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Dermatologist examining a mole

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ACTINIC KERATOSIS

Actinic Keratosis (AKs) are common skin growths. In fact, these growths are so common that treatment for AKs is one of the most frequent reasons that people see a dermatologist.

AKs are also called “solar Keratosis” because they are caused by years of sun exposure. Fair-skinned people have a higher risk for getting AKs. When AKs develop, they tend to appear on skin that receives the most sun, including the:

  • Forehead
  • Ears
  • Neck
  • Arms
  • Hands
  • Lower lip
  • Scalp, especially a bald scalp
  • Lower legs, especially in women

AKs are considered precancerous. Left untreated, (UV) light damages cells in the skin. Changes to these cells cause the skin to become rough and scaly. Bumps or small horn-like growths form. If the cells continue to change, AKs can progress to skin cancer.

What Does Actinic Keratosis Look Like?

Most AKs share common qualities such as being dry, scaly, and rough textured. Not all AKs look the same though. Some are skin colored and may be easier to feel than see. These AKs often feel like sandpaper. Other AKs can appear as red bumps; thick red scaly patches or growths; or crusted growths varying in color from red to brown to yellowish black. A single AK may range from the size of a pinhead to larger than a quarter.

Sometimes an AK grows rapidly upward, and you see a growth that resembles the horn of an animal. When this happens, the AK is called a “cuntaneous horn.” Horns vary in size from that of a pin head to a pencil eraser. Some horns grow straight; others curve. Cuntaneous horns often form on men’s ears.

AKs also commonly form on or at the border of the lip. An AK on the lip is known as “actinic chelitis” and look like a scaly patch on a dry, often cracked lip. The part of the lip with actinic chelitis usually looks white or grayish.

AKs often seem to disappear for weeks or months and then return. This makes treatment important. Left untreated, the damaged cells can continue to grow and skin cancer may develop.

CYSTS

A cyst is harmless, sac-like growth in the deeper layers of the skin. The cyst sac is filled with a soft whitish brown material that sometimes oozes out onto the skin’s surface. We don’t know why cysts appear, nor do we know why some persons get many of them.

Cysts are a nuisance, but they never become cancerous or malignant. Occasionally germs get into the cyst and cause an infection that resembles a boil. When this happens, antibiotics taken by mouth and minor surgery performed in the office may be needed to relieve the pressure and discomfort.

DERMATOFIBROMA

Dermatofibroma is a round brownish to purple growth commonly found on the legs and arms. Dermatofibromas contain scar tissue and feel like hard lumps in the skin. We do not know why people grow dermatofibromas. Some may be caused by insect bites. They are harmless and never turn cancerous.

DRY ITCHY SKIN

Symptoms

Dry skin is abnormal scaling, flaking, and cracking of the upper layer of the skin that leads to itching and discomfort. Sometimes the skin itself may not show much of these changes, yet still be dry and itchy.

Causes

Dry skin is due to lack of water in the skin’s outer layer. Normally, oil glands in the skin produce an oily film which traps water in the skin and prevents it from evaporating. There are several reasons why skin gets dry:

  • Low relative humidity levels (less than 60%) from indoor heat, cold winter air, or even air conditioning.
  • Excessive sun or wind exposure.
  • Excessive contact with soaps and detergents.
  • Heredity
  • Aging. As we get older, our skin gets thinner and loses some of its ability to hold water and produce natural oil.
  • Medically related conditions such as eczema, psoriasis, diabetes, and contact dermatitis.

DYSPLASTIC NEVI

About 1 of every 10 people has at least one unusual (or atypical) mole that look different than an ordinary mole. The medical term for these moles is dysplastic nevi.

Doctors believe that dysplastic nevi are more likely than ordinary ones to develop into skin cancer called melanoma. However, not everyone who has dysplastic nevi gets melanoma. In fact, most moles, both ordinary and dysplastic never become cancerous. Even so, moles should be checked by a dermatologist, especially if they look unusual, grow larger, or change in color or in any other way.

Those at risk for melanoma are those who:

  • Already had the disease
  • Have a close relative who has had the disease
  • Have a history of one or more bad, blistering sunburns as a child or teenager.
  • Have fair skin that burns or freckles easily

ECZEMA

Eczema is a chronic recurring skin disorder that results in dry, easily irritated, itchy skin. There is no cure for eczema, but good skin care is essential to controlling the disease.

What are the characteristics of dry skin?

When you skin is dry, it is not because it lacks grease or oil, but because it fails to retain water. For this reason, a good daily skin care regimen focuses on the basics of bathing and moisturizing.

What other factors create dry skin?

Wind, low humidity, cold temperatures, excessive washing without use of moisturizers, and use of harsh drying soaps can all cause dry skin and aggravate eczema.

How do I take care of my dry skin?

The most important treatment for dry skin is to put water back in it. The best way to get water into your skin is to briefly soak in a bath or shower and to moisturize immediately afterwards.

Use of an effective moisturizer several times every day improves skin hydration and barrier function. Moisturizer should be applied to the hands every time they are washed or in contact with water.

