DermAtlas: Online Dermatology Image Library dermatology image,fibroma,carcinoma, microcystic adnexal,carcinoma, microcystic adnexal,carcinoma, microcystic adnexal,mucocele,cleft lip,tattoo,cosmetic tattoo,tattoo, cosmetic,carcinoma, basal cell,elastosis, solar,carcinoma, basal cell,elastosis, solar,carcinoma, basal cell,elastosis, solar,burn, chemical,drug reaction,Tea tree oid,melaleuca oil

© 2001-2010, DermAtlas	*Image Name:*	irritation_fibroma_2_091201	*File Type:*	jpg
	*Diagnosis:*	FIBROMA	*Category:*	neoplasm, benign / dental/oral disorder
	*Body Site:*	lip	*Age:*	24 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	Higher power shows a haphazard array of collagen fibers in the stroma. There is minimal inflammation. Mucosal cytologic atypia is not present.
	*Comments:*	Oral fibromas (or irritation fibromas) are probably reactive, and not true neoplasms. They are thought to arise from chronic biting, similar to a prurigo nodule of the skin. The buccal mucosa, inner labial mucosa and tongue are common sites. The histology is characteristic in this case, with a fibrous stroma and thickened epithelium.
	*Related Images:*	irritation_fibroma_1_091201

© 2001-2010, DermAtlas	*Image Name:*	microcystic_adnexal_ca_1_091201	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, MICROCYSTIC ADNEXAL	*Category:*	neoplasm, adnexal, eccrine/apocrine / neoplasm, malignant
	*Body Site:*	lip	*Age:*	70 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	At low power, there is an ill-defined lesion in the dermis. Thre is solar elastosis in the superficial dermis. Epidermis is uninvolved.
	*Comments:*	This elderly women presented with a solitary flesh-colored papule on her lip. Clinically, an epidermoid cyst was suspected. Microcystic adnexal carcinomas (MACs) are rare tumors. They often present on the central face of women, as in this case, with a wide age range. While the incidence is low, the number of times it is included in the differential diagnosis on a superficial shave biopsy is high. Histologically, it mimics other sclerosing adnexal tumors, such as desmoplastic trichoepithelioma and syringoma. MACs tend to infiltrate deep, in the shape of an iceberg, with perineural invasion, while the others are more 'V' shaped and superficial. This is why seeing the entire lesion on biopsy is paramount. Recurrences are common as the borders of the lesion are difficult to define. Cool case!
	*Related Images:*	All related Images microcystic_adnexal_ca_3_091201 microcystic_adnexal_ca_2_091201

© 2001-2010, DermAtlas	*Image Name:*	microcystic_adnexal_ca_2_091201	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, MICROCYSTIC ADNEXAL	*Category:*	neoplasm, adnexal, eccrine/apocrine / neoplasm, malignant
	*Body Site:*	lip	*Age:*	70 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	The tumor consists of small infiltrating nests and cords. Small ductule-like formations are noted. Single cells are also present. The background stroma is sclerotic. Perineural invasion is noted.
	*Comments:*	This elderly women presented with a solitary flesh-colored papule on her lip. Clinically, an epidermoid cyst was suspected. Microcystic adnexal carcinomas (MACs) are rare tumors. They often present on the central face of women, as in this case, with a wide age range. While the incidence is low, the number of times it is included in the differential diagnosis on a superficial shave biopsy is high. Histologically, it mimics other sclerosing adnexal tumors, such as desmoplastic trichoepithelioma and syringoma. MACs tend to infiltrate deep, in the shape of an iceberg, with perineural invasion, while the others are more 'V' shaped and superficial. This is why seeing the entire lesion on biopsy is paramount. Recurrences are common as the borders of the lesion are difficult to define. Cool case!
	*Related Images:*	All related Images microcystic_adnexal_ca_3_091201 microcystic_adnexal_ca_1_091201

© 2001-2010, DermAtlas	*Image Name:*	microcystic_adnexal_ca_3_091201	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, MICROCYSTIC ADNEXAL	*Category:*	neoplasm, adnexal, eccrine/apocrine / neoplasm, malignant
	*Body Site:*	lip	*Age:*	70 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	The infiltrating tumor consists of small basaloid cells with minimal cytoplasm. They are fairly monomorphic. Mitoses are observed, but sparse.
	*Comments:*	This elderly women presented with a solitary flesh-colored papule on her lip. Clinically, an epidermoid cyst was suspected. Microcystic adnexal carcinomas (MACs) are rare tumors. They often present on the central face of women, as in this case, with a wide age range. While the incidence is low, the number of times it is included in the differential diagnosis on a superficial shave biopsy is high. Histologically, it mimics other sclerosing adnexal tumors, such as desmoplastic trichoepithelioma and syringoma. MACs tend to infiltrate deep, in the shape of an iceberg, with perineural invasion, while the others are more 'V' shaped and superficial. This is why seeing the entire lesion on biopsy is paramount. Recurrences are common as the borders of the lesion are difficult to define. Cool case!
	*Related Images:*	All related Images microcystic_adnexal_ca_3_091201 microcystic_adnexal_ca_2_091201 microcystic_adnexal_ca_1_091201

