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Uncommon Benign Tumors

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Botulinum toxin A
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Epinephrine
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Diphenoxylate/atropine
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Glycopyrrolate
George Martin, MD Dr. George Martin Dermatology Associates

Dr. George Martin is a native of Philadelphia. He completed his undergraduate education at the University of Pennsylvania. Dr. Martin received his medical degree from the Temple School of Medicine. He completed his residency in internal medicine at the Medical College of Pennsylvania and his dermatology residency at UCLA. He is American Board Certified in both dermatology and internal medicine. Dr. Martin has practiced clinical dermatology in Maui since 1989. He has been a clinical preceptor for numerous medical students and residents and has received several teaching awards. As a practicing clinician, clinical investigator, and internationally recognized lecturer his current areas of interest include cutaneous oncology, psoriasis, atopic dermatitis, acne and connective tissue disorder diseases. Dr. Martin has published in several medical and scientific journals. He is founder and program chairman of the internationally recognized dermatology meeting: Maui Derm: Advances in Cosmetic and Medical Dermatology. Dr. Martin is also co-founder of the key thought leaders meeting in rheumatology: Rheumatology Winter Clinical Symposium. His interest in evidence based medicine led to his creation of the Delphi-based Consensus Conferences in the areas of psoriasis, acne, atopic dermatitis, and rheumatoid arthritis. He is a contributing editor to the Journal of Clinical and Aesthetic Dermatology and the SkinMED Journal as well as a past editor of the Yearbook in Dermatology In 2012, Dr. Martin was awarded the "Palaka Award", Maui County’s highest award for community service.

Whitney High, MD, JD University of Colorado School of Medicine

Dr. High received his Bachelor's and Master's degree in Chemical Engineering from the Colorado School of Mines in Golden, Colorado. After spending time in the industry, he returned to medical school to earn his degree from Mayo Clinic School of Medicine in Rochester, Minnesota where he graduated at the top of his class. Dr. High next completed his internship at P/SL Medical Center in Denver, Colorado, followed by a dermatology residency at the University of Texas Southwestern Medical Center in Dallas, Texas, where he served as a Chief Resident. A dermatopathology fellowship was completed at the University of Colorado, where he remained upon faculty and serves as the Director of the University's large Dermatopathology Lab. Dr. High has studied abroad, earning a diploma in Tropical Medicine & Hygiene from the Gorgas Institute in Lima, Peru. He is a diplomate of the American Board of Dermatology, with Special Qualification in Dermatopathology from the American Board of Pathology. He is also a graduate of the University of Denver Sturm School of Law, where he graduated third in his class while working full time as an attending physician. Dr. High serves as an Assistant Editor for the Journal of the American Academy of Dermatology, and he serves on the editorial board of other journals as well. His research lab was the first to discover the accumulation of gadolinium in nephrogenic systemic fibrosis. He is the recipient of numerous honors and awards. Dr. High is an author of a large number of medical papers and book chapters, and even several textbooks. Dr. High's wife, Dr. Misha Miller, is a dermatologist/Moh's surgeon, and also an obstetrician/gynecologist, and they have two small children, residing in Denver, with his extended family.

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Ask the Expert

Recent Questions

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1. Which of the following benign adnexal tumors is derived from hair follicles?

Select only 1 answer.

  1. A. Syringoma
  2. B. Leiomyoma
  3. C. Trichoepithelioma
  4. D. Eccrine Hidrocystoma

2. What is the primary histological difference between trichoepithelioma and basal cell carcinoma?

Select only 1 answer.

  1. A. Presence of peripheral palisading
  2. B. Presence of clefting between stroma and basaloid islands
  3. C. Presence of angiofibrotic stroma
  4. D. Extensive cellular atypia

3. Which of the following syndromes is associated with multiple familial trichoepitheliomas?

Select only 1 answer.

  1. A. Schopf-Schulz-Passarge syndrome
  2. B. Goltz-Gorlin syndrome
  3. C. Brooke-Spiegler syndrome
  4. D. Muir-Torre syndrome

4. Desmoplastic trichoepitheliomas are most commonly confused with which malignancy in the clinical differential diagnosis?

Select only 1 answer.

  1. A. Squamous cell carcinoma
  2. B. Basal cell carcinoma
  3. C. Merkel cell carcinoma
  4. D. Sebaceous carcinoma

5. Which of the following features distinguishes eccrine hidrocystoma from apocrine hidrocystoma?

Select only 1 answer.