The goal of bathing and moisturizing is to help heal the skin. To repair the skin, it is necessary to decrease water loss.

GRANULOMA ANNULARE

Granuloma Annulare is a raised, bumpy, or ring shaped lesion, which can occur singly or in groups on the skin. It is more common in children and young adults, although it can affect people of all ages. Women are twice as likely as are men to develop granuloma annulare.

What granuloma Annulare Looks Like

Granuloma annulare may be pearly white, skin-colored, red, or purple. It is most often in an isolated area, but may appear as several “bumps” spread over the body. Beginning as a round, firm, smooth bump, the lesion becomes a circular ring with a clear center, which resembles the shape of a doughnut. While granuloma annulare can develop on any part of the skin it appears most often on the tops of the hands and feet, elbows, and knees. It usually does not peel or itch and for that reason, can often go unnoticed.

Causes of Granuloma Annulare

No one knows what causes granuloma annulare, but a reaction in the immune system may play a role. There may be a relationship between granuloma annulare and diabetes. So far, this remains unproven.

Having granuloma annulare does not mean that you are ill. Most people do not have symptoms, and the only sign is a spot on the skin. A few experience mild itching.

Other diseases that granuloma annulare looks like

Granuloma annulare is most often confused with ringworm. It also may look like insect bites. One insect bite in particular may resemble granuloma annulare. This is the initial lesion of Lyme disease, which is called erthema migrans. For this reason, it is important for your dermatologist to inspect these lesions to make the correct diagnosis.

Diagnosis

Sometimes your dermatologist diagnoses granuloma annulare by examining the lesion. A biopsy, a small sample of skin examined under a microscope, may be performed to confirm the diagnosis. To rule out other medical conditions your dermatologist may recommend blood work.

Treatment of Granuloma Annulare

As most people do not have symptoms treatment is not necessary. The spots on the skin generally disappear on their own without leaving scars. Within a few months, most lesions are gone. Occasionally, clearing takes years.

If lesions are widespread or cosmetically undesirable, there are several treatment options. Your dermatologist may prescribe a steroid cream or inject steroids directly into the spot to help it disappear faster. Steroids can thin your skin and should be used according to your dermatologist’s directions.

PUVA, a type of ultraviolet light therapy, may be used to treat widespread disease. This therapy is given under close supervision of a dermatologist. The major side effect of PUVA is a sun-burn type reaction.

Other oral medications may be indicated. It is important to see a dermatologist and get the correct diagnosis and the appropriate therapy.

HERPES ZOSTER (SHINGLES)

Shingles (herpes zoster) is a nerve infection caused by the chicken-pox virus. Shingles results from activation of chicken-pox virus that has remained in your body since you had chicken pox- perhaps many years ago. The virus activation is limited to nerve root. That accounts from the pattern of the rash, which always stops at the body’s midline. The nerve involvement explains the stinging, burning or pain common in shingles. Some patients have discomfort before the rash appears.

The rash of shingles begins as red patches that soon develop blisters. The blisters may remain small or can become large. They heal in two to four weeks. They may leave some scars.

Many patients mistakenly believe that “nervousness” causes shingles. This is wrong: shingles is a viral infection of a nerve that has nothing to do with being “nervous.”

CONTAGION

You don’t have to quarantine yourself. Until your rash is healed, however, you should keep away from persons who have never had chicken pox, are ill, or are unable to fight infection because of a disease or a medication. Small children or infants can catch chicken pox from someone with shingles. Contact with health adults appears safe.

HIVES (urticaria)

Hives are itching red welts or small bumps that last from 15 minutes to several hours. They usually spread suddenly and leave no trace when they disappear. Crops of hives may appear several times a day. They may come and go for days or weeks, sometimes longer. Hives are harmless except when they cause throat swelling; this is rare but requires immediate treatment.

What causes hives?

Hives may be caused by something taken internally, most often medicine such as penicillin or aspirin. Sometimes foods cause hives; shellfish and strawberries are well-known examples. Hives are sometimes caused by infections such as infectious mononucleosis or are the result of internal disease. Occasionally physical agents such as pressure or cold can cause hives. Often the cause can’t be found. Fortunately, we can usually treat hives successfully even though their cause may remain a mystery.

KERATOSIS PILARIS

Keratosis Pilaris is a common skin condition that causes rough patches and small, acne-like bumps, usually on the arms, thigh, cheeks and buttocks. Keratosis Pilaris bumps are usually white, sometimes red, and generally don’t hurt of itch but difficult to treat.

Keratosis Pilaris can occur at any age, although it particularly common in young children. Keratosis Pilaris isn’t often a serious medical condition, and treatment usually isn’t necessary. Gradually, Keratosis Pilaris usually resolves on its own. However, if you’re concerned about the appearance of your skin, ask your dermatologist about treatment options.

Treatment

No single treatment universally improves Keratosis Pilaris. Self-care measures and medicated creams focus on softening the keratin deposits in the skin.

