Thursday, August 30, 2012

Skin Growths in Lymphedema

Skin Growths in Lymphedema

Because of the compromised condition of a lymphovenous limb, we are often susceptible to a large number of skin complications.  These may include various skin growths such as skin tags, warts, dermatofibromaslymphangiomas,and rashes, fungal infectionsThis is in addition to the many infections associated with lymphedema  superficial bacterial infections which include as impetigofolliculitiscarbuncles, furuncles and boils and weeping wounds or sores.

With lymphedema, some types untreated skin conditions can lead to serious consequences including systemic infections (sepsis), gangrene, amputation and even death.  Good skin care and health is critical to our overall good health.

Skin Growths

Skin growths are accumulations of various types of cells that look different than the surrounding skin. They may be raised or flat and range in color from dark brown or black to flesh-colored to red. Skin growths may be present at birth or develop later.

When the growth is controlled and the cells do not spread to other parts of the body, the skin growth (tumor) is noncancerous (benign). When the growth is uncontrolled, the tumor is cancerous (malignant), and the cells invade normal tissue and even spread (metastasize) to other parts of the body. Noncancerous skin growths are often more of a cosmetic problem than anything else.

Doctors do not know what causes most noncancerous skin growths. Some growths, however, are known to be caused by viruses (for example, warts), systemic (bodywide) disease (for example, xanthelasmas or xanthomas caused by excess fats in the blood), and environmental factors (for example, moles and epidermal cysts stimulated by sunlight).


Dermatofibromas are small red-to-brown bumps (nodules) that result from an accumulation of collagen, which is a protein made by the cells (fibroblasts) that populate the soft tissue under the skin.

Dermatofibromas are common and usually appear as single firm bumps, often on the legs, particularly in women. Some people develop many dermatofibromas. 
Causes include trauma, insect bites, and cuts caused by shaving. Dermatofibromas are harmless and usually do not cause any symptoms, except for occasional itching. Usually, dermatofibromas are not treated unless they become bothersome or enlarge. A doctor can remove them with a scalpel.

Epidermal cysts

An epidermal cyst is a common slow-growing bump consisting of a thin sac of skinlike material containing a cheesy substance composed of skin secretions.

Epidermal cysts, often incorrectly referred to as sebaceous cysts, are flesh-colored and range from ½ to 2 inches across. They can appear anywhere but are most common on the scalp, back, and face. They tend to be firm and easy to move within the skin. Epidermal cysts are not painful unless they become infected or inflamed.

Large epidermal cysts are removed surgically after an anesthetic is injected to numb the area. The thin sac wall must be removed completely or the cyst will grow back. Small cysts may be injected with corticosteroids if they become inflamed. Infected cysts are treated with an antibiotic and cut open to drain. Tiny cysts that are bothersome can be burned out with an electric needle.

Because sunlight may stimulate growth of epidermal cysts, fair-skinned people are advised to stay out of the sun and to use protective clothing and sunscreen.

Dermoid cyst

A benign tumor which is made up of hairs, sweat glands, and sebaceous glands. Some internal dermoid tumors may even contain cartilage, bone fragments, and teeth. Dermoid cysts may be removed surgically for cosmetic reasons.


Smooth, firm, raised, fibrous growths on the skin that form in wound sites. Keloids are more common in African-Americans.

Keloids respond poorly to most treatment approaches. Injections of corticosteroid drugs may help to flatten the keloids. Other treatment approaches may include surgery or silicone patches to further flatten the keloids.


Round, flesh-colored growths that have a crater that contains a pasty material. These growths tend to appear on the face, forearm, or back of the hand. They usually disappear after a couple of months, but may leave scars.
Treatment usually includes a skin biopsy to rule out skin cancer. Other treatment may include surgical removal and/or injections of corticosteroids or fluorouracil.


Round or oval lumps under the skin caused by fatty deposits. Lipomas are more common in women and tend to appear on the forearms, torso, and back of the neck.
Lipomas are generally harmless, but if the lipoma changes shape, your physician may perform a biopsy. Treatment may include removal by surgery, if the lipoma bothers the child.

Pyogenic granulomas

Red, brown, or bluish-black, raised marks caused by excessive growth of capillaries (small blood vessels) and swelling. Pyogenic granulomas usually form after an injury to the skin.

