Disorders of the Skin

The skin is the outer covering of one body. Doctors consider it to be a separate “organ” of the body, and it covers a large area. Fortunately, because any disorder of the skin is usually quickly seen, it receives attention more promptly than diseases occurring within the body that generally cannot be seen by the naked eye. People merely rely on symptoms – subjective sensations that tell them something is wrong.

However, although symptoms often arise with skin disorders, such as itch or irritation, the mere sight of an abnormality is frequently enough to bring a patient along to the doctor in search of a cure.

The skin of the face in particular carries major social implications. A clear, pimple-free, smooth skin is equated with beauty and good looks. Much has been made of this in the world. Not only does everybody desire to look attractive, but in the younger age groups, particularly with young women, its importance is major.

Disorders of the Skin Causes

Cancer, a word that conjures up horrible forebodings, is very common on the skin. Skin cancers are among the most common form of carcinoma. Fortunately, once again because they are readily obvious at an early stage, diagnosis tends to be made earlier. At this stage, successful treatment is generally possible. But, like any type of cancer, if left, it may bring serious consequences, and even death.

There are a great many skin disorders. In fact, many books have been written for doctors. In this section, it will be possible (and, I suggest, desirable) to deal with only the more common skin disorders, those that affect most people most often. So if you cannot locate some bizarre, rare skin problem here, it is for this reason.

An extremely large number of disorders can occur with the skin. Because they are obvious from an early stage, treatment can often be commenced promptly, as the skin is the most accessible organ of the entire body.

Skin grows continuously. The outermost layer is called the epidermis, which has an outer layer of dead cells called the Stratum corneum. This is continually shed as new skin cells grow up from active cells underneath. This is why skin lesions, cuts etc soon “heal.” The old cells are completely replaced by new ones. Below this is the dermis. This contains the blood vessels, sweat glands, oil glands (sebaceous glands) and the hair follicles from which the hairs grow. Blood vessels and nerves arc present in this layer.

Deeper than this is the subcutaneous tissue, which contains greater masses of structures, fat, blood vessels, nerves and muscle.

Hair and nails are part of the skin structure. They, too, come from growing cells beneath, and are merely dead objects in themselves.

Many words have been coined to describe the multitude of lesions occurring on the skin. They are merely descriptive, and are used by doctors. They are really unimportant to the treatment of the disorders, although some common expressions are used in this book.

Skin Terminology

These are some of the terms used to describe disorders of the skin:

Macule

This is a flat, non-raised circumscribed area of skin pigmentation such as a freckle or flat mole.

Papule

This is a pimple. It is a raised, small, well-demarcated area and color may vary such as in warts, acne pimples and raised parts of psoriasis.

Plaque

This is an accumulation of papules, and may be quite extensive. In fact, any raised area 2-3 cm or more in diameter is called a plaque. Extensive areas as in psoriasis are often seen. They may be scaly.

Tumor

This is a lump, and it may be below or above the skin surface. It does not necessarily indicate a malignancy (cancer), although lay persons frequently believe the terms synonymous. The Greater bulk of tumors are noncancerous (“benign”).

Weal

This is a raised area of skin. It is usually pinkish, and there may be surrounding redness of the skin, but not necessarily. Hives and allergic reactions, and bites are typical of weals.

Vesicles

These are blisters. Usually small, they are typified by cold-sore Larger sores are called bullae. Sun friction, contact dermatitis and eruptions are common causes.

Pustules

If pus fills the blister (vesicle), then referred to as a pustule. Infection has often occurred, producing the pus.

Scales

Many skin disorders result in scaling of the skin. It is common following sunburn where large sheets come ay rather than fine scales. Dermatitis, particularly seborrhoeic dermatitis the form of dandruff, and psoriasis over scales are typical.

Ulcers

Ulcers break in the skin surface; they are common in skin disorders. It means some serious form of infection or underlying disorder and need careful diagnosis.

Crusts

Any lesion that discharges will ultimately dry out and form a coating or crust. Although these may appear to be satisfactory on inspection, frequently activity is occurring underneath, and this is the important aspect. It must be treated until cured.

Scars

Any skin disorder where inflammation or injury has taken place will be awed ultimately by scarring. These new skin cells have grown into the body. Sometimes these may be very excessive and “keloid” scarring occurs commonly after burning etc.

Some skin disorders tend to occur in specific parts. This often makes diagnosis much easier, although with so many skin diseases having similar characteristics, it can be difficult.

Pruritus

This describes an itch. Many skin troubles are characterized by itch, indeed, it can often be intense. Some have special “antipruritic” (anti-itch) properties, and these are used freely when this symptom is proving troublesome.

Erythema

This means the part is red. Often, particularly if infection is present also, it may be warm or hot.

The list of skin disorders continues. They seem to come in a never-ending profusion. Modern therapy has made a huge difference in treatment. Cancers are among 7:1 or more, important disorders, and prompt therapy is vital. Leave black moles well alone and seek immediate medical advice, for they can be fatal. Birthmarks often disappear without any treatment; freckles and bruises may be status symbols, and at last a cure has been claimed for the troublesome complaint called psoriasis.

Fungus Infections Ringworm (Tinea)

Ringworm, also known as tinea, is a common infection of the skin. Unlike many infections due to bacteria and viruses, ringworm is a “fungus” infection and is really a microscopic “plant.” Infections can be small, localized and barely noticeable. But others are extensive and produce major symptoms. Children are often infected from pet animals. Almost any part of the skin of the body may be affected. The lesions produced vary, depending on the locality.

Diagnosis is often difficult as the sores may simulate other skin disorders. Doctors often rely on special tests. A frequently used one is to take some “scrapings” from the infection and examine these under a microscope. This shows a typical picture of the fungus.

Another method is the use of special ultraviolet light called “Wood’s light.” Under this, certain forms of ringworm give a translucent hue.

Until the advent of the antibiotic called griseofulvin, taken orally, treatment of ringworm consisted of local applications. This often gave poor results. But griseofulvin has revolutionized therapy and brings prompt relief in most cases; here are some of the chief areas affected and the points to check:

Ringworm of the Scalp (Tinea Capitis)

Circular areas of baldness occur on the scalp. Often the lesion is red and scaling. It is found almost exclusively in children, and there is a history of contacting other children with the same complaint or contacting infected animals, usually household pets. Diagnosis is confirmed by the physician from scrapings or by use of Wood’s light.