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A 35-year-old woman consults a physician about a lesion on her finger that developed after a minor injury. The lesion is a scarlet, apparently vascular, raised nodule that bleeds easily and does not blanch on pressure. No inflammatory changes are seen in the surrounding skin and the woman reports that the lesion is not uncomfortable, although its cosmetic appearance does bother her. Which of the following is the most likely diagnosis?
A. Dermatofibroma
B. Keloid
C. Keratoacanthoma
D. Pyogenic granuloma
E. Wart
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D agree...dermatofibroma =( legin general + itching) keloid ( healed skin injury+itching) keratoacanthoma ( pilosebaceous gland)
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The correct answer is D.
All of the skin lesions listed are common minor skin problems that you will need to distinguish clinically. This woman has a pyogenic granuloma. This lesion most commonly develops at a site of previous injury, and is best considered a variation of granulation tissue formation. The name is a misnomer, since the lesion is neither related to bacterial infection nor a true granuloma. Microscopically, proliferating blood vessels in an immature fibrous stroma are seen. The lesions can occasionally be confused with dysplastic nevi or malignant melanoma, but are completely benign. Treatment is with surgical excision, curettage, or electrodesiccation.
A dermatofibroma (choice A) is a red to brown, firm, small papule or nodule, often found on the legs.
A keloid (choice B) is a shiny, hard, smooth, often dome-shaped overgrowth of a scar.
A keratoacanthoma (choice C) is a round, firm, flesh-colored nodule with a central crater.
A wart (choice E) is a rough-surfaced, sharply demarcated, round, firm, nodule whose color may be gray, yellow, brown, or gray-black.
