Skin lesions can be defined as a part of the skin that has an abnormal growth or appearance when compared to intact skin. Skin lesions can be classified into 4 types:
- Infections
- Allergies
- Burns
- Skin Cancer
1. Skin Lesions – Infections
Athlete’s Foot
Athlete’s foot presents as itchy red peeling in the skin between the toes as a result of infection by the fungus tinea pedis. Athlete’s foot is common due to the said areas being prone to sweat or when left wet/ not thoroughly dried.
Candidiasis
Candidiasis is a fungal infection caused by Candida (a yeast). Candida usually presents on the skin and/or within the body, in areas such as the mouth, throat, gut, vagina, as well as areas prone to sweat (eg. under the breasts) and wetness (eg. nappy rash following prolonged humid environment).
When presenting in the mouth, Candidiasis (also known as Thrush) is characterized by white discolorations in the tongue, around the mouth, and the throat. Sometimes, irritation that causes discomfort when swallowing may occur. Oral Candidiasis can at times be caused in prolonged use of oral steroid medication eg. in asthmatic patients.
When presenting within the skin, Candidiasis causes itching, irritation, chafing or broken skin.
Ringworm
Ringworm, a fungal infection of the skin, can affect both humans and animals. Typically, humans acquire ringworm from strays or pets. Ringworm usually presents in areas on the skin such as on the scalp, feet, groin and beard.
Mild ringworm is usually treated successfully by antifungal topical medication (cream). However, more severe ringworm infection usually requires antifungal oral medication to be successfully treated.
Boils and Carbuncles
Boils and Carbuncles are classified as bacterial infections. They happen as a result of inflammation of the hair follicles and sebaceous glands, and quite commonly present on the dorsal neck. Usually, local antibacterial topical medications (eg. Fucidin) don’t work on boils and carbuncles – they are usually treated through oral antibiotics.
Impetigo
Impetigo is a bacterial (staphylococcus) infection of the skin, commonly found in young children. It is highly contagious – in fact, children with Impetigo are required to be kept home so as to avoid spreading of the infection. Impetigo is commonly found around the mouth and nose, and presents as pink water-filled raised lesions which turn into a yellowish crust, which eventually ruptures.
Cold Sores
Cold sores are small fluid-filled blisters presenting around the lips and in the oral mucosa, that cause itching and a stinging sensation. They are caused by Herpes Simplex infection. Herpes Simplex is a lifelong virus that once acquired remains dormant for long periods of time until it causes an outbreak following a trigger.
Chickenpox
Chickenpox is caused by the Varicella Zoster virus. It presents as a very itchy skin rash with blisters. The Varicella Zoster virus is a lifelong virus that once acquired stays in the body, specifically in the sensory nerve ganglia, as a dormant infection.
Shingles
Shingles is the reactivation of the Varicella Zoster virus (which initially causes Chickenpox). Typically, Shingles causes pain in a particular area in the body, which is later on followed by a rash, which initially appears as red spots before turning into blisters that eventually dry up and form scabs.
Warts
Warts are a type of skin infection resulting from the Human Papillomavirus (HPV). Warts present as rough, skin-coloured bumps on the skin which are highly contageous and can be easily spread through skin-to-skin contact. There is currently a vaccine which is offered to girls aged 12 years (ideally administered prior to 1st sexual encounter) to prevent development of the HPV.
2. Skin Lesions – Allergies
Contact Dermatitis
Contact Dermatitis is caused by the irritation or inflammation of the skin following direct contact with a substance or material that triggers an allergic reaction. It causes itching, redness as well as swelling of the skin which eventually progresses to blistering.
Psoriasis
Psoriasis is a chronic condition whereby overproduction of skin cells occurs. It presents as reddened epidermal lesions covered by dry silvery scales, and is commonly triggered by trauma, infection, hormonal changes and stress.
3. Skin Lesions – Burns
Burns are tissue damage and cell death that result from heat, UV radiation, chemicals or electricity. Burns can be minor medical problems or life-threatening emergencies, and treatment depends on their location and severity.
Life-threatening problems happen since in burns:
- the body loses fluids, causing dehydration and electrolyte imbalance, which may lead to circulatory shock;
- the burned skin is only sterile for 24 hours, after which the resulting wound becomes prone to infection.
Estimating the extent of burns in percentages using the rule of nines…
Following calculation of the extent of burns in a patient, a patient is considered critical if:
- >25% of the body has 2nd degree burns
- >10% of the body has 3rd degree burns
- 3rd degree burns are present on the face, hands or feet
4. Skin Lesions – Skin Cancer
There are 3 major types of skin cancer:
- Basal Cell Carcinoma
- Squamous Cell Carcinoma
- Malignant Melanoma
Basal Cell Carcinoma
Basal Cell Carcinoma is the least malignant but most common type of skin cancer that most often develops on areas of skin exposed to the sun. This type of cancer arises from cells within the stratum basale and presents itself as shiny dome-shaped nodules which eventually develop a central ulcer.
Squamous Cell Carcinoma
Squamous Cell Carcinoma is the second most common form of skin cancer which is characterised by abnormal accelerated growth of squamous cells. Squamous Cell Carcinoma arises from cells within the stratum spinosum and presents itself as a scaly, reddened papule that gradually forms a shallow ulcer with a firm raised border.
Malignant Melanoma
Malignant Melanoma, the most deadly form of skin cancer, develops from the pigment-producing cells known as melanocytes. It may develop spontaneously or from existing moles that suddenly start exhibiting changes, indicating cancer growth.
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