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Dr. Zain Husain, Heather, and Courtney discuss the top 10 benign findings commonly seen on skin exams, describing how they look, where they appear, and when they may be confused with skin cancer. They cover seborrheic keratoses, cherry angiomas (and related vascular lesions), skin tags (including DPNs), benign moles/nevi with the ABCDEs and “ugly duckling” concept, lentigines (“liver spots”) versus freckles and the risks of cosmetic laser treatment without proper evaluation, dermatofibromas and the malignant DFSP, milia and look-alikes, sebaceous hyperplasia and its overlap with basal cell carcinoma, idiopathic guttate hypomelanosis, and fibrous papules/angiofibromas. They emphasize avoiding at-home removal, using dermoscopy and biopsy when warranted, and getting lesions checked if changing or symptomatic.
00:00 Welcome Skin Side Out
00:18 Seborrheic Keratoses
03:20 Cherry Angiomas
07:54 Skin Tags Basics
09:55 Dont DIY Removal
11:33 Giant Skin Tag Story
15:05 Benign Moles ABCDEs
18:02 Dermoscopy and raised moles
19:29 New moles and normal changes
20:33 Trust symptoms and biopsy
21:30 Lentigines and sun spots
23:43 Laser risks and melanoma
24:42 Freckles vs liver spots
26:10 Dermatofibroma and dimple sign
28:46 DFSP warning signs
29:58 Milia and safe extraction
33:06 Sebaceous hyperplasia lookalikes
36:42 Idiopathic guttate hypomelanosis
39:15 Fibrous papule on the nose
40:53 Final takeaways and skin checks
Creators and Guests
Host
Host
What is Skinside Out?
Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.
[00:00:00] Dr. Zain Husain, MD: We are like skin nerds on the verge of weirdos. Yeah. But that's why we love what we do. Welcome to Skin Side Out. I'm your host, Dr. Zane, with Heather and Courtney. So today, we're gonna be talking about the top 10 benign things we see on a skin exam from the inside out. So let's get right into it. So we're gonna be showing some images on the screen, but we'll also be describing it for our listeners at home.
Um, so Heather, I'd like you to take the first one.
[00:00:34] Heather Murray, PA-C: So the first one is seborrheic keratoses, or the singular is seborrheic keratosis. Um, these are, like we can see in the photo, um, really stuck on, typically brown lesions. Um, sometimes they can be flat. Sometimes they can be, like, skin colored, but this is kind of like a classic look to them.
They have a very, like, waxy, warty kind of look. Some people call them barnacles. Um, they are- What do you like to
[00:01:03] Dr. Zain Husain, MD: call them?
[00:01:04] Heather Murray, PA-C: Wisdom spots or, um- No, no, no, no.
[00:01:06] Dr. Zain Husain, MD: Weeds of-
[00:01:06] Heather Murray, PA-C: Weeds in the garden of life. They do- That's so
[00:01:09] Dr. Zain Husain, MD: poetic.
[00:01:11] Heather Murray, PA-C: They do come with time. Um, they are genetic, so, um... And they're also... You can get them anywhere, but they are very common in areas of friction.
So, like for females, very common, like where necklaces lie, bra straps, under the breasts. Um, but you could have it anywhere.
[00:01:27] Courtney Carroll, LE: I think a lot of people, um, also mistake these for melanoma- Mm-hmm ... because sometimes they can look really dark and scary and brown and just- And they can have, like, black dots and- Pieces coming out.
Yeah. Yeah, black dots. So I think a lot of times you'll see someone that's like, "I have a melanoma," and then you look and you're like, "Oh, that's just a SK." Yeah. And they- And sometimes
[00:01:44] Dr. Zain Husain, MD: they can be symptomatic, so they can get itchy. They can sometimes you know, have some pain associated- Mm-hmm ... especially if it's, like, you know, being scratched off.
So that's something that we tell our patients, "Oh, like if you have a lesion that has symptoms such as, you know, itching, bleeding, um, you know, it's concerning," but oftentimes they're seborrheic keratoses.
[00:02:04] Heather Murray, PA-C: Yeah. They can be treated with liquid nitrogen. There are also some lasers that can treat them as well.
Um, typically it's considered cosmetic. There's nothing that you can do to prevent them. Um, but those are typical ways that we can treat it. We also used to use... I don't know if you used it a lot, but, like, um, I'm branking- blanking on the brand name, but, like, a high percentage of hydrogen peroxide.
Mm-hmm.
Um, it seems to work, but it's not- But it was very expensive. Yeah, it's very expensive. Yeah.
[00:02:35] Dr. Zain Husain, MD: Um, Escota, right? Yeah. Yeah. Yeah. Um, so I think that these are completely harmless. They don't need to be treated unless they're irritated or they bother you cosmetically. And you can be covered with hundreds of these.
Mm-hmm. Mm-hmm. So, you know, patients get really alarmed, like, "Oh, how can you tell what's, you know, a mole versus an SK?" It takes a lot of training and being able to decipher, um, what these lesions are. And dermatoscopically, we- are able to see certain clinical findings, um, those keratin, um, horn cysts- Mm-hmm
um, we can visualize, and that tends to help us with distinguishing that between other skin lesions. Mm-hmm. All right, so SKS done. So we have this beautiful red papule. What do we have here, Courtney?
[00:03:28] Courtney Carroll, LE: This is a cherry angioma. Um, basically these are just a benign collection of blood vessels under the skin, so sometimes people will notice that if they pick at them it will bleed a lot because it's all those little blood vessels in there.
Um, I've heard them called blood moles before- ... which I think is like- Hmm ... number one- Hmm ... a cool band name. Um, and number two- ... it's just, like, a funny, um... I guess technic- you know, they're not a mole, but it is funny to think about, like, a little blood mole.
[00:03:55] Dr. Zain Husain, MD: And it's funny how many patients freak out about this too.
Mm-hmm. Yeah. And like, "Oh my God, I'm getting so many of these," and, you know, they're, like, worried it's, like, a sign of something serious like cancer. Mm-hmm. But these are also genetically- Mm-hmm ... um, derived, and many times there's a family history of having them. You will get more as you age, just like with seborrheic keratosis.
So nothing to worry about. However, if they do bother you, you know, there are treatment options, right? Mm-hmm. So we can use lasers, um, that are vascular specific. We can use electrocautery. Um, some people even use, um, liquid nitrogen on these, and sometimes that can help, um, or shave and cauterize.
