a new ugly duckling. Other melanomas start within an existing mole or freckle – watch out for change.

Normal moles Most people have several normal moles on their skin and a few people have lots of them. These ‘normal moles&rshquo; are also called melanocytic naevi because they are made up of melanocyte cells. Normal moles may be flat or raised and vary in colour from pink to brown or black. The colour depends on how much pigment or melanin is made by the melanocytes. They are mostly round or oval shaped but can sometimes be odd shaped. They can be tiny spots or up to several centimetres in size. Normal moles are harmless but in some cases a melanoma may start from within them. People with lots of moles, especially those with over 100 moles, are at greater risk of getting melanoma than those with few moles. If you start to notice any changes in a mole, it’s best to get it checked out by a doctor. Funny-looking moles Funny-looking moles are also called atypical naevi or dysplastic naevi. These moles are basically normal moles with some unusual features such as large size or an odd shape with blurred edges or a flat and bumpy surface.

Funny-looking moles may look like melanoma but are actually harmless (benign) spots that don’t need to be removed. However, if you have a few, particularly five or more of these funny-looking moles, your chance of getting a melanoma is increased. If you are unsure about any of your funny-looking moles it’s best to get them checked out. Brown spots and freckles Freckles are small flat brown marks that most often appear on the face and other exposed parts of the body in the summer months. They are most often seen in fair-skinned people with red hair but can be seen in people with darker skin colour too. Freckles are formed when the skin is exposed to the sun. Freckles are harmless, but if one starts to look funny compared to others then it’s best to get it checked out. Larger, flat, brown spots on the face and hands that start to appear in middle-aged people, known as age spots or liver spots, are properly called solar lentigines. These occur in people of all skin types if they have spent too much time exposed to the sun.

Solar lentigines are harmless too but because they can sometimes turn into melanoma it is good to get them checked out, especially if they start to change colour or shape. Seborrhoeic keratoses Seborrhoeic keratoses grow in number as we get older. Most people over 40 have at least one of these warty spots, and some people have hundreds. They are stuck on to the skin rather like barnacles and can be clustered around the neck or under the breasts, or scattered all over the body. They can be any colour including white, yellow, brown and black. Seborrhoeic keratoses can be irritating, but are actually harmless. If in doubt – check it out! These are different kinds of moles and freckles Normal moles Brown Spots on Face - Pictures, Causes, Prevention, Treatment, Home Remedies Brown Spots on Face Lemon Juice and Apple Cider Vinegar What are Brown Spots on Face? These brown spots seen on the face are known as freckles. The word freckle is originated from the Middle English word freken, which came from freknur of the Old Norse that means freckled.

These are multiple spots of concentrated melanin which emerge in clusters and mostly seen on individuals with lighter skin tone on their upper-body skin areas including the cheeks, nose, arms and upper shoulders. These brown skin discolorations appear as flat, tanned rounded spots which develop randomly on the skin. Also called as ephelis, these brown spots, in contrast to Lentigines and moles, do not involve an increased number in melanocytes, the melanin producing cells. There are two common and basic types of freckles, namely, the Ephelides and Lentingines. The former, which is a genetic trait, is used to describe a freckle which has a flat, light brown to slightly reddish characteristic and usually disappears during winter seasons. This kind of freckle is more common in people with reddish hair, green eyes and lighter complexions, although they can be seen on other people with variations in skin tones. Using sunblock regularly and avoiding sun exposure can suppress the development of Ephelides. The latter type which is also known as liver spot is a sort of freckle which does not fade away in winter; instead, it forms after many years of cumulative exposure to the sun and is more common in older people.

Predominantly, freckles are visible on the face, but may also appear anywhere especially on sun-exposed areas including the shoulders. Infants rarely have freckles; it is more commonly found in children. Freckles may disappear after some alterations brought by laser therapies and topical creams but may recur upon exposure to the sun. but in some instances, it fades away with age. Brown Spots on Face Causes Genetic Predisposition Anybody can have freckles no matter what their genetic background is; nevertheless, the development of these brown spots is hereditary and is correlated to the presence of the dominant melanocortin-1 receptor MC1R gene variant. Sun exposure The development of freckles is initiated by cumulative sun exposure. The melanocytes are activated once the skin is exposed to ultraviolet B radiation, increasing the production of melanin, thus causing darkening of the spots. Other causes and Predisposing factors Aging Birth control pills Brown Spots on Face Prevention Since the individual’s genetic component of freckling is non-modifiable, preventive measures are focused on sun avoidance and protection. Absolutely, prevention of freckling is much more effective than later attempting to remove them as it becomes more difficult and may sometimes be unsatisfactory.

