Common Dermatological Diagnoses G-M

Common Dermatological Diagnoses G-M


What is generalized exfoliative dermatitis?

Generalized exfoliative dermatitis is a severe inflammation of the entire skin surface due to a reaction to certain drugs, or as a result of complications from another skin condition. In some cases, lymph node cancer (lymphoma) can cause generalized exfoliative dermatitis. Often, however, no cause can be found.

What are the symptoms of generalized exfoliative dermatitis?

The following are the most common symptoms of generalized exfoliative dermatitis. However, each individual may experience symptoms differently. Symptoms may include:

  • extreme redness of the skin
  • scaling
  • thickened skin
  • itching
  • swollen lymph nodes
  • fever
  • loss of fluids and proteins through the damaged skin

The symptoms of generalized exfoliative dermatitis may resemble other skin conditions. Always consult your physician for a diagnosis.

How is the cause of generalized exfoliative dermatitis determined?

Diagnosis includes careful elimination of known causes, such as certain drugs (i.e., penicillin and barbiturates). In addition, your physician may check for other skin conditions such as atopic dermatitis, as well as for lymphoma (which may be the cause of the generalized exfoliative dermatitis condition), during a physical examination and medical history.

Treatment for generalized exfoliative dermatitis

Specific treatment for generalized exfoliative dermatitis will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the reaction
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the reaction
  • your opinion or preference

Severe cases of generalized exfoliative dermatitis may require hospitalization while the person is being treated with antibiotics, intravenous (IV) fluids, and nutritional supplements. Treatment will vary depending upon the cause:

  • If certain drugs are causing the condition, eliminating them usually clears up generalized exfoliative dermatitis condition.
  • If another skin condition causes generalized exfoliative dermatitis, treating the other skin condition usually clears up the generalized exfoliative dermatitis condition.
  • If lymphoma is causing the condition, treating the lymphoma usually clears up the generalized exfoliative dermatitis condition.

Other treatments may include:

  • heated blankets (to keep warm)
  • cool baths
  • petroleum jelly applied to skin, followed by gauze
  • corticosteroids

Forty to 50 percent of Americans who live to the age of 65 will have skin cancer at least once. The most common types of skin cancer in the United States are basal cell and squamous cell carcinomas. These are referred to as nonmelanoma skin cancers and are generally the result of sun exposure.

Approximately one in 59 people will develop melanoma during their lifetime. Malignant melanoma is a cancer that begins in the melanocytes, the pigment-producing cells in the skin. The majority of melanoma cases (90 percent) are due to environmental factors such as ultraviolet radiation (sun exposure). However, about 5 percent to 10 percent of cases occur in people with a family history of melanoma. In some of these families, the risk to develop melanoma will be inherited in an autosomal dominant fashion. In other words, parents with a mutation have a 50/50 chance to pass on the susceptibility to each of their children regardless of gender.

One type of hereditary melanoma, called the familial cutaneous malignant melanoma/dysplastic nevus syndrome  is caused by a gene on chromosome 9, known as p16, or CDKN2A. This condition accounts for about 20 percent of the familial cases of melanoma. Mutations in p16 result in unregulated cell growth. Persons with a p16 mutation have an increased lifetime risk to develop melanoma (50 percent or more) as well as an increased risk (approximately 17 percent) to develop pancreatic cancer. Genes on chromosomes 1 and 12 have also been found to be involved in familial cases of melanoma.


What is granuloma annulare?

Granuloma annulare is a chronic skin condition characterized by small, raised bumps that form a ring with a normal or sunken center. The cause of granuloma annulare is unknown.

What are the symptoms of granuloma annulare?

The following are the most common symptoms of granuloma annulare. However, each individual may experience symptoms differently. Symptoms may include:

  • yellowish or skin-colored bumps
  • one or several rings of bumps on feet, legs, or hands

The symptoms of granuloma annulare may resemble other skin conditions. Always consult your physician for a diagnosis.

How is granuloma annulare diagnosed?

In addition to a complete medical history and physical examination, diagnosis is usually confirmed with a skin biopsy (removing a small sample of tissue for examination under a microscope).