[00:04:30] Courtney Carroll, LE: Mm-hmm.
Yeah. It's fun to to laser them. I mean, they'll turn this nice purple dusky color- Mm-hmm ... um, usually immediately and, um, yeah, it's- It's very satisfying. Yes. It's so satisfying. My mom, um, I've told them this, but my mom has, like, 100 of these things, and- Didn't
[00:04:45] Dr. Zain Husain, MD: we do some test fires on them? Yeah.
[00:04:47] Courtney Carroll, LE: She has, like, that big one on her thigh, and that cleared up- Mm
which I loved seeing. Um, but she's just so prone to them, and I've started seeing some appearing on me so. Yeah. Yeah. Always in the laser room. And your
[00:04:57] Dr. Zain Husain, MD: SK's, right?
[00:05:01] Courtney Carroll, LE: I don't have an SK yet, okay? I'm not there. I
[00:05:04] Heather Murray, PA-C: think
[00:05:04] Courtney Carroll, LE: I have an SK. Yeah. I feel like an SK is, like, your- It's tiny. Yeah. It, it's, like, your sign of aging.
Like, when you get that first SK, like, ugh, can't be talked about.
[00:05:12] Dr. Zain Husain, MD: And by the way, I was just kidding. No judgments. He's
[00:05:14] Courtney Carroll, LE: judging,
[00:05:15] Dr. Zain Husain, MD: obviously.
[00:05:16] Heather Murray, PA-C: Um- Another reason why we get cherry angiomas is when our skin cells turn over faster, um, sometimes they just, like, make a mistake and pop that little blood mole- Mm-hmm
um, up there. So like Courtney said, it's not really a mole, but it's just kind of, like, a mistake. Yeah.
[00:05:36] Dr. Zain Husain, MD: And these are, like, superficial capillaries. Um, that's why it's so intensely red. The blood's flowing through them. Um, there are variations of them. Um, so they can be more ve- veins and, like, venous blood going through it, so it's more of a purple, violaceous color.
So sometimes it can be really dark. Sometimes it almost looks even black.
[00:05:54] Heather Murray, PA-C: Mm-hmm.
[00:05:54] Dr. Zain Husain, MD: Um, and then when you look under a dermoscopy, you can kind of see that purplish tinge, and this- beautiful, like, cluster. It's almost like a raspberry. Mm-hmm. Um, that's how I describe it. Um, kind of a texture, and that gives it away that, you know, this is a vascular lesion.
[00:06:09] Heather Murray, PA-C: Mm-hmm.
[00:06:09] Dr. Zain Husain, MD: Um, there's other variations, like pyogenic granulomas, also highly vascular. Um, and these can ulcerate and bleed, so oftentimes we see patients come into the office, "Hey, I got this bleeding blood blister." Mm-hmm. And oftentimes, you know, it's a pyogenic granuloma. We treat it, um, and oftentimes, um, you know, it cures it.
Um, there's also another variation called, um, you know, those angiokeratomas. Um, these are also more like vein-like lesions. They're more purple. Um, and interestingly enough, it can be found on scrotums, on men, and that's the most common area we see them. And I've treated many patients. Um, you know, some guys are self-conscious about it.
Um, they're completely harmless, but sometimes they can bleed, um, spontaneously or with, you know, manscaping. So some of the you know, patients come in, and they wanna treat it, and I use a vascular laser. I had this guy a few months ago, maybe 200 plus angiokeratomas- Mm ... on his scrotum, and he did awesome.
He did really, really well. Um, with two sessions we were able to clear the vast majority of the angiokeratomas. He felt a lot better about himself, um, and that's really satisfying.
[00:07:21] Heather Murray, PA-C: Did you use cautery or laser?
[00:07:23] Dr. Zain Husain, MD: Laser.
[00:07:24] Heather Murray, PA-C: Okay. Nice. Yeah,
[00:07:24] Dr. Zain Husain, MD: so I used, um, the Nd:YAG laser, and we targeted the, you know, the venous blood, and it worked really well.
what happens when we see an angioma bleed? Um, is that a cause for concern?
[00:07:40] Heather Murray, PA-C: No.
[00:07:41] Dr. Zain Husain, MD: Yeah. Um, typically these are pretty superficial. They can be, you know, controlled with just pressure most of the time. But if you kinda get a recurrent angioma that bleeds, um, it's probably a good idea just to get it cauterized.
[00:07:53] Heather Murray, PA-C: Mm-hmm.
[00:07:54] Dr. Zain Husain, MD: All right. Next up we've got this fleshy skin-colored papule. What is this, Heather?
[00:08:01] Heather Murray, PA-C: Probably a skin tag. Maybe an intradermal nevus. Yeah. No, um, skin tags are very common. Um, most people know what a skin tag is. They're actually, um, kind of related to seborrheic keratoses. So, um most of them are pedunculated, meaning, like, they have a little stalk on the- I love that word, by the way.
One of my... Oh, me too.
[00:08:26] Courtney Carroll, LE: I love that. I love that word, pedunculated.
[00:08:28] Heather Murray, PA-C: Yeah.
[00:08:28] Courtney Carroll, LE: Like, fun word. Yeah, it's just
[00:08:30] Heather Murray, PA-C: like a little stalk at the little stem. Mm-hmm. Um, sometimes they're small, sometimes they're really big. Nothing to worry about. They're also common in areas of friction. Genetics can play a role. Um-
[00:08:41] Dr. Zain Husain, MD: I even see the hormonal changes too.
Mm-hmm. Um, pre-diabetics and diabetics. Yeah. Um, perimenopausal, menopausal women can sometimes get this. Mm-hmm. Um, obese patients. Um, so often- You know, there's some relation with metabolic syndrome, so there's some dysfunction of hormones.
[00:08:58] Heather Murray, PA-C: Mm-hmm.
[00:08:58] Dr. Zain Husain, MD: Um, are they dangerous?
[00:09:00] Heather Murray, PA-C: No.
[00:09:00] Dr. Zain Husain, MD: Are they annoying?
[00:09:01] Heather Murray, PA-C: Yes.
[00:09:02] Dr. Zain Husain, MD: Yes. Yeah, they can be annoying, and patients often come to us, um, you know, for treatment.
So this is a cosmetic service. We typically use electrocautery for destruction. You can use liquid nitrogen. You can snip and clip. I mean, old school, but it works.
