Skin Conditions: Cysts, Lumps and Bumps

There are a number skin conditions that cause lumps and bumps to appear on the surface of the skin or just below the skin. This article covers some of the most common ones, and includes the following:

• Skin cysts
• Cherry angioma
• Dermatofibromas
• Epidermoid cysts
• Folliculitis
• Keratoacanthoma
• Keratosis pilaris
• Lipomas
• Neurofibromas

Skin Cysts

Cysts are noncancerous, closed pockets of tissue that can be filled with fluid, pus, or other material.

Cysts are common on the skin and can appear anywhere. They feel like small peas under the surface of the skin. Cysts can develop as a result of infection, clogging of sebaceous glands (oil glands), or around foreign bodies, such as earrings.

What Are the Symptoms of Skin Cysts?

Skin cysts usually are:

• Slow-growing
• Painless
• Smooth to the touch when they are rolled under the skin

How Are Skin Cysts Treated?

Cysts usually do not cause pain unless they rupture or become infected or inflamed. Some cysts disappear on their own without treatment. Other cysts may need to be drained. That involves piercing the cyst with a sharp object and draining it. Some inflamed cysts can be treated with an injection of cortisone medication to cause it to shrink. Cysts that do not respond to other treatments or reoccur can be removed surgically.

Cherry Angioma

A cherry angioma is a smooth, cherry-red bump on the skin.

Although cherry angiomas usually appear on the trunk of the body, they can occur nearly anywhere. The cause of cherry angiomas is not known and the growths usually appear on people over the age of 40.

What Are the Symptoms of Cherry Angiomas?

Cherry angiomas are small, bright red growths that are smooth. The size of the growths can vary from the size of a pinhead to about a quarter inch in diameter.

How Is a Cherry Angioma Treated?

In most cases, cherry angiomas do not require treatment. If they are cosmetically unappealing or are subject to bleeding, angiomas may be removed by lasers or electrocautery -- the process of burning or destroying tissue by use of a small probe with an electric current running through it. Removal may cause scarring.

Dermatofibromas

Dermatofibromas are harmless round, red-brownish skin growths that are most commonly found on the arms and legs. Dermatofibromas contains scar tissue and feel like hard lumps in the skin.

The cause of dermatofibromas is not known.

What Are the Symptoms of Dermatofibromas?

The symptoms of dermatofibromas include:

• A red, brown or purple growth that can change colors over time
• A growth that is as small as a BB pellet
• Tenderness, pain and itching; however, growths also can be painless
• A dimple that appears when the growth is pinched

How Are Dermatofibromas Treated?

In most cases, there is no need to treat dermatofibromas. However, the growths can be removed surgically or can be flattened by being frozen with liquid nitrogen.

 

Epidermoid Cysts

Epidermoid cysts, also called sebaceous cysts, are benign (non-cancerous) skin cysts formed from blocked oil glands in the skin. Most commonly, epidermoid cysts are found on the genitals, trunk and back; but, they also can occur in other areas of the skin.

What Are the Symptoms of Epidermoid Cysts?

In general, epidermoid cysts have a round appearance. A dark portion of the cyst is visible on the skin. If the cysts become infected, they will become red and tender. When the cysts are squeezed, they can produce a cheesy white discharge.

How Are Epidermoid Cysts Treated?

The effective treatment of epidermoid cysts requires that the sac of the cyst be completely removed. If the cyst is squeezed and the discharge is forced out, the cyst will reappear in the skin. Usually, a doctor will be able to remove the cyst by making only a small incision in the skin. Antibiotics may be prescribed to treat infected cysts.

Folliculitis

Folliculitis is an inflammation of the hair follicles. It can be caused by an infection in the hair follicles, by chemical irritation or by physical irritation (for example, shaving or friction from clothing). Typical body sites that are involved in folliculitis include the face, thighs and scalp.

Folliculitis is more common in people who have diabetes mellitus. It also is more common in people who are obese or have compromised immune systems.

What Are the Symptoms of Folliculitis?

The main lesion in folliculitis is a papule or pustule with a central hair. The hair shaft in the middle of the lesion may not be seen.

Other symptoms include:

• Multiple red pimples and/or pustules on hair-bearing areas of the body
• A rash
• Itching skin

How Is Folliculitis Treated?