Use of sunscreens with SPF 30 Use of wide-brimmed hats Avoidance of the peak sun hours of 10 AM to 4 PM Seeking shade and staying indoors. Brown Spots on Face Treatment There are a number of available methods which are both safe and effective in lightening and reducing the appearance of brown spots. Commonly, the following treatment modalities are combined to achieve best results. Still, not everyone’s skin will improve with similar treatments and these spots may easily recur when environmental factors participate in the process. Bleaching or fading creams Retinoids Occasionally used in combination with other bleaching creams, tretinoin helps lighten the skin when applied unfailingly over a recommended period of several months. Cryosurgery In treating some types of freckles, a light freeze with liquid nitrogen can be used but not all spots respond well to freezing and burning. Advertisement Laser treatment Multiple types of lasers can lighten the appearance of brown spots safely and satisfactorily with low risk of scarring and skin discoloration. These may include suitable green and red light devices. Photofacials or Intense Pulsed Light treatments Intense light therapy can vaporize the skin surface, therefore eliminating the pigmented lesion.

Chemical peels This can aid in lightening the freckles and improve irregular pigmentation. Brown Spots on Face Home Remedies Onions Chop up an onion, squeeze the juice out of and dip a cotton ball into the juice and apply on the brown spots Aloe Vera Aloe vera has healing properties which can even out skin color. Vitamin E Vitamin E oil is applied directly on the spots. In addition, Vitamin E supplement can be taken. It is helpful in rejuvenating the skin and also an effective anti-oxidant. Lemon Juice and Apple Cider Vinegar Applying lemon juice on the brown spots is a good way to bleach the discolorations, and result is noticeable after a couple of months of application. Drinking apple cider vinegar can also result to the reduction of the brown spots, and result should be in plain sight in about 5 to 6 months. Brown Spots on Face Pictures Also Read: Sunburn Complications - Mayo Clinic Intense, repeated sun exposure that results in sunburn increases your risk of other skin damage and certain diseases. These include infection, premature aging of your skin (photoaging) and skin cancer. Infection Ruptured blisters make you more susceptible to bacterial infection.

See your doctor if you notice signs or symptoms of infection, which include pain, redness, swelling and an oozing blister. Premature aging of your skin Sun exposure and repeated sunburns accelerate the skin's aging process, making you look older than you are. Skin changes caused by UV light are called photoaging. The results of photoaging include: Weakening of connective tissues, which reduces the skin's strength and elasticity Deep wrinkles Fine red veins on your cheeks, nose and ears Freckles, mostly on your face and shoulders Dark or discolored spots (macules) on your face, back of hands, arms, chest and upper back — also called solar lentigines (len-TIJ-ih-neze) Precancerous skin lesions Precancerous skin lesions appear as rough, scaly patches in areas that have been damaged by the sun. They may be whitish, pink, tan or brown. They're usually found on the sun-exposed areas of the head, face, neck and hands of fair-skinned people. These patches can evolve into skin cancer. They're also called actinic keratoses (ak-TIN-ik ker-uh-TOE-seez) and solar keratoses.

Skin cancer Excessive sun exposure, even without sunburn, increases your risk of skin cancer, such as melanoma. It can damage the DNA of skin cells. Sunburns in childhood and adolescence may increase your risk of developing melanoma later in life. Skin cancer develops mainly on areas of the body most exposed to sunlight, including the scalp, face, lips, ears, neck, chest, arms, hands and legs. Skin cancer on the leg is more common in women than in men. Some types of skin cancer appear as a small growth or a sore that bleeds easily, crusts over, heals and then reopens. With melanoma, an existing mole may change or a new, suspicious-looking mole may develop. A type of melanoma called lentigo maligna develops in areas of long-term sun exposure. It starts as a tan flat spot that slowly darkens and enlarges. See your doctor if you notice a new skin growth, a bothersome change in your skin, a change in the appearance or texture of a mole, or a sore that doesn't heal. Eye damage The sun can also burn your eyes. Too much UV light damages the retina, lens or cornea.