[00:09:17] Courtney Carroll, LE: Mm-hmm. You... I shouldn't say this. I told my ex-boyfriend's mom to do this. I was like, "Just put dental floss on it." Well- I did not wanna deal with that
no, you did not. I had-
[00:09:24] Heather Murray, PA-C: I did, 'cause I know... Mm. Oh, my God. I had a patient- I know ... come in one time, and she was like, "I really want this skin tag removed on my chest. I tried to, to remove it with dental floss." Mm-hmm. "I just, like, tied the dental floss really tight." So cut the blo- blood flow off. Yeah, but then she was like, "But it didn't work, and the dental floss is still on there."
Yeah. I've, I've
[00:09:44] Courtney Carroll, LE: seen- So it's, like, wrapped around. I've seen that a lot where, yeah, the dental floss, like, is... Number one, they can't even cut it off 'cause it's so tight at that point. Yeah. And then it's stuck on there, and they're like, "Can you get both things off?" Yeah.
[00:09:55] Dr. Zain Husain, MD: Yeah. And, you know, along those lines, should you be treating these at home?
The answer is no. I've actually-
[00:10:02] Courtney Carroll, LE: 100% no ... No. I just would not care for that one. I had a
[00:10:04] Dr. Zain Husain, MD: patient, I had a patient who took a knife and tried to, like, cut it off. Started bleeding, then it got infected. Oh, my
[00:10:12] Heather Murray, PA-C: gosh. Um,
[00:10:13] Dr. Zain Husain, MD: and, you know, that led to an ER visit- Mm-hmm ... antibiotics, I mean, the whole cellulitis picture.
You don't wanna do that. I mean, yes, it'll cost a little bit of money, but you'll get it done right. Mm-hmm. You can get multiple done at the same time. You'll be numb. You'll, um... I mean, sanitation.
[00:10:29] Heather Murray, PA-C: Yeah. I think I have had a couple patients, um, say that they've tried, like, nail clippers. Ooh. Oh, God. Yeah. I've, I've actually heard
[00:10:36] Courtney Carroll, LE: that too.
Yeah. Yeah. And when... Like, when I used to- That's not cool ... be a medical assistant, like, take people back, they would tell me, they'd be like, "I tried to remove it with nail clippers." Eh, I would hope to God that you sanitized those clippers before. You just, like, you know? Yeah. Who knows? Yeah.
[00:10:50] Dr. Zain Husain, MD: Yeah. Don't be a hero.
Just come into the office. We'll take care of it. It's really easy. Um, so there are variations of skin tags as well. So, um, what about those lesions that we see on people's faces? Sometimes it can be flat. Sometimes they're a little bit fleshy. Um, often hyperpigmented. What are those called?
[00:11:12] Heather Murray, PA-C: DPNs. Yeah.
Dermatosis papulosa nigra. Mm-hmm. Um, which is more common in skin of color. Um, but like Dr. Hussain mentioned, it's mostly, like, a pigmented skin tag.
[00:11:26] Dr. Zain Husain, MD: Yeah. Um, and you know, most of them are pretty small and not noticeable, but sometimes they can grow. So let's tell, let's talk about that story- Oh, gosh ... and my patient.
You love that story. I do. I feel like we've talked about it before. Oh, my God, I, I, I should post a picture of that skin tag. Yeah. So I had a patient who had this skin tag that started growing from his butt Like right by the, you know, gluteal cleft, the crack, and it kept growing. It grew like a tail.
Literally, there was like a cord. It literally was. It was like a cord, and like it had its own pulse. And it g- had this like fleshy bottom, and it was like dangling. It was about 10 centimeters, right? It w- it would be dangling from his butt- It was a fistful, yeah ... down to his knees. Yeah.
[00:12:08] Courtney Carroll, LE: Well, that's- Well, no, it wasn't that far
not knees. Oh, thighs.
[00:12:13] Dr. Zain Husain, MD: I... Mid-thigh,
[00:12:13] Courtney Carroll, LE: mid-thigh.
[00:12:15] Dr. Zain Husain, MD: But anyway, it looked like a tail coming out of his butt.
[00:12:17] Courtney Carroll, LE: It did.
[00:12:18] Dr. Zain Husain, MD: And he also tried to chop it off, and started bleeding, having a lot of pain, had to go to the ER. And we actually excised it in the office. And let me tell you, that thing was hard to excise. It was thick-
[00:12:31] Courtney Carroll, LE: Look
[00:12:31] Dr. Zain Husain, MD: at that blood flow
vascular. Mm-hmm. It's g- it had blood vessels, like pretty significant ones. Mm-hmm. It had its
[00:12:34] Heather Murray, PA-C: own
[00:12:35] Courtney Carroll, LE: ecosystem. It
[00:12:36] Dr. Zain Husain, MD: really was. It was special.
[00:12:37] Heather Murray, PA-C: Well, the thing, the weird thing was when he came into the office, he was just like, "I have a skin tag I want removed." Yes. Yeah. Like so nonchalant. We're like, "Okay, do you mind if we take a look?"
And then it was like- ... "Oh," like that's a pretty large skin tag. Yeah. Like literally it was like...
[00:12:54] Dr. Zain Husain, MD: Large is an understatement.
[00:12:56] Courtney Carroll, LE: Yeah.
[00:12:56] Dr. Zain Husain, MD: Yeah, that one thing was a monster.
[00:12:58] Courtney Carroll, LE: Yeah. It's like when you like watch Dr. Pimple Popper, and you see- Yeah ... someone go in with like an abscess that's like the size of like their head.
And you're like- Mm-hmm ... "Man, how'd you let it, like go that long?" That was like the same
[00:13:09] Heather Murray, PA-C: sentiment. And we're talking about this very lightly, but I think, like don't feel ashamed- Mm-hmm ... if you have something like this. Like we see it all the time. It is kind of satisfying a little bit to see these- Yeah
like, um, these things that we don't commonly see. Like we don't commonly see skin tags that big. Mm-hmm. This excites us. Like
[00:13:28] Courtney Carroll, LE: not in a negative way, like in a fun, like it's exciting. We wanna help you. Yeah.
[00:13:33] Dr. Zain Husain, MD: Yeah. We are like skin nerds on the verge of weirdos. Yeah. But that's why we love what we do. Yeah. Um, but he was very happy- Yeah
after his result. His butt looked so much better.
[00:13:46] Courtney Carroll, LE: I would ima- I would imagine he felt better. Yeah. And you know
[00:13:48] Dr. Zain Husain, MD: what? Like it was interfering with his daily life, right? Yeah, he was probably not sitting. With that thing, like sitting, and I think he worked in construction or something physical. Mm-hmm. So like, I think that's really what prompted him to actually get treatment.