  1. A. Apocrine hidrocystoma shows fluctuation in size
  2. B. Apocrine hidrocystoma has a bluish tinge
  3. C. Apocrine hidrocystoma has multiple loculations
  4. D. Eccrine hidrocystoma is associated with hyperthyroidism

6. Which of the following treatments is recommended for treating multiple trichoepitheliomas on the face?

Select only 1 answer.

  1. A. Shave biopsy followed by electrodessication
  2. B. Mohs micrographic surgery
  3. C. Needle drainage
  4. D. CO2 laser resurfacing

7. A 45-year-old woman presents with multiple small, firm, skin-colored papules symmetrically distributed around her eyelids. These lesions are asymptomatic. Which of the following is the most likely diagnosis?

Select only 1 answer.

  1. A. Granulomatous rosacea
  2. B. Syringoma
  3. C. Sebaceous hyperplasia
  4. D. Trichoepithelioma

8. Which of the following benign tumors is associated with pain, particularly in response to cold temperatures?

Select only 1 answer.

  1. A. Leiomyoma
  2. B. Syringoma
  3. C. Trichoepithelioma
  4. D. Eccrine Hidrocystoma

9. Which feature is commonly associated with syringomas on histology?

Select only 1 answer.

  1. A. Large basaloid islands with peripheral palisading
  2. B. Tadpole-shaped ductal structures in fibrous stroma
  3. C. Cellular atypia and mitotic figures
  4. D. Clefting between stroma and epithelial cells

10. Which of the following treatment methods is most effective for desmoplastic trichoepithelioma?

Select only 1 answer.

  1. A. Electrodessication and curettage
  2. B. Shave excision
  3. C. Mohs micrographic surgery
  4. D. CO2 laser ablation

11. A patient with Graves' disease presents with multiple fluid-filled papules on the lower eyelids. Which diagnosis is most likely?

Select only 1 answer.

  1. A. Apocrine hidrocystoma
  2. B. Eccrine hidrocystoma
  3. C. Syringoma
  4. D. Basal cell carcinoma

12. Which of the following clinical signs is most characteristic of eccrine hidrocystomas?

Select only 1 answer.

  1. A. Painful lesions that worsen with cold
  2. B. Tense, fluid-filled papules that increase in size with heat
  3. C. Pearly nodules with telangiectasias
  4. D. Firm nodules with a central punctum (dilated pore)

13. Which uncommon benign skin tumor is associated with Reed's syndrome; a hereditary condition linked to an increased risk of renal cell carcinoma?

Select only 1 answer.

  1. A. Syringoma
  2. B. Trichoepithelioma
  3. C. Leiomyoma
  4. D. Eccrine hidrocystoma

14. Which of the following histological features helps differentiate desmoplastic trichoepithelioma from morpheaform basal cell carcinoma?

Select only 1 answer.

  1. A. Presence of papillary mesenchymal bodies
  2. B. Retraction between tumor cells and stroma
  3. C. Peripheral palisading of tumor cells
  4. D. Necrosis and ulceration

15. Which of the following is a characteristic of syringomas?

Select only 1 answer.

  1. A. Yellowish nodules commonly found on the scalp
  2. B. Symmetrically distributed small papules around the periocular region
  3. C. Single, large, painful nodules on the extremities
  4. D. Blue-tinged fluid-filled lesions on the face

16. Which tumor is likely to respond best to CO2 laser ablation?

Select only 1 answer.

  1. A. Syringoma
  2. B. Desmoplastic trichoepithelioma
  3. C. Trichoepithelioma
  4. D. Eccrine hidrocystoma

17. Which of the following benign tumors can present with both cystic and solid nodules, particularly on the face, and is associated with Brooke-Spiegler syndrome?

Select only 1 answer.

  1. A. Sebaceous adenoma
  2. B. Trichoepithelioma
  3. C. Apocrine hidrocystoma
  4. D. Pilomatricoma

18. In the differential diagnosis of desmoplastic trichoepithelioma, which malignancy is known to have a similar annular clinical presentation?

Select only 1 answer.

  1. A. Sebaceous carcinoma
  2. B. Basal cell carcinoma
  3. C. Merkel cell carcinoma
  4. D. Squamous cell carcinoma

19. Which of the following lesions clinically may be confused with granulomatous rosacea?

Select only 1 answer.

  1. A. Syringoma
  2. B. Eccrine hidrocystoma
  3. C. Leiomyoma
  4. D. Trichoepithelioma