Some pyogenic granulomas disappear without treatment. Sometimes a biopsy is necessary to rule out cancer. Treatment may include surgical removal.

Seborrheic keratoses

Flesh-colored, brown, or black wart-like spots. More common in middle-aged and older people, seborrheic keratoses may be round or oval and look like they are "stuck" on the skin.

Usually, no treatment is necessary. If the spots are irritated, or the patient wants them removed for cosmetic reasons, treatment may include freezing the area with liquid nitrogen or surgery.

For further information:

Other related Skin Conditions:

Warts and Verrucas
Acroangiodermatitis associated with Lymphedema
Lymphomatoid Papulosis
Papillomatosis cutis carcinoides
Cutis Marmorata and Lymphedema
Elephantiasis nostras verrucosa - Skin Plaque and Nodules

Skin manifestations of obesity: a comparative study.

Skin manifestations of obesity: a comparative study.

Sept 2011


Department of Dermatology, Federal University of Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.


Background:Obesity is one of the world's biggest health problems nowadays. Little research has been done on the skindiseases that affect obese patients. 

Objective: To study the prevalence of skin manifestations in obese patients compared with a control group of normal-weight patients. 

Methods:A total of 76 obese patients [body mass index (BMI) ≥30 kg/m(2) ] and 73 with normal-weight volunteers (BMI 18.5-24.9 kg/m(2) ) were included in the study and had their complete medical history and skin examination evaluated by the same examiner. All patients were investigated for the presence of metabolic syndrome. 

Results:The dermatoses that showed a statistically significant relationship with obesity, compared with the control group were: striae (P < 0.001), plantar hyperkeratosis (P < 0.001), acrochordons (P = 0.007), intertrigo (P < 0.001), pseudoacanthosis nigricans (P < 0.001), keratosis pilaris (P = 0.006), lymphedema (P = 0.002) and bacterial infections (P = 0.05). The presence of striae, pseudoacanthosis nigricans and bacterial infections were also found to be correlated with the degree of obesity. 

Conclusions:Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. Skin care of obese patients deserves particular attention, not only because of the high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient's quality of life.

Wound care management of a patient with stage III lymphedema.

Wound care management of a patient with stage III lymphedema.

July Aug 2012


Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. dsheehan@luriechildren'



The sequelae for patients living with stage III lymphedema, including immobility, functional impairment, isolation and emotional burden, that affect quality of life are highlighted.


The case patient's medical history upon initial evaluation, descriptive wound characteristics and treatment plan are described in detail.


A comprehensive treatment regimen resolved the patient's wound.


The definition, staging and prevalence of lymphedema are reviewed.


Successful lymphedema wound treatment includes working with experienced healthcare providers, management of wound drainage and odor, the use of higher pressure compression, and complying with lifestyle changes.

Wednesday, August 29, 2012

The Role of Skin Care in Lymphedema Managementt

The Role of Skin Care in Lymphedema Management

Skin care plays an essential role in both prevention of lymphedema in those patients at risk of developing this condition, and in the management of existing lymphedema. Current methods of cancer treatment lower the risk of developing lymphedema. However, if a patient had surgery involving the lymphatic system – a radical mastectomy for example – even many years ago, the risk for developing lymphedema will always be present, even if this patient never had any arm swelling. 

Prevention is in the patients’ best interest and a great tool to avoid the onset of lymphedema. The skin is the first line of defense against foreign invaders and is usually impermeable to bacteria and other pathogens. However, any defect in the skin such as burns, chafing, dryness, cuticle injury, cracks, cuts, splinters, and insect bites can present an entry site for pathogens or infectious agents and cause infection.
Patients who already have, or had lymphedema are susceptible to infections of the skin and nails. Lymphedematous tissues are saturated with protein-rich fluid, which serves as an ideal nutrient source for bacteria and other pathogens. Lymphedematous skin also tends to be dry and may become thickened and scaly, which increases the risk of skin cracks and fissures.  
Editor's note: See the full text of this article in
This is an excellent website and you may want to take time to wander through it