[00:13:58] Courtney Carroll, LE: This is like a crazy question to ask. This is crazy. Yeah. But do you think if he was like sitting on the toilet, do you think it touched the water? Probably.
[00:14:06] Dr. Zain Husain, MD: Yeah. Oh, I never even thought about that. It touches it without a
[00:14:09] Courtney Carroll, LE: doubt, without a doubt. Only you would think of that. I would because like I just feel like that in, in a sense would like drive- Yeah
I need it off, like yeah. 'Cause the stock was probably like this big, right? Yeah.
[00:14:20] Heather Murray, PA-C: It reminded me of a lion's tail. Like waist down. Like a lion tail. That's the best way to describe it. Yeah, it really was. There was this, there was a tail- And it was probably this thick, the actual stock was probably- Oh, it was...
[00:14:28] Courtney Carroll, LE: Yeah. Yeah. I just, for me, I can't imagine like- I felt a skin tag on the back of my thigh one day that was probably the size of, like, I don't know, maybe like a dime, and immediately I was like, "This needs to come off." Like-
[00:14:40] Heather Murray, PA-C: Well, I
[00:14:40] Courtney Carroll, LE: think
[00:14:40] Heather Murray, PA-C: he waited so long He waited a long time ... I think he did admit that he was, like, embarrassed by it- Oh
and he thought, like, like he didn't know what to do, and he thought maybe it would go away or something, but it just kept getting bigger.
[00:14:49] Dr. Zain Husain, MD: Yeah. Well, kudos to his girlfriend. She never- Yeah ... made him self-conscious about it. Yeah. She was very supportive. Um, so I thought that that was cool. Yeah.
[00:14:57] Courtney Carroll, LE: Yeah. That's so true.
Yeah. Yeah.
[00:14:59] Dr. Zain Husain, MD: All right. I think- You better
[00:15:00] Courtney Carroll, LE: marry her.
[00:15:04] Dr. Zain Husain, MD: All right. So we have six images here of these hyperpigmented macules and papules. So, you know, flat lesions and some of them that are raised. What are these, Courtney?
[00:15:16] Courtney Carroll, LE: These are benign moles. You might also hear the term NEVI. That is just the medical jargon for moles.
So moles can appear in, like, all different shapes and sizes. I think people tend to, um, get anxious about new moles. I, I think, I think context is everything when it comes to a mole. I think taking into account, like, what your normal subset looks like, taking into account, you know, how new it is or if it's been there for a while, if it's changing.
But a lot of times people will come in with concerns about a certain mole and, you know, if they are normal, we're able to usually tell them. So we see a large variety, I would say, of moles, um, both, you know, flat and a little bit raised.
[00:15:59] Heather Murray, PA-C: Mm-hmm. And we're kind of looking for, like Courtney mentioned, like, everybody kind of has their signature mole.
So we're kind of looking for what we call the ugly duckling sign, where we're seeing, okay, based on how all of your moles present, which one is, like, really standing out to us? Mm-hmm. Like for instance, like in these photos, like if all of your... A lot of your moles look like the bottom center one- Mm-hmm
but then you have this one up top- Mm-hmm. Yeah ... that's, like, a lit- maybe a little bit asymmetrical, then that might stand out to us. It could be benign, but it's definitely the one that doesn't seem like your typical.
[00:16:34] Dr. Zain Husain, MD: And I know that we discussed it in a prior episode on skin checks, um, the ABCDEs of melanoma.
Can we go through that again for our audience?
[00:16:42] Heather Murray, PA-C: Yeah. So, um, A... So these are red flags. Um, it's not, like, a hard and fast rule. But A stands for asymmetry. So if you were to cut the mole in half, is the left the same as the right, or top versus bottom? If it's not, could be a red flag. B is border. So if it kind of has wonky borders.
So like, like I mentioned, like that top center one, eh, the borders are a little bit, um, different. They're not quite spherical. Um, but that could be potentially a sign to biopsy. C is color. So technically you can have, um, two different colors in a mole, and it can be benign, but it's not a guarantee. But anything more than two, especially if it's, like- Grayish white or, um, like has some sort of like black hue to it, that could be a red flag.
D is diameter, so if something's bigger than six millimeters, so like the size of a pencil eraser, that can also be concerning. Um, but however, there are moles that are bigger and are fine. Yeah. And then E is evolution, so something that's new or changing.
[00:17:51] Dr. Zain Husain, MD: And like you can see just with these six images, um, there is clinical variety.
Mm-hmm. And there are so many different variations that, you know, we see on patients. So we rely often on dermoscopy, um, which allows us to magnify, look at the moles, um, with more precision, look at pigment patterns and other clinical features to help us diagnose and also decide whether we need to biopsy or not.
And I think that's been really helpful and has changed the landscape of dermatology, where we just used to rely just on our naked eye. Now we have other tools that we can use to, you know, help us make those clinical decisions. Um, and in addition to this, like another thing that I commonly hear from my patients is that, "Oh, I'm worried because this mole is raised."
And that doesn't necessarily mean that it's harmful. So there are intradermal nevi, which are moles that have a little bit of elevation because these collections of pigment-producing cells called melanocytes are just distributed in such a way that it actually has a raised component. Another one that we see, congenital nevi.
So these are moles that patients have had since birth or, um, shortly after, and they often have also signature benign features, but they can look a little scary sometimes. Sometimes they have hairs growing through them. Um, that's nothing that we need to be worried about. Um, and sometimes they're raised, have different colors in them.
But, um, what really gives us some more reassurance is that it's been there for a while, hasn't changed, and, um, we often can reassure our patients.
[00:19:29] Courtney Carroll, LE: And you can develop new moles up until- Mm-hmm ... what is it? 40 usually. And not that you should just put aside any like new mole that you get, but that being said, I think, um, we do tend to see a lot of like kind of the younger generation who's more, um, in tune with their skin, I think just based off of, you know, like social media and being more cautious, which is great.
Um, but yeah, sometimes you'll get that patient that's like coming in with like every single new mole. And you're like- Mm-hmm ... "Nope. Looks good, but like let's just continue to monitor. Like if it's changing, like let's take a peek." But sometimes I will see like those patients who are in their like early 20s and maybe even like- Mm-hmm
early 30s that are like, "Oh, this is new. It's that teeny-tiny little pigment." And you're like, "Let's just monitor." And
[00:20:07] Dr. Zain Husain, MD: moles can change, right? So with sun exposure, UV radiation, um, moles can sometimes change in pigment. Doesn't necessarily mean that they're harmful.