Treatment for granuloma annulare

Specific treatment for granuloma annulare will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the condition
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

Granuloma annulare usually clears up by itself. Treatment may include corticosteroid treatments (cream, tape, or injections).


What is an ingrown hair?

An ingrown hair is a hair that curls and penetrates the skin with its tip, causing inflammation. Ingrown hairs are more common among people with very curly hair. Most ingrown hairs occur in the beard area.

What are the symptoms of an ingrown hair?

The most common symptom of an ingrown hair is inflammation of the skin, followed by pus formation. However, each individual may experience symptoms differently. The symptoms of an ingrown hair may resemble other skin conditions. Always consult your physician for a diagnosis.

How is an ingrown hair diagnosed?

Diagnosis of an ingrown hair can be confirmed with a medical history and a physical examination.

Treatment for an ingrown hair

An ingrown hair often heals on its own. However, in the case of chronic ingrown hairs, treatment may include:

  • allow the hair to grow longer
  • depilatory (to remove the hair)
  • electrolysis (to remove the hair

What is keratosis pilaris?

Keratosis pilaris is a common skin disorder characterized by small, pointed pimples. The pimples usually appear on the upper arms, thighs, and buttocks. The condition worsens in the winter and usually clears up in the summer. Keratosis pilaris has no known cause, but tends to run in families.

Treatment for keratosis pilaris

Usually no treatment is necessary for keratosis pilaris, since it normally clears up by itself. Treatment may include:

  • using petroleum jelly with water, cold cream, or salicylic acid (which removes the top layer of skin) to flatten the pimples
  • using a tretinoin cream (a drug which is chemically related to vitamin A).

There are many different types of lesions and skin conditions that can be treated with laser surgery. Your physician will decide if you are a candidate for the particular surgery. The following is a brief overview of some of the skin conditions that can be treated with laser surgery:

    Port-wine stains
    Port-wine stains are congenital (present at birth) capillary malformations. The color of this birthmark is usually pink, red, or purple. About 0.3 percent of children are born with port-wine stains. As the child grows, the mark may become darker. Port-wine stains can appear on any part of the body and can vary in size. The type of laser usually used for this condition is the pulsed dye laser.

    A pulsed dye laser is a type of laser that has a high electric lamp which produces a short, high-energy flash of light. The light is colored when it passes through a dye. The color of the dye can be changed, depending upon the type of pigmented skin spots that are being treated. Adults may have this procedure performed on an outpatient basis with only local anesthesia. Children or persons with large port-wine stains, may be treated under general anesthesia. Multiple treatments may be necessary.

    Hemangiomas
    Hemangiomas are a common type of vascular birthmark. About 10 percent of Caucasians have hemangiomas. Hemangiomas may vary in appearance, from red, raised patches to deeper, purple areas. Hemangiomas usually appear within the first month of life, grow rapidly for the first year, and may start to go away by the time the child is 5 years old. Fifty percent of hemangiomas become smaller naturally by age 5. Hemangiomas are either superficial or deep. Surgery may be indicated for large or growing hemangiomas, or hemangiomas that are causing problems because of their location. The type of laser usually used for this condition is the pulsed dye laser. Multiple treatments may be necessary.

    Café au lait macules
    These are tan-colored lesions that may appear anywhere on the body. The size of the lesions varies. Some of the lesions can be very large, and cosmetic removal may be desired. A variety of lasers may be used for removal of these spots. Recurrence is common.

    Telangiectasias
    Telangiectasias are small blood vessels that are located under the surface of the skin. The vessels may appear red, purple, or blue. The most common places these are seen include the face, upper chest, and neck. Related vessels can be found in the legs, called spider veins. Removal is usually for cosmetic reasons.

    There are many causes of telangiectasia, including heredity, sun damage, hot and spicy foods, emotions, hormones, some medications, and adult acne. Treatment of these lesions may include lasers or sclerotherapy. Sclerotherapy is a procedure in which a small needle is used to inject medication into the vessels, causing them to shrink. New vessels may continue to develop throughout the person's life, depending on the underlying cause of the lesions.