How to Choose Skin Care Products

How to Choose Skin Care Products

Mon, 17 Dec 2007 16:01:29
The high absorption ability of the skin makes it necessary for individuals to choose personal skin care products with outmost care.
As a result, using personal care products containing one or probably more of the following ingredients is dangerous.
· Mineral Oil, Paraffin, and Petrolatum - Petroleum products coat the skin like plastic, clog the pores and create toxins, which can slow down cellular development and result in early aging.
· Parabens - It is widely used as a preservative in the cosmetic industry (including moisturizers) and is a carcinogen. It also has hormone-disrupting qualities and interferes with the body's endocrine system.
· Phenol carbolic acid - Found in many lotions and skin creams. It can cause circulatory collapse, paralysis, convulsion, coma and even death caused by respiratory failure.
· Propylene glycol - it is used as a moisturizer in cosmetics and as a carrier in fragrance oils. It can cause dermatitis, kidney or liver abnormalities, and may inhibit skin cell growth or cause skin irritation.
· Acrylamide - Which is found in many hand and face creams, is linked to different tumors.
· Sodium laurel or lauryl sulfate (SLS) - also known as sodium laureth sulfate (SLES) - Found in car washes, engine degreasers, garage floor cleaners and in over 90% of personal care products.
It breaks down the skin's moisture barrier, easily penetrates the skin, and allows other chemicals to easily penetrate as well.
Combined with other chemicals, SLS becomes a 'nitrosamine', a potent class of carcinogen. It can also cause hair loss. SLES is sometimes disguised with the labeling 'comes from coconut' or 'coconut-derived'.
· Toluene - Poison! Danger! Harmful or fatal if swallowed! Harmful if inhaled or absorbed through the skin. Made from petroleum or coal tar, and found in most synthetic fragrances.
Chronic exposure is linked to anemia, lowered blood cell count, liver or kidney damage, and may affect the developing fetus.
· Dioxane - Found in compounds known as PEG, Polysorbates, Laureth, ethoxylated alcohols. It is common in a wide range of personal care products and is considered a carcinogen.
*Contributed by Anne, RN and member. Moderator of Advocates for Lymphedema

Antioxidant nutrients and skin protection

Antioxidant nutrients and skin protection

Free radical damage is one of the principal mechanisms of aging. Free radicals are highly and indiscriminately reactive chemicals that can damage any structure in living cells. The most common source of free radicals is normal burning of fuel that occurs in every cell every minute of every day. (Generally, the more free radicals a species produces, the shorter its life span.) Skin suffers additional free radical damage from sunlight and pollutants. Topical antioxidants provide some protection against environmental damage to the skin and may be somewhat effective in slowing down the skin aging. However, topical antioxidants are relatively unreliable. Their effect depends on skin permeability, other ingredients in the cream and many other factors. It appears that increasing oral intake of some antioxidants may additionally protect skin from free radicals. Keep in mind, however, that relatively little solid research has been done specifically on skin benefits of oral or topical antioxidants and much of the supporting evidence is indirect.
A very important chemical property for an oxidant is its solubility in water and fat (or oil). Basically, living organisms have two types of internal media, watery extra- and intracellular space and oily membranes that serve as partitions enclosing individual cells and various intracellular compartments. Water-soluble antioxidants are effective mainly in extra- and intracellular fluid, whereas fat-soluble antioxidants protect biological membranes. Both types of antioxidants are needed to create an effective shield against free radicals for the entire body, and skin in particular.
Vitamin E is a principal fat soluble antioxidant vitamin in the body. It protects cellular membranes, lipoproteins and other “oily” structures. Skin is high in unsaturated fatty acids (“oily” molecules especially susceptible to free radical damage), and can benefit from vitamin E protection (both oral and topical).
Flavonoids are a diverse group of plant pigments with antioxidant properties. These substances are responsible for color in many fruits, vegetables and flowers. In addition to providing color that attracts insects or animals, these pigments protect plants from environmental stress. In addition to being potent antioxidants, some flavonoids have antiallergic, anti-carcinogenic, anti-viral and anti-inflammatory activity. Over 4,000 flavonoids have been characterized and classified, but only a few have been researched. As far as skin benefits are concerned, two classes of flavonoids appear to be especially beneficial: proanthocyanins (found in grapes and pine bark) and polyphenols (found in green tea).
Coenzyme Q10, Lipoc acid, Cysteine, Methlonine
Coenzyme Q10, lipoic acid, cysteine and methionine are potent antioxidants. But they also play other roles that are at least as important as their antioxidant activity. See also the article about conditionally essential nutrients in this section.