Topical antibiotics, oral antibiotics or antifungal medications may be used to treat infections associated with folliculitis. Treatment also involves preventing further damage to the hair follicles. Steps that can help achieve this goal include:

• Minimizing friction from clothing
• Not shaving in the affected area, if possible. If shaving is necessary, use a clean new razor blade or an electric razor each time.
• Keeping the area clean

Keratoacanthoma

A keratoancanthoma occurs when cells in a hair follicle do not grow normally. The growth apparently is triggered by a minor skin injury in an area that previously had suffered sun damage. Ultraviolet radiation from sun exposure is the biggest risk factor in keratoacanthomas.

A keratoacanthoma usually will appear on sun-damaged skin as a thick growth that has a central crusted plug.

Keratoacanthomas appear most often in people who are over the age of 60.

What Are the Symptoms of a Keratoacanthoma?

Keratoacanthomas are rapidly growing, red, dome-shaped bumps with central craters. Some keratoacanthomas can grow to extremely large sizes, occasionally 3 to 6 inches in diameter.

How Are Keratoacanthomas Treated?

Keratoacanthomas can be removed by:

• Cryotherapy (freezing the growth with liquid nitrogen)
• Curettage (cutting out or scraping off the growth)

 

Keratosis Pilaris

Keratosis pilaris (commonly called KP) appears as "chicken skin bumps" on the skin. These bumps usually appear on the upper arms and thighs. They also can appear on the cheeks, back and buttocks. Keratosis pilaris, while unattractive, is harmless.

What Are the Symptoms of Keratosis Pilaris?

This disorder appears as small, rough bumps. The bumps are usually white or red, but do not itch or hurt. Keratosis pilaris is usually worse during the winter months or other times of low humidity when skin becomes dry. It also may worsen during pregnancy or after childbirth.

How Is Keratosis Pilaris Treated?

Although the condition may remain for years, it gradually disappears before age 30 in most cases. Treatment of keratosis pilaris is not medically necessary; but, individuals with this condition may want to seek treatment for cosmetic reasons.

The initial treatment of keratosis pilaris should be intensive moisturizing. A cream such as Acid Mantle, Vaseline or Complex 15 can be applied after bathing, and then re-applied several times a day. Other treatments may include:

• Medicated creams containing urea (Carmol-20) or alpha-hydroxy acids (Aqua Glycolic, Lacticare) applied twice daily
• Efforts to unplug pores by taking long, hot soaking tub baths and then rubbing the areas with a coarse washcloth or stiff brush

Lipomas

Lipomas are subcutaneous soft tissue tumors or nodules that usually are slow-growing and are considered benign (not harmful). They have a firm, rubbery consistency. Lipomas tend to form on the trunk, shoulders, neck, but can appear elsewhere on the body.

What Are the Symptoms of Lipomas?

Lipomas can appear as solitary nodules or in groups. Most lipomas are less than 5 cm in diameter and are asymptomatic, but they can cause pain when they compress nerves.

How Are Lipomas Treated?

Lipomas are not removed unless there is a cosmetic concern, a compression of surrounding structures, or an uncertain diagnosis. Lipomas generally do not infiltrate into surrounding tissue so they can be removed easily during excision.

An alternative to standard excision is to manually squeeze the lipoma through a small incision. This technique is useful in areas with thin dermis, such as the face and extremities. Liposuction-assisted lipectomy also can be used to remove large lipomas with minimal scarring.

Neurofibromas

Neurofibromas are soft, fleshy growths that occur on or under the skin, sometimes even deep within the body. These are benign (harmless) tumors; however, they can turn malignant or cancerous in rare cases.

What Are the Symptoms of Neurofibromas?

The symptoms of neurofibromas may vary, depending on the locations and the sizes of the tumors. Symptoms can include:

• A painless, slow-growing mass
• Occasional pain
• Electric-like "shock" when the affected area is touched
• Neurological problems if the tumor involves a major motor or sensory nerve or a nerve that is compressed between the tumor and a hard structure

How Are Neurofibromas Treated?

If the tumor is not causing any symptoms, no treatment may be necessary. However, doctors may choose to surgically remove the neurofibroma if it is affecting a major nerve. In most cases, neurofibromas are treated successfully and do not recur.

Reviewed by doctors at The Cleveland Clinic Department of Dermatology.