    Wrinkles
    The use of lasers to help remove wrinkles is one of the great advances in cosmetic plastic surgery. The term used to describe this procedure is a laser peel. This type of wrinkle removal process is safer than other methods of wrinkle removal when performed by an experienced surgeon. There is less of a chance of scaring, swelling, and crusting with the laser peel. Prior to the actual surgery, your physician may prescribe facial medications for you to use to help prepare your skin. These medications may be used for four to six weeks prior to the laser peel. After the laser peel, your physician will explain proper skin care to prevent crust formation and infection. Many different types of lasers may be used for laser peels.

    Warts
    Warts are growths of skin or membrane that are not malignant (cancerous). Warts are caused by the human papilloma virus and are often hard to destroy. Many different types of treatments have been used for wart removal, including surgical excision, application of medications to the wart, or freezing the wart. As a result of the side effects of these treatment modalities, use of the laser has been warranted. The type of laser used is usually the pulsed dye laser. Multiple treatments may be necessary until the wart is gone.

    Scars
    Scars may be formed for many different reasons, including infections, surgery, injuries, or inflammation of tissue. A scar is the body's natural way of healing and replacing lost or damaged skin. Scars may appear anywhere on the body. The composition of a scar may vary - the scar may be flat, lumpy, sunken, colored, painful, and/or itchy. Scars may be treated with a variety of different lasers, depending on the underlying cause of the scar. Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for scars is performed in conjunction with other treatments such as injections of steroids, use of special dressings, and the use of bandages. Multiple treatments may be necessary.

    Tattoo removal
    Approximately 10 million Americans have some type of tattoo. There are several types of tattoos: decorative tattoos, which are placed for decorative purposes; cosmetic tattoos, which are known as permanent cosmetics, such as permanent eyeliner or lipstick; traumatic tattoos, which are a result of a trauma that embeds a foreign substance, such as dirt, in the skin; medical tattoos, such as those placed by a physician as landmarks for radiation therapy; and amateur tattoos, done by individuals on themselves or by nonprofessionals. There are many factors that determine the outcome of laser surgery on removing tattoos. These include the patient's age, skin type, type of tattoo, age of the tattoo, color of the tattoo, size and depth of the tattoo, and whether the tattoo was performed by a professional or an amateur. Some ink colors may be completely resistant to laser treatment. Laser removal of tattoos breaks up the color without damaging normal skin. The body then absorbs the pieces of pigment without leaving a scar as previous tattoo removal methods did. Multiple treatments may be necessary.


What is laser surgery?

Laser surgery is a type of surgery that uses special light beams instead of instruments for surgical procedures. Laser stands for "light amplification by the stimulated emission of radiation." Lasers were first developed in 1960. Newer laser modifications continue to have a large impact on medical and surgical practices. A large part of their impact has been seen in the treatment of various skin lesion and diseases.

How does a laser work?

The functioning of a laser goes back to Albert Einstein's quantum theory of radiation and includes other theories that help explain local tissue damage. As the light beam hits the skin, the skin may either reflect the light away, scatter the light, absorb the light, or let the light pass through the different layers. Each layer of the skin uses the light differently.
Certain parts of the skin, called chromophones, absorb the light. When these chromophones absorb the light, physical, mechanical, chemical, or temperature changes may occur in the tissue. There are many different types of lasers, including the carbon dioxide laser, the YAG (neodymium, or yttrium aluminum garnet) laser, and the argon laser. Each type works in a different manner and may be used for different treatment options. Laser light can be delivered either continuously or intermittently.

What types of surgeries use lasers?

There are many indications for the use of lasers in surgery. The following are some of the more common indications:

  • to remove tumors;
  • to help prevent blood loss by sealing small blood vessels;
  • to seal lymph vessels to help decrease swelling and decrease the spread
    of tumor cells ;
  • to treat some skin conditions, including to remove or improve warts, moles,
    tattoos, birthmarks, scars, and wrinkles.

What are lice?

Lice are tiny insects that can infest the skin anywhere on the body. Lice infection is characterized by intense itching.
Lice are highly contagious, spreading from person to person by close body contact, shared clothes, and other items (such as hats, hairbrushes, and combs). There are three types of human lice, including the following:

  • Head lice
  • Body lice
  • Pubic lice
Facts about lice

Head lice:

  • Head lice are less likely to occur in African-Americans.
  • Head lice are seen mostly in childcare settings and among school-aged children.
  • The child usually has itching in the head area.
  • Lice, or the eggs (called nits), can usually be seen on the hair, behind the ears, and on the neck.