Sun damage to the lens can lead to clouding of the lens (cataracts). Sunburned eyes may feel painful or gritty. Sunburn of the cornea is also called snow blindness. Young AR, et al. Sunburn. Accessed Dec. 4, 2013. Baron ED. Selection of sunscreen and sun-protective measures. Accessed Dec. 4, 2013. Chien AL, et al. Photoaging. Accessed Dec. 4, 2013. Geller AC, et al. Primary prevention of melanoma. Accessed Dec. 4, 2013. Auerbach PS. Wilderness Medicine. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. Accessed Dec. 5, 2013. Bolognia JL, et al. Dermatology. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. Accessed Nov. 25, 2013. The Risks of Tanning. U.S. Food and Drug Administration. Accessed Dec. 4, 2013.

Benzocaine topical products: Sprays, gels and liquids: Risk of methemoglobinemia. U.S. Food and Drug Administration. Accessed Dec. 4, 2013. AskMayoExpert. Sunburn (adult and pediatric). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013. Reed KB, et al. Increasing incidence of melanoma among young adults: An epidemiological study in Olmsted County, Minnesota. Mayo Clinic Proceedings. 2012;87:328. Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. Accessed Dec. 4, 2013. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. Accessed Dec. 4, 2013. Watson M, et al. Preventing skin cancer through reduction of indoor tanning: Current evidence. American Journal of Preventive Medicine.

2013;44:682. Quatrano NA, et al. Current principles of sunscreen use in children. Current Opinion in Pediatrics. 2013;25:122. Reinau D, et al. Outdoor workers' sun-related knowledge, attitudes and protective behaviours: A systematic review of cross-sectional and interventional studies. British Journal of Dermatology. 2013;168:928. Diaz JH, et al. Sun exposure behavior and protection: Recommendations for travelers. Journal of Travel Medicine. 2013;20:108. FDA sheds light on sunscreens. U.S. Food and Drug Administration. Accessed Dec. 10, 2013. Sunscreens. American Academy of Dermatology. #.UbdQaJzm9lP. Accessed Dec. 10, 2013. Wolff K, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. Accessed Dec. 10, 2013.

The cutaneous manifestations of metastatic malignant melanoma. International Journal of Dermatology. 2012;51:243. Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders, Elsevier; 2013. Accessed Dec. 11, 2013. Products and Services Black, dark discoloration of skin - Brown spots and patches | the dynamic natural skin care the dynamic natural skin care Black, dark discoloration of skin - Brown spots and patches Oct 2013 Home › Skin discoloration › Black, dark brown skin discoloration spots and patches Dark brown discoloration of skin and patches is due to hyperpigmentation. Brown discoloration of skin and formation of pigmented patches in most of the cases is caused by excessive production of the melanin pigment. Sun damage, diseases, inflammation, hormonal imbalances, injuries etc. can cause excess pigmentation leading to skin discoloration and the incidence of dark brown skin patches. People with dark skin tones as with Mediterranean, African or Asian origins are more prone for excess pigmentation.

Sun exposure Sun exposure, which has ultraviolet A and ultraviolet B radiation, brings about color changes in two different ways. Initially the Ultraviolet A (UVA) radiation which is usually in the range of 320 to 400 nm., by oxidative stress, causes the release of melanin from the melanocytes and causes its oxidation by combining with oxygen leading to rapid darkening discoloration patches of melanin. Secondly, melanogenesis, which is skin reaction to photo-damage from UV radiation (CPD-DNA damage or direct DNA damage), increases the production of melanin pigment. The tanning or darkening by melanogenesis is a delayed reaction and the brown patches become visible only about three days after exposure. Sunscreens, umbrellas and hats can go a long way in protection from sun damage. Freckles, age or liver patches and lentigines Freckles (aka ephelis) are brown discoloration often visible in people with fair complexion and are concentrated clusters of melanin deposits. Though many people have freckles, their origin is genetic in nature and freckles are triggered by exposure to sun.

