Skin Lesions

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:

  1. Infections
  2. Allergies
  3. Burns
  4. Skin Cancer

1. Skin Lesions – Infections

Athlete’s Foot

skin lesions athlete's foot
Retrieved from https://health.clevelandclinic.org/how-you-can-stop-foot-and-toe-fungus-in-its-tracks/ on 15th October 2021

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

skin lesions candidiasis
Retrieved from https://www.mymed.com/diseases-conditions/candida/signs-and-symptoms-of-candidiasis on 15th October 2021

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

skin lesions ringworm
Retrieved from https://www.askdrsears.com/topics/health-concerns/skin-care/ringworm/ on 15th October 2021

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

skin lesions boils and carbuncles
Boil (left) vs Carbuncles (right) – Retrieved from https://www.diagnose-me.com/symptoms-of/boils-abscesses-carbuncles.php on 15th October 2021

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

skin lesions impetigo
Retrieved from https://www.nhs.uk/conditions/impetigo/ on 15th October 2021

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

skin lesions cold sores
Retrieved from https://www.evansondds.com/cold-sores-what-are-they-how-to-avoid-them/ on 15th October 2021

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

skin lesions chickenpox
Retrieved from https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Chickenpox-Vaccine-What-You-Need-to-Know.aspx on 15th October 2021

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

skin lesions shingles
Retrieved from https://www.straitstimes.com/singapore/health/5-things-to-know-about-shingles on 16th October 2021

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

skin lesions warts
Retrieved from https://www.skincarenetwork.co.uk/dermatology/men/genital-warts/ on 16th October 2021

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

skin lesions contact dermatitis
Retrieved from https://nationaleczema.org/eczema/types-of-eczema/contact-dermatitis/ on 16th October 2021

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

skin lesions psoriasis
Retrieved from https://infusionassociates.com/infusion-therapy/psoriasis/ on 16th October 2021

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

skin lesions burns
Retrieved from https://urgentcaresouthaven.com/burn-care-at-home-the-dos-and-donts-to-keep-in-mind/ on 16th October 2021

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:

  1. the body loses fluids, causing dehydration and electrolyte imbalance, which may lead to circulatory shock;
  2. the burned skin is only sterile for 24 hours, after which the resulting wound becomes prone to infection.
degrees of burns
Retrieved from https://pt.slideshare.net/winreyes/burn-injury-13545329/3 on 16th October 2021

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
estimating burns rule of nines
Retrieved from https://www.chegg.com/homework-help/human-anatomy-8th-edition-chapter-5-problem-6cr-solution-9780134243818 on 16th October 2021

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

skin lesions malignant melanomas
Retrieved from https://www.medpagetoday.com/resource-centers/advances-hematologic-malignancies/noncutaneous-second-primary-malignancy-patients-melanoma/2864 on 16th October 2021

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.

skin lesions malignant melanomas
Retrieved from https://miiskin.com/melanoma/symptoms-signs/ on 16th October 2021

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