Body lice:

  • Body lice are usually seen in people with poor hygiene.
  • Body lice are rare in children.
  • Body lice cause severe itching, which is often worse at night.
  • With body lice, in some cases, lice and eggs can be found in the seams of clothes.

Pubic lice:

  • Pubic lice are very contagious and can be transmitted through sexual contact, or by contaminated items such as towels and clothes.
  • Pubic lice can affect the pubic hair, but also can cause infections of the hair on the chest, abdomen, thighs, and eyebrows.
  • Itching of the affected area is a common symptom of pubic lice.
How are lice diagnosed?

The eggs laid by lice are usually visible to the naked eye, making it easy for your physician to diagnose. Pubic lice leave small, brown spots on the parts of clothing that come into contact with the genitals or anus.

Treatment for lice

Specific treatment for lice will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the infestation
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the infestation
  • your opinion or preference

Lice are treatable. Application of a medicated cream rinse or shampoo is usually effective treatment for head and/or pubic lice. Specific instructions need to be followed. Discuss this with your physician. Examples of medicated cream rinses or shampoos include the following:

  • Malathion (Ovide®) - this is a new treatment that is safe and effective for lice and nits
  • Lindane (Kwell®) - do not use if there are open sores on the head because of toxicity
  • Pyrethrins (RID®) - this treatment does not kill nits (lice eggs)
  • Permethrin cream rinse (Nix®) - this treatment does not always work due to lice resistance
  • Nits need to be removed from the hair with a fine-tooth comb.
  • Combs and brushes should be soaked in hot water with the shampoo for period of at least 15 minutes.

For body lice:

  • Medications are usually not needed to treat body lice.
  • Treatment for body lice usually consists of improving hygiene and washing clothes.
  • Bed sheets and blankets should be washed in hot water and dried in a hot dryer.

What is melanoma?

Melanoma is a disease of the skin in which cancer cells are found in the melanocytes, the cells that produce color in the skin or pigment known as melanin. Melanoma usually occurs in adults, but it may occasionally be found in children and adolescents. Melanoma may also be called cutaneous melanoma or malignant melanoma. Melanoma is the rarest, but most virulent, form of skin cancer.
Melanoma is a more serious type of cancer than the more common basal cell cancer, or squamous cell cancer. Although the incidence of melanoma is lower than other types of skin cancer, it has the highest death rate and is responsible for 75 percent of all deaths from skin cancer.

Where is melanoma most often found?

Melanoma most often appears on fair-skinned men and women, but people with other skin types can be affected. Rarely, melanomas can form in parts of the body not covered by skin such as the eyes, mouth, vagina, large intestine, and other internal organs.

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.
Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors.
But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What are the risk factors for melanoma?

Persons with the following characteristics may be at an increased risk for melanoma:

  • blond or red hair;
  • blue eyes;
  • fair complexion;
  • family history of melanoma;
  • a changed or changing mole;
  • many ordinary moles (more than 50);
  • many freckles;
  • an immunosuppressive disorder;
  • dysplastic nevi;
  • sun exposure (The amount of time spent unprotected in the sun directly affects your risk of skin cancer);
  • inability to tan.

Dark-brown or black skin is not a guarantee against melanoma. African-Americans can develop this cancer, especially on the palms of the hands, soles of the feet, under nails, or in the mouth.

What are the symptoms of melanoma?

The following are the most common symptoms of melanoma. However, each individual may experience symptoms differently. Symptoms may include:

  • change in the size, shape, or color of a mole;
  • oozing or bleeding from a mole;
  • a mole that feels itchy, hard, lumpy, swollen, or tender to the touch.

Because most malignant melanoma cells still produce melanin, melanoma tumors are often shaded brown or black. Melanoma can also appear on the body as a new mole. Men most often develop melanoma on the area of the body between the shoulders and hips, or on the head or neck. Women most often develop melanoma on the arms and legs. However, melanoma can spread quickly to other parts of the body through the lymph system, or through the blood. Like most cancers, melanoma is best treated when it is diagnosed early.