Freckles contrast from moles and lentigines in that there is no increase in the number of melanin producing cells. Lentigo (plural lentigines) is a benign hyperplasia (proliferation of cells) of melanocytes. Regardless of sun exposure lentigo is stable in color and differ from moles in its linear spread, whereas moles are multilayer nests of melanocytes. Liver patches are associated with aging and are blemishes on the skin associated with exposure to UV radiation from the sun. These dark brown liver patches particularly form on the face, hands, neck, shoulders and head. Freckles, lentigines and liver patches are benign and harmless and if required can be treated with skin whitening treatments Melasma - brown patches Chloasma or melasma are dark hyperpigmentation patches particularly common in women. Melasma are irregular dark, brown patches of excess pigment found on the nose, upper cheek, lips and forehead causing cosmetic discoloration. Melasma is usually prevalent in pregnant women (mask of pregnancy), women using contraceptives or women under HRT (hormone replacement therapy) medications.

Melasma patches also prevalent in men and women of Jewish descent, Russian descent, German descent and Native American descent. Genetic predisposition, thyroid diseases and female hormones (estrogen and progesterone) are the determining factors of developing melasma. Melanocytic nevus (mole) skin discoloration Melanocytic nevus is a common dark brown growth of the epidermis which are known as birth mark. Melanocytic nevus may form subdermal under the skin or form a pigmented growth on the dermis. Melanocytic nevi present at the time of birth or around the time of birth are called congenital nevi. Melanocytic nevi may also appear in the childhood or later stages of life and their discoloration may range fromlight to very dark brown. Though in most of the cases Melanocytic nevi are harmless, any mole which changes color, shape, size or hurts may have to be investigated as some can turn into melanoma (a type of skin cancer). Addison's disease Addison's disease, a chronic adrenal insufficiency disease, is a rare endocrine disorder wherein adrenal glands malfunction or show functional insufficiency.

Apart from the symptoms like weight loss, weakness, nausea, fever, diarrhea, muscle pains and headache, the Addison's disease affected person suffers from dark brown skin discoloration patches. It can give rise to brown freckles on the face, neck and shoulders and also dark brown skin discoloration patches on the knees, elbows, toes, knuckles and forehead. Alkaptonuria Alkaptonuria or dark urine disease is a rare inherited disorder leading to degradation of tyrosine and production and accumulation of homogentisic acid. Alkaptonuria causes damage to cartilage and heart valves and precipitates formation of kidney stones. Alkaptonuria disorder leads to dark brown patches of skin in sun exposed areas and around sweat glands. Acanthosis nigricans Acanthosis nigricans is brown to dark, velvety, poorly defined skin discoloration. Acanthosis nigricans dark brown skin discoloration patches usually found in the body folds like groins, armpits, neck folds etc. Acanthosis nigricans, typically occurs in persons below 40 years and it is associated with obesity, hormonal anamallies and insulin resistance.

Control of blood sugar and obesity improves the symptoms. Scleroderma diabeticorum and dark brown patches Scleroderma diabeticorum is a rare disorder affecting people with type 2 diabetes. Scleroderma diabeticorum causes thickening of epidermis on the upper back and the back of the neck with excess of dark brown patches melanin deposits. Scleroderma diabeticorum can be treated by bringing blood sugar under control and using moisturizers for softening the epidermis. Dark, brown skin discoloration between thighs and in armpits In some persons, especially in obese persons, the skin between the thighs and also in the armpits gets dark brown discoloration patches due excess melanocyte deposit as a result of excessive sweating and dead cells build-up leading to dermatitis and related fungal infections. Use of antifungal preparations followed by exfoliation and dermabrasion, if necessary, can remove the excess skin pigmentation and the dark brown patches to a great extent. Related topics: Common Benign Growths Common Benign Growths Summary Human skin is subject to a variety of common benign growths, but most never require medical attention.

Management (or lack thereof) requires an appreciation of how such growths appear and behave, coupled with the ability to differentiate them from more serious entities. This article provides a selected compilation of the more common benign growths that affect the skin. Seborrheic keratoses Figure 1: Click to Enlarge Seborrheic keratoses may be the most common benign tumor of the skin. Typically, they are scaly (hyperkeratotic), brown (hyperpigmented), often somewhat greasy plaques that vary in size and thickness and often appear to be stuck onto the skin surface ( Fig. 1 ). They occur on any surface except the palms, soles, and mucosa. They are common in adults, more so with advanced age, and unusual in children. Their cause is unknown, but a genetic predisposition may be present in some families. The sudden eruption of many, often pruritic seborrheic keratoses on the trunk (Leser-Trélat sign) has been implicated as a cutaneous marker of internal malignancy, commonly gastric adenocarcinoma. Evaluation of such patients should include upper endoscopy and age-appropriate cancer screening.