[00:20:16] Courtney Carroll, LE: Pregnancy, I see. Yeah. Pregnancy- Mm
[00:20:18] Dr. Zain Husain, MD: estrogen, um, and other hormones can influence the appearance of moles. Um, so, you know, we always take the patient's history and, and the context, um, when we're making decisions about whether to biopsy or if we're concerned about things.
[00:20:33] Courtney Carroll, LE: And I would lastly add to that, if your gut is just telling you- Mm-hmm
I do not like this mole- Mm-hmm ... you should prompt... Your provider should take ca- You... They should biopsy it, you know? Or if it's giving,
[00:20:44] Heather Murray, PA-C: like, a weird sensation. Yeah. Or if it's itching. Sometimes you just ne-
[00:20:47] Courtney Carroll, LE: Yeah. I had a dysplastic mole on my arm that I had told my provider that I wanted biopsied, and she's like, "It's fine.
It's benign," and ends up coming back severely atypical, and- Mm-hmm ... like, I just... You know, just trust your body. Yeah. And
[00:21:00] Dr. Zain Husain, MD: that's also important, to listen to your patients. I mean, unless it's, like, a clear-cut, like, oh, it's an SK- Mm-hmm ... we can really reassure them. I mean, if there are symptoms associated with it, I have a low threshold to biopsy.
I mean, biopsy i- is a low-risk procedure.
[00:21:14] Courtney Carroll, LE: Takes two seconds.
[00:21:15] Dr. Zain Husain, MD: Takes two seconds, and- Yeah ... you get reassurance, and peace of mind- Mm-hmm ... is valuable- Yeah ... in my opinion. Mm-hmm. Agreed. So instead of worrying about it, like constantly monitoring it, you know, I'm happy to take it off. Um, and then you can get an answer.
[00:21:26] Courtney Carroll, LE: Yeah. Yeah. Okay.
[00:21:30] Dr. Zain Husain, MD: All right, so we have these dark, um, flat macules, um, in kind of irregular shape. What are these? Liver spots. I just wanted to say
[00:21:42] Heather Murray, PA-C: that. Is this a back or- No, it's a hand. The hand. Oh, okay. I thought, was this his, like, trap, and this was his face? No, I think that's his hand. Okay. Yeah, it's that's his thumb up there.
Okay. I see. I see.
[00:21:52] Courtney Carroll, LE: Um,
[00:21:53] Heather Murray, PA-C: for- Like- Wait,
[00:21:53] Courtney Carroll, LE: should I visually describe what we're- Yes ... for people who are not watching? Lentigines. Lentigines. We're looking at a, the back of a hand. It's a little wrinkly, probably an older person, maybe in their 60s or 70s, and there's multiple brown spots that are variable in shade and color.
[00:22:09] Heather Murray, PA-C: And now this is where it gets kind of tricky because, like, this one in the middle, like, it is pretty asymmetrical, and people might think, "Oh, that's a mole. I need to be concerned. What if it's melanoma?" Um, lenti- lentigines, or the singular is, um, lentigo, they can very commonly be asymmetrical in the borders.
Um, we call it, like, a moth-eaten appearance. It kind of looks like a moth took a bite out of it, and that is very common. It's not concerning. However, there is a type of malignant form called- Mm-hmm ... lentigo maligna, which is obviously concerning, but, um- Don't just assume that because- Mm-hmm ... it's asymmetrical that it's worrisome.
[00:22:53] Dr. Zain Husain, MD: And these lesions are typically more superficial. Um, so on dermoscopy we can see patterns that look very reassuring, and it's just an indication of a lot of sun exposure- Mm-hmm. Mm-hmm ... sun damage. We see it on sun exposed areas especially, so the back of the hands- Mm-hmm ... the face, the neck. Shoulders.
[00:23:13] Heather Murray, PA-C: Mm-hmm. Mm-hmm.
[00:23:14] Dr. Zain Husain, MD: And, you know, a lot of people, you know, don't really like the way that it looks, so we do have, um, pigment specific lasers that we can use to help make it look better. But it's so important to be evaluated by your dermatologist or team because we wanna make sure that, you know, they're completely normal, they're just lentigines, um, background sun damage.
They aren't anything concerning, like a pigmented lesion, um, that's concerning for, like, an atypical mole or melanoma because that is a big no-no.
[00:23:43] Courtney Carroll, LE: That's what scares me, I would say- Mm-hmm ... most about, like, places that do cosmetic procedures- Mm ... that don't have dermatology... Like, a dermatologist on practice, I would say, because I think it's so scare- Like, yeah, looking...
I think any other person can be like, "Oh yeah, we'll just hit that with, like, the laser- Mm-hmm ... and just treat the pigment," but without having, like, someone who truly knows what to look for. Again, like, that melanoma is always just sitting in the back of my head, and like-
[00:24:09] Heather Murray, PA-C: Mm-hmm ...
[00:24:10] Courtney Carroll, LE: I'm never one to hesitate to pull either of you guys when I see a spot that's, like, a l- a freckle that is just like, eh, I don't like how that looks, you know?
Mm-hmm. And I think that's what scares me most about, like, the med spas that just, like, just treat.
[00:24:22] Heather Murray, PA-C: Well, yeah. You know? I had a patient... Well, she wasn't my patient, but, um, at my previous practice where she came in and she had had a spot on her face- Mm-hmm ... lasered multiple times, and it was melanoma. Oh, my gosh.
And she was young. Wow. She was maybe 40, and she had a huge scar from it. Oh my God, that scares me. Yeah. Yeah. Yeah.
[00:24:42] Dr. Zain Husain, MD: And how is this differentiated from freckles or ephelides?
[00:24:47] Heather Murray, PA-C: Freckles are usually, like, tiny, um, circular, very even, um, I guess, in the shape. Mm-hmm. Um, typically there's a little more genetic component to that.
They can... You can get more with sun, but, um, these are more, like, I guess, more common to get over time. Mm-hmm. So it's, it's more common, like- Accumulated ... yeah, with the older age- Yeah ... I guess.
[00:25:17] Dr. Zain Husain, MD: Like kids, um, you know, can- More often ... often get freckles. Yeah. And with, especially with lighter skin types, um, so we do see that a lot.
Mm-hmm. Yeah.