The symptoms of melanoma may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Distinguishing benign moles from melanoma

To prevent melanoma, it is important to examine your skin on a regular basis, and become familiar with moles, and other skin conditions, in order to better identify changes. According to recent research, certain moles are at a higher risk for changing into malignant melanoma. Moles that are present at birth, and atypical moles, have a greater chance of becoming malignant. Recognizing changes in your moles, by following this ABCD Chart, is crucial in detecting malignant melanoma at its earliest stage. The warning signs are:

Normal Mole / Melanoma Sign Characteristic
Photo comparing normal and melanoma moles showing asymmetry Asymmetry When half of the mole does not match the other half
Photo comparing normal and melanoma moles showing border irregularity Border When the border (edges) of the mole are ragged or irregular
Photo comparing normal and melanoma moles showing color Color When the color of the mole varies throughout
Photo comparing normal and melanoma moles showing diameter Diameter If the mole's diameter is larger than a pencil's eraser

Photographs Used By Permission: National Cancer Institute

Melanomas vary greatly in appearance. Some melanomas may show all of the ABCD characteristics, while other may only show changes in one or two characteristics. Always consult your physician for a diagnosis.


What is Merkel cell cancer?

Merkel cell cancer is also known as neuroendocrine cancer of the skin, or trabecular cancer. Characterized by firm, shiny skin lumps, this rare cancer develops on or just beneath the skin and in the hair follicles. Merkel cell cancer most often is found on sun-exposed areas of skin, such as the neck and head. The cancer mostly affects Caucasian people between the ages of 60 and 80 years of age. The cause of the cancer is unknown.

What is the appearance of Merkel cell cancer tumors?

Merkel cell cancer tumors usually are firm, shiny skin lumps that do not hurt. The lumps, or tumors, may be red, pink, or blue and can range in size from smaller than a quarter inch to larger than two inches in diameter.

How is Merkel cell cancer diagnosed?

Early diagnosis and treatment of Merkel cell cancer is crucial in preventing the cancer from spreading. However, diagnosis of Merkel cell cancer is difficult, as it can resemble many other types of cancer.

Treatment for Merkel cell cancer:

Specific treatment for Merkel cell cancer will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, and therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment may include:

  • surgery to remove the tumor (including a border of healthy tissue)
    Since Merkel cell cancer grows fast and often spreads (metastasizes), your physician may also remove nearby lymph nodes.
  • chemotherapy-treatment with drugs to destroy cancer cells.
  • radiation therapy-uses a radiation machine that emits x-rays to kill cancer cells and shrink tumors.

What is molluscum contagiosum?

Molluscum contagiosum is a viral disease of the skin that causes small, pink or skin-colored bumps on the skin. It is not harmful and usually does not have any other symptoms. The virus is inside the bumps and is mildly contagious. These bumps usually clear over an extended period of time.

What causes molluscum contagiosum?

Molluscum contagiosum is caused by a virus called the poxvirus. It is most common in children and adolescents, although it can affect adults. The virus usually is spread through skin-to-skin contact with an infected person. People with weakened immune systems, young children, and people living in warm, humid climates are more susceptible to molluscum contagiosum.

What are the symptoms of molluscum contagiosum?

The bumps are small and are usually pink or skin-colored. Eventually, the bumps tend to have a small sunken center. The number of lesions usually ranges between two to 20. The lesions usually occur in groups or clusters. They are not harmful, but may cause some cosmetic concern for the individual if they appear on the face or other visible areas.

How is molluscum contagiosum diagnosed?

Molluscum contagiosum is usually diagnosed based on a medical history and physical examination. The lesions are unique and usually are diagnosed on physical examination. Additional tests are not routinely ordered.

Treatment for molluscum contagiosum:

Specific treatment for molluscum contagiosum will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the condition
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

In most cases, the lesions will heal without treatment over a period of six to nine months. Additional treatment options may include:

  • removal of the lesions
  • use of topical medications (to speed the resolution of the lesions)