Reference Link:

http://www.webmd.com/skin-problems-and-treatments/guide/cysts-lumps-bumps

Cosmetic Procedures: Laser Tattoo Removal

It is estimated that close to 10% of the U.S. population has some sort of tattoo. Eventually, as many as 50% of them want to have laser tattoo removal.

There is good news for those who have an unwanted body design. Newer laser tattoo removal techniques can eliminate your tattoo with minimal side effects. Here's how it works: lasers remove tattoos by breaking up the pigment colors of the tattoo with a high-intensity light beam.

Black tattoo pigment absorbs all laser wavelengths, making it the easiest to treat. Other colors can only be treated by selected lasers based upon the pigment color.

Who Can Benefit From Laser Tattoo Removal?

Because each tattoo is unique, removal techniques must be tailored to suit each individual case. In the past, tattoos could be removed by a wide variety of methods but, in many cases, the scars were more unsightly than the tattoo itself.

Patients with previously treated tattoos may also be candidates for laser therapy. Tattoos that have not been effectively removed by other treatments or through home remedies may respond well to laser therapy providing the prior treatments did not result in excessive scarring.

How Do I Find a Reputable Doctor to Do Laser Tattoo Removal?

You want to make sure you find a reputable dermatologist or cosmetic surgery center to ensure proper treatment and care. If possible, you should obtain a recommendation from your family physician for a dermatologist or skin surgery center that specializes in tattoo removal.

 

What Can I Expect During the Laser Tattoo Removal?

Depending on the size and color of your tattoo, the number of treatments will vary. Your tattoo may be removed in two to four visits, though many more sessions may be necessary. You should schedule a consultation, during which time a trained professional will evaluate your personal situation and advise you on the process.

Treatment with the laser varies from patient to patient depending on the age, size and type of tattoo (amateur or professional). The color of the patient's skin, as well as the depth to which the tattoo pigment extends, will also affect the removal technique.

In general, this is what will happen during an office visit for tattoo removal using the newer lasers:

• Protective eye shields are placed on the patient.
• The skin's reaction to the laser is tested to determine the most effective energy for treatment.
• The treatment itself consists of placing a hand piece against the surface of the skin and activating the laser light. As many patients describe it, each pulse feels like a grease splatter or the snapping of a rubber band against the skin.
• Smaller tattoos require fewer pulses while larger ones require more. In either case, the tattoo requires several treatments and multiple visits. At each treatment, the tattoo should become progressively lighter.
• Immediately following treatment, an ice pack is applied to soothe the treated area. The patient will then be asked to apply a topical antibiotic cream or ointment. A bandage or patch will be used to protect the site and it should likewise be covered with a sun block when out in the sun.

Most patients do not require any anesthesia. However, depending on the location of the tattoo and the pain threshold for the patient, the physician may elect to use some form of anesthesia (topical anesthesia cream, painkiller injections at the site of the procedure).

What Are The Possible Side Effects?

There are minimal side effects to tattoo removal by lasers. However, you should consider these factors in your decision:

• The tattoo removal site is at risk for infection. You may also risk lack of complete pigment removal, and there is a slight chance that the treatment can leave you with a permanent scar.
• You may also risk hypopigmentation, where the treated skin is paler than surrounding skin, or hyperpigmentation, where the treated skin is darker than surrounding skin.
• Cosmetic tattoos like lip liner, eyeliner and eyebrows may darken following treatment with tattoo removal lasers. Further treatment of the darkened tattoos usually results in fading.

 

Is Laser Tattoo Removal Safe?

Thanks to newer technology, treatment of tattoos with laser systems has become much more effective with very little risk of scarring. Laser treatment is often safer than many traditional methods such as excision, dermabrasion or salabrasion (using moist gauze pads saturated with a salt solution to abrade the tattooed area) because of its unique ability to selectively treat pigment involved in the tattoo.

In many cases, certain colors may be more effectively removed than others. It is known that blue/black tattoos respond particularly well to laser treatment -- the response of other colors is under investigation.

Remember, the information provided here is designed to provide general information only and is not a replacement for a physician's advice. For details pertaining to your specific case, please arrange a consultation with a physician experienced in the use of tattoo lasers.

Does Insurance Cover Laser Tattoo Removal?

Since tattoo removal is a personal option in most cases and is considered a cosmetic procedure, most insurance carriers will not cover the process unless it is medically necessary. Physicians or surgery centers practicing tattoo removal may also require payment in full on the day of the procedure. If you are considering tattoo removal, be sure to discuss associated costs up front with the physician, and obtain all charges in writing before you undergo any treatment.

