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 

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.

Keloids

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.

Keratoacanthomas

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.

Lipomas

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






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