MOLLUSCUM CONTAGIOSUM

Molluscum contagiosum consists of small, harmless, skin growth caused by virus. They resemble pimples at first. Later, when they enlarge, they often have a waxy, pinkish look and a small central pit.

Molluscum contagiosum can be spread from person to person by direct skin contact. It is harmless and never turns cancerous.

PERIORAL DERMATITIS

Perioral dermatitis is a common skin problem that affects young women and occasionally, men or children. “Perioral” refers to the area around the mouth, and “dermatitis” indicates a rash or irritation of the skin. The areas most affected by perioral dermatitis are the facial lines from the nose to the sides of the boarders of the lips, and the chin. The areas around the nose, eyes, and cheeks can also be affected. There are small red bumps, mild peeling, mild itching, and sometimes burning associated with perioral dermatitis. When the bumps are the most obvious feature, the disease can look like acne.

PITYRIASIS ROSEA

Pityriasis rosea is a common, harmless skin disease caused by a virus that is everywhere.

We know that:

  • Pityriasis rosea is not contagious.
  • Pityriasis rosea clears up in about three to six weeks, sometimes a little longer. When clear the skin returns to its normal appearance. There will be no scars.
  • Pityriasis rosea is not related to foods, medicines or nervous upsets.
  • Pityriasis rosea always disappears by itself.
  • A single scaling spot often appears 1 to 20 before the general rash. The rash covers mainly the trunk but may spread to the thighs, upper arms, and neck. Pityriasis rosea usually avoids the face, although sometimes a few sports spread to the cheeks.
  • Second attacks of pityriasis rosea are rare.

ROSACEA

Rosacea is a fairly common annoying face rash of adults. The rash of rosacea has a red area and pimples. It is especially noticeable on the nose, mid-forehead, and chin. Rosacea pimples resemble the acne pimples of teen-agers, and years ago rosacea used to be acne rosacea. Rosacea is only a skin condition and is not related to your general health. Sometimes eye irritation occurs in rosacea. While in some persons rosacea causes mild itching or burning, its unsightly appearance is the usual reason for treating it.

SCABIES

If the following instructions are followed carefully, one treatment usually is enough to cure scabies. Some itching any persist for four to seven days. This is normal and does not mean more treatment is required. The itching will gradually disappear.

  • The medication may be in a cream or lotion form. If you are using a lotion, be sure to shake it to mix the medication with the lotion.
  • You do not have to take a bath before the treatment. If you have a thick, crusty scabs, you may take a bath to soak off the crusts. The skin should be thoroughly dried before you apply the cream or lotion.
  • The medication should be applied to all skin areas, not just the itching areas. However, do not apply anywhere above the jaw. Scabies do not infect the face or scalp.
  • Be sure to include the following areas during application: armpits, navel, buttocks, anal and genital areas and webbed areas of the fingers and toes.

The medication should be left on for 8-12 hours then washed off with soap and water bath.

  • A moisturizing skin cream may be used for any remaining itching.
  • Clothing and bed linens should be changed and laundered.
  • Scabies is infections. You may be infected by coming in contact with someone who has the disease or by wearing contaminated clothing. Therefore, family members or other people who come in close contact with you should be examined, especially if they are itching. It is possible that they may be treated even if they show no symptoms of having scabies.

SEBORRHEIC KERATOSIS

Seborrheic Keratosis are harmless, common skin growths that first appear during adult life. As time goes by, more growths appear. Some persons have a very large number of them. Seborrheic appear on both covered and uncovered parts of the body. They are not caused by sunlight. The tendency to develop seborrheic keratosis is inherited.

Seborrheic Keratosis are harmless and never become malignant. They begin as raised, light brown spots. Gradually they thicken and take on a rough, wart like surface. They slowly darken and may turn black. These color changes are harmless. Seborrheic keratosis are superficial and look as if they were stuck on the skin. Person who have several seborrheic keratosis can usually recognize this type of benign growth. However if you are concerned or unsure about any growth consult the doctor.

SKIN TAGS

“Skin tags” perfectly describes the little growths some people develop about the neck, armpits or groin, for they look like little bits of skin. The medical name is acrochordon. The tendency to develop skin tags in inherited. Skin tags sometimes turn tan or brown. They are harmless and never become cancerous or malignant. At times a skin tag may become sore from rubbing against clothing or jewelry. While annoying, this is not dangerous.

TINEA VERSICOLOR

Tinea versicolor is a harmless skin disorder caused by a germ living on normal skin. Usually this germ-which all of us have on our skin –grows sparsely and is not visible. In some individuals it grows more actively. This causes these light scaling patches on the trunk, neck or arms known as tinea versicolor. On untanned skin tinea versicolor rash is a pink or coppery tan. On tan skin the tinea versicolor patches are lighter, since the tanning doesn’t occur in the rash areas. The failure to tan is temporary: the skin tans normally after the rash has cleared up.

Tinea versicolor is not contagious. Tinea versicolor is more common in hot, humid climates and often comes back in the summertime.