Reviewed by the doctors at The Cleveland Clinic, Department of Dermatology.

Severe Psoriasis May Up Risk of Death

Study Shows Patients With Severe Psoriasis Die Earlier

By Salynn Boyles
WebMD Medical News

Reviewed by Louise Chang, MD

Dec. 17, 2007 -- Psoriasis is not generally thought of as life-threatening, but it just might be for those with the severest forms of the disease.

People with severe psoriasis had a 50% increased risk of death compared with people without the inflammatory skin disease in a newly reported study.

Men with severe psoriasis died an average of 3.5 years earlier than men without the condition, while women with severe psoriasis died 4.4 years earlier than women without psoriasis.

Having mild psoriasis was not associated with an increased risk of death, and the researchers did not have information on causes of death.

But researcher Joel M. Gelfand, MD, says the findings make it clear that patients with severe psoriasis are at greater risk than has been realized.

"To put this in perspective, this finding suggests that more years of life are lost related to severe psoriasis than to severe hypertension," he tells WebMD.

Psoriasis and Death

As many as 7.5 million Americans have psoriasis, according to the National Institutes of Health.

About 80% to 85% of patients have mild to moderate psoriasis, while 15% to 20% have more extensive skin involvement. These patients generally require treatment with systemic medications like the drugs methotrexate and cyclosporine or newer biologics such as Enbrel, Remicade, and Humira.

Using a national medical records database from the U.K., Gelfand and colleagues from the University of Pennsylvania School of Medicine identified 133,568 patients with mild psoriasis, defined as having a diagnosis of psoriasis but no history of treatment for the condition.

An additional 3,951 patients were identified with severe psoriasis.

For each patient, up to five people without psoriasis who visited doctors for other causes were used for comparison.

During the study period, the death rate among patients with severe psoriasis was almost twice as high as in patients without psoriasis (21.3 deaths per 1,000 individuals per year vs. 12 deaths per 1,000 individuals per year).

During the study period, patients with severe psoriasis had a 50% increased risk of death compared with those without psoriasis. Those with milder psoriasis didn't have an increased risk of death compared to those without psoriasis.

The study appears in the December issue of the Archives of Dermatology.

Is Inflammation to Blame?

Earlier research by Gelfand and others found that people with severe psoriasis are at increased risk for a wide range of chronic conditions, including heart disease.

Psoriasis is now widely believed to be an autoimmune disease involving inflammation and the accelerated growth of skin cells and blood vessels, which produce the swollen, red lesions characteristic of the condition.

"One theory is that this chronic inflammation impacts other organs and systems within the body," Elizabeth Horn, PhD, of the International Psoriasis Council tells WebMD.

Inflammation within the body is increasingly recognized as a major contributor to a host of life-threatening conditions.

"We know that chronic inflammation is bad for a variety of organs and that it is probably involved in a number of chronic diseases, including cardiovascular disease and diabetes," Gelfand says.

Horn says the latest research should serve as a wake-up call to patients and their doctors that severe psoriasis is a serious disease.

"We are learning that there is something happening in people with severe psoriasis that may not be happening with milder forms of the disease," she says.

Horn and Gelfand agree that patients with severe psoriasis need to be especially vigilant about taking care of their overall health.

"It is very important for these patients to see their internist regularly, to have age-appropriate screenings, and to have their cardiovascular risks assessed and treated, if necessary," Gelfand says.

 

Psoriasis Signs

The signs of psoriasis vary depending on the type you have. Some common signs for plaque psoriasis -- the most common variety of the condition -- include:

• Plaques of red, inflamed skin, often covered with loose, silver-colored scales. These plaques may be itchy and painful and sometimes crack and bleed. In severe cases, the plaques of irritated skin will grow and merge into one another, covering large areas.
• Disorders of the fingernails and toenails, including discoloration and pitting of the nails. The nails may also begin to crumble or detach from the nail bed.
• Plaques or crust on the scalp.
• Small areas of bleeding where the involved skin is scratched.

Psoriasis can also be associated with psoriatic arthritis, which causes pain and swelling in the joints. The National Psoriasis Foundation estimates that between 10% to 30% of people with psoriasis also have psoriatic arthritis.

 

Reference Link:

http://www.webmd.com/skin-problems-and-treatments/guide