Therapy is usually not necessary unless plaques are pruritic, irritated or inflamed, or of cosmetic concern. When necessary, cryotherapy (liquid nitrogen) or curettage is usually adequate. If the clinical diagnosis is uncertain, a biopsy is warranted. Figure 3: Click to Enlarge Dermatosis papulosa nigra is a condition of hyperpigmented, hyperkeratotic plaques similar to seborrheic keratoses and acrochordons (skin tags), both clinically and histologically. Dermatosis papulosa nigra growths are common and usually are found on the face and neck, with a particular predilection for periorbital skin of darkly pigmented persons ( Fig. 2 ). Approximately 50% of the black population has these benign growths, and women are more affected than men by a ratio of 2 : 1. Therapy is usually not necessary unless the growths become itchy or irritated, although many people desire treatment for cosmetic reasons. Treatment options include scissor excision, curettage, or cryotherapy, all of which can produce hypo- or hyperpigmentation.

Back to Top Sebaceous hyperplasia Sebaceous hyperplasia is a benign enlargement of sebaceous glands surrounding a follicle characterized by small flesh-colored to yellow papules, often with a central dell, on the face of adults ( Fig. 3 ). More common in men and in patients with organ transplants, sebaceous hyperplasia lesions are often numerous, and individual papules can resemble basal cell carcinomas (particularly when accompanied by telangiectasias) or even molluscum contagiosum. Treatment, primarily for cosmesis, includes cryotherapy, curettage, and laser therapy. Ephilides (freckles) Ephilides are small, discrete, hyperpigmented macules on the sun-exposed skin of fair-complected individuals, usually redheads and blonds. Ephilides are not growths per se; they represent focal increased melanin in the skin, and they tend to darken in the summer with increased sun exposure and lighten in the winter. When present in large numbers, they indicate excessive sun (photo) damage and an increased risk of sun-induced skin cancer, including melanoma, basal cell carcinoma, and squamous cell carcinoma.

Ephilides are benign and harmless, and treatment is not necessary. Topical bleaching creams, chemical peels, or cryotherapy can lighten ephilides of cosmetic concern. Figure 4: Click to Enlarge Lentigines are hyperpigmented macules or patches that can resemble nevi (moles). Usually pale tan to brown, they typically appear in white adults and increase in number with advancing age ( Fig. 4 ). Lentigines tend to occur on the sun-exposed skin of the face, neck, upper trunk, forearms, and hands. Unlike ephilides, lentigines are the result of epidermal hyperplasia and of variable proliferation of melanocytes and subsequent melanization. Lentigines are benign, but they occasionally transform into lentigo maligna (superficial melanoma). If change occurs in a lentigo (e.g., rapid growth, change in color or surface contour), a dermatologic evaluation is warranted and a biopsy may be necessary. Many lentigines indicate excessive photodamage and increased risk of sun-induced skin cancer. Like treatment for ephilides, treatment for lentigines is primarily for cosmetic reasons.

Options include cryotherapy, chemical peels, laser therapy, and bleaching creams containing hydroquinone. Figure 12: Click to Enlarge Nevi are common benign growths, usually hyperpigmented or skin-colored macules, papules, or small plaques, probably derived from proliferating altered melanocytes (nevus cells). Age, race, and genetic and environmental factors (primarily sun exposure) all contribute to the development of nevi for any particular patient. Nevi can develop anywhere on the body and usually declare themselves by the early adult years. Most nevi are categorized by histologic subtypes: junctional, compound, or intradermal. Junctional nevi are hyperpigmented macules composed of nevus cells located in the epidermis ( Fig. 5 ); compound nevi are hyperpigmented papules composed of nevus cells in both the epidermis and dermis; and intradermal nevi are brown to flesh-colored soft papules with nevus cells confined to the dermis ( Fig. 6 ). The blue nevus is a well-circumscribed, blue-black, dome-shaped papule commonly mistaken for melanoma.