© 2001-2010, DermAtlas	*Image Name:*	mucocele_1_091201	*File Type:*	jpg
	*Diagnosis:*	MUCOCELE	*Category:*	dental/oral disorder
	*Body Site:*	lip	*Age:*	31 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	There is a large cystic cavity filled with eosinophlic mucin. The overlying mucosa appears uninfolved.
	*Comments:*	This woman presented with a history of a growing mass on her inner (mucosal) lower lip. Mucoceles are fairly common and may result from retention of mucus within ducts of minor salivary glands or from rupture, spilling the mucus into the stroma with an associated inflammatory response. This is an extravasation mucocele with mucin lined by foamy histiocytes. Mucoceles are benign, but may mimic malignancies clinically.
	*Related Images:*	mucocele_2_091201

© 2001-2010, DermAtlas	*Image Name:*	Cosmetic_Tattoo_of_Cleft_Lip_1_091120	*File Type:*	jpg
	*Diagnosis:*	CLEFT LIP / TATTOO / COSMETIC TATTOO / TATTOO, COSMETIC	*Category:*	treatment
	*Body Site:*	face / vermillion/ vermilion border / lip	*Age:*	29 years
	*Contributor:*	Cheryl Doss, RN
	*Description:*	scar from cleft lip repair, cosmetic lip tattoo, and 1 month later
	*Comments:*	A 29-year-old woman received a cosmetic tattoo on her lips after multiple surgical interventions including scar revisions. The lip color camouflages the residual scar and simulates a natural-looking vermillion with full lip color.

© 2001-2010, DermAtlas	*Image Name:*	basal_cell_carcinoma_3_090731	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, BASAL CELL / ELASTOSIS, SOLAR	*Category:*	neoplasm, malignant / lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	lip / face	*Age:*	73 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	1 cm annular crusted plaque with overlyign telangiectasias
	*Comments:*	This 73-year-old woman was evaluated for a slowly enlarging crusted plaque on the lateral aspect of the left upper lip. A skin biopsy showed a basal cell carcinoma.
	*Related Images:*	All related Images basal_cell_carcinoma_1_090731 basal_cell_carcinoma_2_090731

© 2001-2010, DermAtlas	*Image Name:*	basal_cell_carcinoma_2_090731	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, BASAL CELL / ELASTOSIS, SOLAR	*Category:*	neoplasm, malignant / lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	lip / face	*Age:*	73 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	1 cm annular crusted plaque with overlyign telangiectasias
	*Comments:*	This 73-year-old woman was evaluated for a slowly enlarging crusted plaque on the lateral aspect of the left upper lip. A skin biopsy showed a basal cell carcinoma.
	*Related Images:*	All related Images basal_cell_carcinoma_1_090731 basal_cell_carcinoma_3_090731

© 2001-2010, DermAtlas	*Image Name:*	basal_cell_carcinoma_1_090731	*File Type:*	jpg
	*Diagnosis:*	CARCINOMA, BASAL CELL / ELASTOSIS, SOLAR	*Category:*	neoplasm, malignant / lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	lip / face	*Age:*	73 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	1 cm annular crusted plaque with overlyign telangiectasias
	*Comments:*	This 73-year-old woman was evaluated for a slowly enlarging crusted plaque on the lateral aspect of the left upper lip. A skin biopsy showed a basal cell carcinoma.
	*Related Images:*	All related Images basal_cell_carcinoma_2_090731 basal_cell_carcinoma_3_090731

© 2001-2010, DermAtlas	*Image Name:*	Tea_tree_oil_burns_1_090617	*File Type:*	jpg
	*Diagnosis:*	BURN, CHEMICAL / DRUG REACTION / TEA TREE OID / MELALEUCA OIL	*Category:*	environmental injury / drug reaction
	*Body Site:*	lip / mouth / face	*Age:*	18 years
	*Contributor:*	Kadiyali Srivatsa, MD
	*Description:*	red edematous crusted patches, papules, plaques
	*Comments:*	This adolescent girl was advised to use Tea tree oil (melaleuca oil) for her acne. The following morning she awoke with swollen lips and a burning sensation on her face. The lesions on her vermillion borders did not exted into her mouth. Oil extracted from the leaves of the Melaleuca alternifolia is said to have antifungal and antibacterial action as well as a beneficial effect on methicillin resistant Staphylococcus aureus skin infections. Tea tree oil can produce contact irritant skin reactions including erythema, erosions, ulcerations which can also involve mucous membranes.