[00:25:24] Courtney Carroll, LE: I was gonna say, I feel like mine wax and wane. Mm-hmm. Like, they get more prominent in the summer, and then kind of- For your freckles? Yeah. Yeah.
[00:25:31] Heather Murray, PA-C: And you mentioned, um, liver spots, and, like, that, that it's called liver spots. It's a very sexual thing. There's actually... Yeah. There's actually no- correlation to the liver Yeah.
Mm-hmm It's not concerning at all. I think the reason why they called them liver spots is because they have the same color- Mm-hmm ... as a liver. Okay. But it
[00:25:51] Courtney Carroll, LE: doesn't mean- Should
[00:25:53] Heather Murray, PA-C: I call them
[00:25:53] Courtney Carroll, LE: my chocolate chip spots?
[00:25:54] Heather Murray, PA-C: Right, but it doesn't mean that you have, like, a liver abnormality or anything.
[00:25:59] Courtney Carroll, LE: Yeah.
[00:25:59] Heather Murray, PA-C: That's
[00:25:59] Courtney Carroll, LE: a good point to bring up- Yeah
'cause I do think
[00:26:01] Heather Murray, PA-C: people
[00:26:01] Courtney Carroll, LE: associate Yeah.
[00:26:04] Dr. Zain Husain, MD: All right. So those are our lentigines. Let's move on. Okay, so Heather, you wanna give a description?
[00:26:12] Heather Murray, PA-C: Sure. This is, looks like a pink papule, um, with maybe a central either induration or discoloration. Um- What's induration? Like a little indentation. Um, so this looks like a dermatofibroma, and the reason why I bring up the central part of it is because, um, there's a classic sign for these called the, um, dimple sign.
And if you kind of like squeeze at it from the sides, the, the center of it depresses, and that kind of reassures you that it is a dermatofibroma, which dermatofibromas are little scar-like bumps. It is very common. It is most common on female legs. It could be due to shaving, ingrown hairs, bug bites, any sort of trauma.
It's just like a little scar. Um, but you... I wouldn't just assume that it's benign because it creates a little dimple in the middle. Um, like I said, that's the classic sign for it, but not all dermatofibromas have the dimple sign, and then vice versa, just because it has a dimple sign doesn't mean it's fine.
[00:27:26] Dr. Zain Husain, MD: And like Heather mentioned, it's often related to some type of trauma, so, you know, like shaving or an ingrown hair or like a bug bite. However, it can also happen in the setting of certain systemic diseases. Mm-hmm. So for instance, um, I've seen this in HIV patients. Um, I've seen this in connective tissue disease, um, patients, like lupus.
So, you know, when you do see a bunch of these, um, that does kind of raise some flags, I mean, is something else going on, um, or just all this repetitive trauma. And you can also get this in the setting of acne. So, like some people get keloids with certain acne, um, lesions. You can also form dermatofibromas as well So, um, that's another reason why I tell my patients not to pick at or manipulate their acne because you have the potential for keloiding or forming dermatofibromas, which are difficult to get rid of.
[00:28:20] Courtney Carroll, LE: Mm-hmm. Yeah, sometimes, um, I know occasionally you can offer like a, a steroid injection to the area to try to flatten it out a little bit. Occasionally, if it's really bothersome, and painful, and itchy, um, you know, surgery can be done, but you do kind of risk removing that, essentially a scar with, you know, another scar.
[00:28:39] Dr. Zain Husain, MD: Sometimes we use cryotherapy too. Mm-hmm. Sometimes that can flatten it out, but it's a hit or a miss. Mm-hmm. Um, dermatofibromas are really annoying and tough to treat. Mm-hmm.
[00:28:46] Heather Murray, PA-C: And there's, um, a worrisome type called DFSP which is... Typically, if your dermatofibroma is changing, then I would definitely have it rechecked.
[00:28:58] Dr. Zain Husain, MD: Yeah, so that's malignant. That is cancer. Um, we surgically treat those typically with Mohs surgery or wide local excision, and that's something that is oftentimes missed because they kinda look like scars- Mm-hmm ... and, you know, patients kind of do not correlate them with something that's growing.
[00:29:20] Heather Murray, PA-C: Mm-hmm.
[00:29:20] Dr. Zain Husain, MD: Um, yeah, it's... And it's odd. Like actually, I had one of my cousins who, like, had something on her abdomen, and she had a biopsy. It came back as DFSP. Oh, wow. She's like, "Oh, what should I do with this?" I'm like, "Oh, you need to see, you know, a Mohs surgeon. Get rid of it. Um, this is cancer."
[00:29:36] Courtney Carroll, LE: Mm-hmm.
[00:29:37] Dr. Zain Husain, MD: So, um, it is an unusual, um...
But we do see it.
[00:29:41] Courtney Carroll, LE: Yeah, I, I've only seen it one time, um, in a patient. He was in his early 30s, and it was on his chest. And sure enough, we, you know, removed the whole thing. But it was just interesting to see the presentation and kind of how it differentiated from, you know, just a regular dermatofibroma, so.
Mm-hmm.
[00:29:57] Dr. Zain Husain, MD: All right. I love these pearly white papules underneath this eyelid. Courtney, what are these? Your favorite.
[00:30:06] Courtney Carroll, LE: Milia. Mm-hmm. Um, the pimple you can't pop. Mm-hmm. Um, milia are basically tiny white bumps. You can think of them... If you've ever... In fact, you guys will laugh at me. I literally just exc- not excised, popped one last night.
I had my little 11 blade at home, and I went in there. I knew it was a milia 'cause it wasn't coming out with my Q-tip. So I just created my little opening, and popped it out. Um, basically, these are very common, um, on the face, and sometimes on the neck we'll see them. Um, it's basically... I, I describe them as almost like little cysts to my patients.
I feel like that makes like the most sense. Um, they're kind of clogged pores that they don't really have an opening. So really, by you pushing and shoving, it's not gonna do anything- Mm-hmm ... other than just create inflammation and potentially scarring. So you do really wanna see someone, um, who can actually create that little opening and then help express that material out.
So they are benign. Um, I tend to see them one of, one of kinda three ways. I think genetics does play a little bit of a part. I think friction also. Sometimes if people rub their eyes a lot, I tend to see them around the eyes. Or the other thing would be like an overuse of like a moisturizer. Mm-hmm. So especially, again, that eye area, I think if someone's using really overly moisturizing ingredients, then we'll start to see those pores clog and get that milia around.