Blue nevi are collections of nevus cells, melanocytes, and macrophages containing melanin in the dermis. They are most often found on the dorsal surfaces of the hands and feet ( Fig. 7 ). Some nevi may be atypical (dysplastic), perhaps portending melanoma. Signs of atypia or perhaps even melanoma include Asymmetry, irregular Border, uneven or multiple Colors, and large Diameter (>6 mm). These features constitute the ABCDs of melanoma. If such features are present, a dermatologic evaluation is warranted, and a biopsy may be necessary. An excisional biopsy is preferred to allow histologic evaluation of the entire lesion. Persons who have many atypical moles often have a family history of atypical nevi and might have a family history of melanoma. Such persons have an increased risk of melanoma and deserve a regular dermatologic evaluation in addition to regular self examinations. Back to Top Cherry angioma Cherry angiomas are ubiquitous benign vascular growths, usually small red papules or macules, that occur in adults and increase in number with age ( Fig. 8 ).

Angiomas can appear anywhere on the body but tend to be more common on the trunk and proximal extremities. They are invariably asymptomatic but can bleed with trauma. Treatment is not necessary, but laser therapy is the most successful means of destruction for cosmetic purposes. Back to Top Dermatofibroma Dermatofibromas are firm papules or plaques with a dusky red to brown color. They are most commonly found on the extremities ( Fig. 9 ). With palpation, they often seem to retract, giving the dimple sign. Dermatofibromas are benign tumors of fibroblast and histiocytic origin that can follow trauma. They are usually asymptomatic but occasionally are pruritic or irritated. When indicated, therapy involves intralesional corticosteroids or simple excision. Back to Top Acrochordon (skin tag) Acrochordons are pedunculated flesh-colored to brown soft papules commonly found in intertriginous areas such as the neck, axillae, and groin ( Fig. 10 ). Increased numbers of acrochordons tend to occur in obesity and pregnancy.

Occasionally, acrochordons twist and strangulate their blood supply, resulting in pain or irritation, or they become irritated from clothing or jewelry. Treatment with simple snip excision is usually adequate. Back to Top Lipoma Lipomas are benign, soft, mobile tumors of fat that vary in size from a few millimeters to 10 centimeters or more ( Fig. 11 ). Lipomas are characterized by slow growth, with eventual stabilization and little tendency to involute. They are usually solitary and asymptomatic but may be painful if they entrap or compress nerves or if they contain thrombosed vessels (a variant termed angiolipoma). Some familial syndromes exhibit numerous lipomas, such as Proteus syndrome and Gardener's syndrome. A lipoma overlying the sacrum of an infant can indicate an underlying spinal abnormality, a situation that warrants radiographic evaluation. Treatment, when desired or necessary, is either excision or liposuction. Back to Top Epidermal inclusion cyst Epidermal inclusion cysts (EICs) are flesh-colored, firm nodules with a central punctum, usually found on the face or upper trunk of adults ( Fig. 12 ).

The central punctum is the follicular opening from which the cyst is derived. As the name implies, EICs evolve from fully differentiated squamous epithelium trapped in the dermis with accumulation of keratinaceous debris. “EICs” on the scalp are actually pilar cysts or trichilemmal cysts and can be distinguished histologically. The presence of many EICs is occasionally associated with syndromes that have other dermatologic and internal implications, such as Gardener's syndrome. Unless the cyst ruptures, EICs do not require therapy. When they do rupture, inflammation and pain occur that warrant treatment with incision and drainage, warm compresses, and often intralesional corticosteroids and even systemic antibiotics for secondary infection. In that scenario, excision is usually recommended after the inflammation subsides. Back to Top Milium Milia are asymptomatic small white or yellow papules that occur primarily on the faces of women and newborns. These cystic collections of keratin just under the epidermal surface can also occur with porphyria cutanea tarda and other blistering diseases. Treatment is usually for cosmetic reasons and consists of incision followed by expression of cystic contents.

Topical tretinoin may help to treat and prevent milia in affected persons. Figure 13: Click to Enlarge Pyogenic granulomas are solitary, often pedunculated, erythematous papules or small nodules that are often friable and bleed easily with minor trauma. Sites of predilection include the fingers, face, and lips ( Fig. 13 ). Pyogenic granulomas develop rapidly (over the course of several weeks), and the sudden occurrence can be quite alarming to the patient. They probably represent a reactive neovascularization, potentially in response to injury. Pyogenic granulomas are common in pregnancy; termed granuloma gravidarum, they usually arise on the gingival mucosa. Treatment options include curettage, deep shave excision with fulguration of the base, complete excision, or laser ablation. Recurrence is common, especially after incomplete removal.

Question: Freckles, brownish yellow spots usually found mostly on the face, neck and hands are also known as . ?
Answer: Lentigo