Common Skin Growths: Malignant or Benign?

Common skin growths (medically coined skin neoplasm) can be:

Malignant: A cancerous growth that can spread very quickly and invade nearby tissues
Benign: A non-cancerous growth that usually grows very slowly and does not spread to other areas

When a healthcare provider is consulted regarding a skin growth, the first step in the diagnostic procedure is a physical examination. The diagnostician must examine the skin closely to determine whether the growth is benign or if it has the potential to be malignant.

If a growth appears to have the potential to be malignant, a tissue sample must be sent to the lab and a biopsy must be performed. A biopsy involves looking under a microscope to determine if cancerous cells are present in a tissue sample. 

Here is a closer look at common skin growths, both malignant and benign.

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Malignant Skin Growths

Malignant skin growths (neoplasms) are very common. They often grow and spread uncontrollably and can invade other tissue and organs.

Malignant skin growths can also spread (metastasize) to other parts of the body. 

Many malignant skin growths have identifiable precursor conditions. A precursor is an abnormal group of cells that may turn into cancer. A precursor can also be referred to as pre-cancerous.

Some pre-cancerous skin growths have a low risk of becoming cancerous, while others have a very high risk. An abnormal mole is a precursor for a type of skin cancer called melanoma. 

Types of Malignant Skin Growths

Types of malignant skin growths include:

Melanoma: A type of malignant skin growth that usually arises from a mole, but can arise from normal skin. These commonly appear on the chest and back (in men) and the legs (in women). A malignant mole usually appears brown or black, but may appear pink, tan, or white. They may have areas with different colors and may spread quickly. 
Basal cell carcinoma: The most common form of skin cancer, appears as raised translucent, shiny, pink, red, or pearly bumps, and may have blue, black, or brown areas. Basal cell carcinoma is often a result of sun exposure or tanning beds. This type of skin cancer can be seen on the scalp.
Squamous cell carcinoma: A slow-growing type of skin growth that may appear as flat reddish-brown patches on the face, neck, ears, lips, and the back of the hands. 
Merkel cell carcinoma: A rare and dangerous, fast-growing type of skin cancer that is often difficult to treat. Merkel cell carcinoma often starts in sun-exposed areas of the skin, appearing like firm, pink, red, purple lumps or bumps on the skin that may open up as ulcers.

Kaposi sarcoma: Arises from cells that line lymph or blood vessels, can appear as skin tumors involving areas that form purple, red, or brown blotches or tumors on the inside of the mouth, or other areas of the body.
Lymphoma of the skin: There are different types of skin lymphomas, including T-cell lymphomas and mycosis fungoides. They appear as one or more patchy, red lesions that can be very itchy. The lesions may progress into solid raised tumors of the skin (called plaques).

Visit the American Cancer Society's Skin Cancer Image Gallery to learn more and view images of common types of malignant skin growths.

Diagnosis and Treatment of Malignant Skin Growths

Early diagnosis and treatment of a malignant skin growth are very important. Complete excision (surgical removal) often results in a cure. In fact, complete excision will cure almost all cases of skin cancer if performed in the early stages.

A probable diagnosis of a cancerous skin growth can be made considering some specific factors, including:

The patient's risk factors
The history of the skin growth and its location
The appearance of the skin growth
The texture of the skin growth

A definitive diagnosis can only be made by performing a biopsy and getting the histologic (microscopic analysis of tissue) examination results from the lab.

The ABCDEs of Melanoma

Melanoma is a tumor of cells that form melanin, a malignant growth linked with skin cancer. Often, a melanoma begins as a mole, but it can also arise from normal skin.

When a diagnostician diagnoses and classifies melanomas, they use a specific method of assessing the abnormalities. The method is called the ABCDEs of melanoma. 

The characteristics of skin damage that are considered part of the ABCDEs of melanoma include:

Asymmetry: The definition of asymmetry is when something is not uniformly shaped. Symmetrically round moles are usually non-cancerous or benign; those that are asymmetrical are often melanomas.
Border: Melanoma often involves an irregular-shaped mole with borders that are not well defined; comparatively, a non-cancerous mole has smooth, well-defined borders.
Color: Melanoma lesions often have more than one shade or color; non-cancerous moles are usually one solid color.
Diameter: The size of a normal mole is typically 6 mm (.24 inches) or less in diameter; a melanoma is usually larger than 6 mm in size.
Evolution: Melanoma often changes in size, shape, and color; benign moles don't usually change over time.