Especially with
[00:31:28] Dr. Zain Husain, MD: occlusion, um- Mm-hmm ... you know, Aquaphor- Mm-hmm ... Vaseline.
[00:31:32] Courtney Carroll, LE: Which you like Aquaphor on the eye. I do.
[00:31:34] Dr. Zain Husain, MD: Yeah. I, I love the, I love the moisturization, especially for sensitive skin.
[00:31:37] Courtney Carroll, LE: Yeah.
[00:31:38] Dr. Zain Husain, MD: Um, but like, you know, if you don't need the moisture, then, you know- Mm-hmm ... you don't use it. Yeah.
[00:31:42] Heather Murray, PA-C: Take it with a grain of salt.
And there's typically keratin in it- Mm-hmm ... which is a skin protein. Um, but yeah, they're completely benign. Yeah.
[00:31:53] Courtney Carroll, LE: Yeah, they are fun to extract. They're, they're usually- They are ... just a little white pearl that you're, you know, that you'll get out. Mm-hmm. But, um, you know- But like with the
[00:32:00] Dr. Zain Husain, MD: skin tags, I would not advise doing that at home.
No. Go to a professional. Because with any manipulation- Right ... you can have inflammation, scarring, and it's often on cosmetically sensitive areas like your face.
[00:32:11] Courtney Carroll, LE: Mm-hmm.
[00:32:12] Dr. Zain Husain, MD: So- Around the
[00:32:12] Courtney Carroll, LE: eye especially. Oh, yeah.
[00:32:14] Dr. Zain Husain, MD: Yeah. And you don't wanna bring sharp objects by your eye.
[00:32:17] Courtney Carroll, LE: Unless you're me. Yeah. Um No. No. I will say it was last night that I did it, and yeah, I had my little 11 blade.
But it's hard to s- It was... It's right here, and it's hard to like in the mirror see that. So I did almost think about just waiting until today to have you do it. But I was like, "No, I can do it." And the first poke, I definitely didn't get in there. Mm-hmm. And I was like- ... "That's okay, we'll just do another." And then when it came out, I was like, "Oh, glory."
Yeah. And
[00:32:42] Dr. Zain Husain, MD: there's some lesions that can look very similar to milia. Mm-hmm. So syringomas. Mm-hmm. These are these benign sweat duct, um, growths that can also be found under the eyes. Sebaceous gland hyperplasia can sometimes look like this. Mm-hmm. Um, even little acne cysts, um, can look similar. So, um, they're all benign, which is a good thing, but sometimes they require different treatment options.
Mm-hmm. All right. So we have these waxy, um, bilocated or has like a little tiny depression in the center, um, orange- Two skin colored papules on the face. What are these, Courtney?
[00:33:21] Courtney Carroll, LE: Sebaceous hyperplasia. So these are basically, um, enlarged oil glands, and I think a lot of times they get confused with milia. Mm-hmm. A lot of times when I'm doing facials, people will think that they are milia.
But it's funny, even if you were to, um, take a little blade and pop that open, sometimes you'll actually express oil out of there. So they do tend to kind of... Even with my own, I tend to see them flare a little bit, where sometimes they'll get a little bit more raised and kind of like die back down, and kind of go through that cycle.
They are completely benign, but there are multiple ways that you can take care of them. Um, s- the number one specifically being cauterization, where we do kind of singe those areas. But I think the main difference between these and milia, number one, a little bit, is the coloration. These will tend to appear a little bit more orange than white.
Mm-hmm. And then the second thing is definitely that indentation is- Mm-hmm ... kind of my telltale sign that that is definitely a sebaceous hyperplasia and not a milia.
[00:34:15] Heather Murray, PA-C: But you do have to be careful 'cause there is a type of skin cancer that often gets confused- Mm-hmm ... called basal cell carcinoma. And that can sometimes have an induration in the middle.
Um, and they both look, typically look very, like, shiny and pearly. So you definitely don't want to assume that that's a- Mm-hmm ... sebaceous- And
[00:34:33] Dr. Zain Husain, MD: there's a malignant version of these- Yes ... growths called sebaceous carcinoma, and that is also a serious condition that we treat with MOHS surgery. Um, with the sebaceous gland hyperplasia, what are some of our treatment options for patients, aside from destructive methods?
Um, you know, we often prescribe some medicines. What do we typically
[00:34:54] Heather Murray, PA-C: prescribe? Um, retinols can help. I think if you have a lot of them, i- it's very difficult to treat all of them with just a retinol or retinoid. Um, they can definitely help prevent. Also, salicylic acid can help target excess oil to prevent- Mm
some from forming. Um, these are very common in acne-prone individuals, so if you do have a history of acne- Mm ... or if you have- Rosacea. Yeah, or more oily skin type in general, you have... You, you might get the sebaceous hyperplasia. But it's kind of y- you do have a perk where you're probably not gonna form as many fine lines and wrinkles because your skin is oily.
Mm. Um, so yeah, a couple different options.
[00:35:37] Dr. Zain Husain, MD: Um, I like using Accutane- Mm-hmm ... um, for patients who have severe sebaceous gland hyperplasia. It just melts them away. Mm-hmm. Um, it also reduces the oil production, which is also another problem these patients complain about. So one of the other beautiful things about Accutane that we can use for.
[00:35:54] Courtney Carroll, LE: We actually used to use a laser at my last practice. Mm. But we would mark it... Because there's not a lot of pigment on there, we would actually mark it, um, with like a red marker, and then Um, I think we were using maybe a 532 on there, and, um, basically kind of creating a little bit of, like, that destruction.
And then we would actually use some Q-tips to express the oil out and hit it again, and that actually worked pretty well.
[00:36:17] Dr. Zain Husain, MD: Yeah. I mean, I think there were a few lasers that were used to target acne, um, with a specific wavelength. I think the 1726 nanometer, like the AviClear- Mm-hmm ... um, and the A- Accure, the Accure Cl- Laser.
Mm-hmm. Um, but I don't really know if it really helped that much with- I think for
[00:36:38] Courtney Carroll, LE: the cost- Yeah. Yeah ... honestly, cautery is such a better- Oh, yeah. It's pretty painful too. It
Should we say this next one all together?
[00:36:45] Dr. Zain Husain, MD: Let's do it. Idiopathic gutta hypomelanosis. Idiopathic gutta hypomelanosis. I
[00:36:49] Courtney Carroll, LE: love that word, or the term. And
[00:36:51] Dr. Zain Husain, MD: I love it when patients look at us after we say it.
They're like, "What?"
[00:36:55] Heather Murray, PA-C: Yeah. It's like you're speaking an alien language. Sometimes I'll ask them to repeat it, and they're just like, And
[00:37:00] Dr. Zain Husain, MD: you sound r- you sound really smart. So smart. So what are these car- lesions?
[00:37:06] Heather Murray, PA-C: Um, they're kind of like white freckles. Mm-hmm. So they're sun related, little, um, hypopigmented macules, meaning, like, flat spots.
They are- Um, more commonly seen in the summer, and that's really... Obviously they're sun related, but also they are just more apparent. Mm-hmm. Because if you get tan in the summer, then the contrast between those spots and your normal skin are higher.
[00:37:34] Dr. Zain Husain, MD: And some categorizes as a subtype of seborrheic keratosis that are just hypopigmented.
[00:37:39] Heather Murray, PA-C: Mm-hmm.
[00:37:40] Dr. Zain Husain, MD: Um, so rather than being hyperpigmented like many of the ones that we saw in the past, um, on another slide, these are just, you know, less apparent because they have no pigment. Mm-hmm. Or less pigment.
[00:37:51] Heather Murray, PA-C: There's, um, not much that you can do to treat them. There has been some success with liquid nitrogen, which I think a lot of people don't think to freeze them with liquid nitrogen because there is a risk for hypopigmentation from the liquid nitrogen.
But there is a little bit of inflammation there associated with the spot. And so if we can lightly freeze it, it could calm down the inflammation enough to where the spot would go away, but it's not a guarantee that it would be successful.
[00:38:18] Dr. Zain Husain, MD: Have you seen improvement with chemical peels? Have you ever tried them on them?
[00:38:22] Courtney Carroll, LE: I haven't. I'd actually be more intrigued to try something like Latisse and do like a little microneedling on them.
[00:38:28] Heather Murray, PA-C: Do you think the chemical peels would be more effective because it's lightening the normal skin? Or do you think it's- No, I think it's
[00:38:35] Dr. Zain Husain, MD: more like these superficial growths, um- And it's just exfoliating off
I think it's hopefully just exfoliating them off. Hmm. Um, because I don't really think of them as vitiligo-like lesions.
[00:38:43] Courtney Carroll, LE: Yeah.
[00:38:44] Dr. Zain Husain, MD: Um, so like the Latisse, um, you know, mechanism's more for like depigmentation. Mm-hmm. Um, I don't consider these, um, the same category.
[00:38:54] Courtney Carroll, LE: Yeah. You run the trial and let me know how it goes.
Will do.
[00:39:00] Heather Murray, PA-C: It's probably a lot harder to do Latisse in... There's... Just because they're-
[00:39:04] Dr. Zain Husain, MD: So many ...
[00:39:05] Heather Murray, PA-C: Yeah, typically so many. Mm-hmm. Take a Q-tip and... All right. Yeah. You try that. Okay, you can do that for an hour. All right,
[00:39:15] Dr. Zain Husain, MD: And now we have our final image. So Heather, I know that there's a lot of redness over there. That's not what we're looking at. We're looking at that little bump by the nasal ala. What is that?
[00:39:27] Heather Murray, PA-C: That is a fibrous papule.
So these are little, um, benign growths that you can get very commonly on the nose. Um, it has a little bit of fibrotic tissue there. A lot of times it can look like a raised mole, like a flesh-colored mole, but they are, um, a little bit different. They're typically a lot firmer than a mole. Mm-hmm
[00:39:54] Dr. Zain Husain, MD: And a lot of people don't like the way that they look.
Mm-hmm. Um, so I often do cosmetic shaves or if they're really small, a little bit of electrocautery destruction. Mm-hmm. And they heal up beautifully, so patients are typically very happy with that.
[00:40:09] Courtney Carroll, LE: They tend to, like... I, I've heard patients call them, like, clear moles before. Mm. Because I feel like they're not, like you said, they're not as pigmented usually, and they also...
Sometimes you can actually see, like, the vascularity in them, and they- Mm-hmm ... just tend to have, like, that more, like, clear appearance.
[00:40:23] Dr. Zain Husain, MD: Yeah. They're technically a form of angiofibroma. Mm-hmm. So that's why you kind of see the angio, which is the blood vessels- Mm-hmm ... and the fibroma, the fibrous tissue.
Mm-hmm. Um, and very normal, often genetically influenced, too. There are also genetic syndromes that can be associated with angiofibromas, like tuberous sclerosis, for instance. Um, so you can see a ton of them on the face. Mm-hmm. But yeah, these are pretty common and, you know, most patients are just annoyed cosmetically, or they're worried about, oh, this is skin cancer.
[00:40:51] Heather Murray, PA-C: Mm-hmm.
[00:40:52] Dr. Zain Husain, MD: Okay. All right, so there we have it. Those were the 10 most common benign findings we see on skin exam. Um, so not everything that you see on exam is something to worry about. However, it's a good idea to get checked regularly by your dermatology provider. Um, and if you are worried about something, if it's changing, if there are symptoms associated with it, you should definitely get it checked out.
It's worth knowing and, you know, we can determine if a biopsy is necessary. I think peace of mind is always a great thing. Um, any last words?
[00:41:28] Courtney Carroll, LE: I was just gonna agree. Even if you feel like, you know, you see one of these things and you're like, "Oh, I think I have this freckle," or whatever.
[00:41:36] Heather Murray, PA-C: Mm-hmm.
[00:41:36] Courtney Carroll, LE: These are benign lesions, but things can always be out of the norm.
Mm-hmm. So it's always better, yeah, to get something checked that is changing, that is having, um, you know, a little bit of, like, variety that doesn't look like the norm. Mm-hmm. It's always better just to get that checked than just to assume that it's benign.
[00:41:53] Dr. Zain Husain, MD: And many of these lesions have a more sinister malignant counterpart sometimes.
Mm-hmm. So there can also be a time of transition between- Mm-hmm ... a benign to a malignant lesion, so.
[00:42:04] Heather Murray, PA-C: Yeah.
[00:42:05] Dr. Zain Husain, MD: Um, something to keep in mind. Well, I hope you enjoyed this episode. I think it was a nice addition to our Anatomy of a Skin Exam, um, episode, so hopefully you get a clear idea of what a skin check is, what we can find on it, and just have a little bit more reassurance that most things that we find are benign.
Hopefully you enjoyed this episode, but until next time, Skin Side out.