Changing Moles

If you notice a change in a mole over time, or you notice any of the other signs of the ABCDEs of melanoma, be sure to consult with your healthcare provider as soon as possible.

Benign Skin Growths

Benign skin growths are common, and most of them do not require any type of medical treatment. An important intervention, when it comes to benign skin growths, is to know the common signs and symptoms of those that may be cancerous, and to seek medical care when skin growths look suspicious.

Common types of benign skin growths include:

Seborrheic keratoses: Appear as scaly, brown, and sometimes greasy plaques that can vary in size and thickness. Treatment may be needed if the plaques are itchy, irritated, or inflamed. Treatment may include cryotherapy (liquid nitrogen) or curettage (the use of a specific tool to scrape or scoop tissue). A biopsy could be ordered if the diagnostician deems the area is suspicious.
Cherry angioma: Benign vascular growths that appear as small red macules or papules anywhere on the body (but more common on the trunk and extremities). Treatment is not necessary, but laser surgery is often performed for cosmetic reasons.
Dermatofibromas: Firm papules or plaques, dusky red to brown, found most often on the arms and legs. Dermatofibromas do not usually cause any symptoms, but they can be itchy or cause irritation. Treatment may involve corticosteroids to relieve itchiness, or they may be removed using a simple excision method.

Lipomas: Soft, slow-growing fat tumors that can grow to 10 cm (3.9 inches) or larger. They do not usually cause any symptoms, but if they compress a nerve, they can be painful. Note, when an infant has a lipoma over the sacrum area, it can be a sign of a spinal abnormality that would warrant further evaluation. If treatment is needed, it usually involves excision or liposuction.
Nevus (mole): A mole is a hyperpigmented or skin-colored raised papule or small plaque, derived from melanocytes (cells that produce melanin). Sometimes a mole can be bluish-black colored, called a blue nevus, which is often mistaken for melanoma. 
Skin tags (acrochordon): Flesh-colored or brown, soft papules usually found in the neck, under the arm, or in the groin. They may become irritated or cause pain as a result of cutting off the blood supply. Treatment may involve a minor excision procedure when these benign skin growths become bothersome.
Pyogenic granulomas: Solitary, small nodules or papules that often appear on the face, lips, and fingers. These benign skin growths may develop quickly and are common during pregnancy. Treatment may involve laser ablation, curettage, or excision, but often this type of skin growth reoccurs.

Cysts (epidermal inclusion): Flesh-colored, firm nodules with a small dome-shaped projection in the middle, called a punctum. The punctum is the opening of a hair follicle (which is where they arise from). Cysts do not require any type of treatment unless they rupture. A ruptured cyst may involve pain and inflammation and may need to be incised and drained. Other treatment modalities may include corticosteroids (for inflammation) and antibiotics (for infections). Once the inflammation subsides, excision is usually the mode of treatment.
Dermatosis papulosa nigra: A skin condition involving hyperpigmented, keratotic plaques (similar to those seen in seborrheic keratosis and skin tags). The skin growths seen in dermatosis papulose nigra are common among the Black population; treatment is not necessary unless the growths become irritated or itchy. Treatment may involve curettage, cryotherapy, or scissor (snip) excision.
Lentigines: Hyperpigmented patches or macules that are pale tan to brown and look similar to moles. Lentigines commonly occur on the upper trunk, face, neck, hands, and forearms. They are usually benign, but can change into a malignant skin growth called "lentigo maligna" (superficial melanoma). Signs to watch for in benign lentigines include a change in color or a change in the outline of the growth. A biopsy may be needed.

A Word From Verywell

Keep in mind that although most skin growths are benign, knowing the signs and symptoms to look for suspicious growths is important.

Also, some benign growths can be a sign of something more serious (such as a hormonal disorder). If you are unsure, or if a skin growth is symptomatic, changes in appearance, or shows signs of malignancy, be sure to seek medical attention as soon as possible.

When it comes to malignant skin growths (skin cancer), early intervention is imperative to successful treatment outcomes.

 

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