Scars Scars are a natural part of the body's healing process. A scar results from the biologic process of wound repair in the skin and other tissues. Most wounds, except for very minor ones, result in some degree of scarring. Scars can result from accidents, diseases, skin conditions such as acne , or surgeries. How Do Scars Form? Scars form when the dermis (deep, thick layer of skin) is damaged. The body forms new collagen fibers (a naturally occurring protein in the body) to mend the damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue. Scars form after a wound is completely healed. There are different kinds of scars. Most scars are flat and pale. However, in cases when the body produces too much collagen , scars can be raised. Raised scars are called hypertrophic scars or keloid scars. Both of these kinds of scars are more common in younger and dark-skinned people. Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne .

Scars also can appear as stretched skin. Such scars result when the skin stretches rapidly (for example, as in growth spurts or during pregnancy ). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process. How Can Scars Be Treated? Although scars cannot be completely removed, their appearance can be improved to some extent. Methods for improving the appearance of scars include: Topical treatments, such as vitamin E , cocoa butter cream, and several commercial skin care products are available over-the-counter with the claim to help heal scars but are not effective Surgery. Although it will not remove a scar, surgery can be used to alter a scar's shape or make it less noticeable. Surgery is not recommended in cases of hypertrophic or keloid scarring (raised scars) because there is a risk of recurring scars as well as more severe scarring that results from the treatment. Steroid injections. A long term course of steroid injections into a scar may help flatten it. Injections may help to soften the appearance of keloid or hypertrophic scars. Radiotherapy. Low-dose, superficial radiotherapy is used to prevent recurrence of severe keloid and hypertrophic scarring.

This treatment is used only in extreme cases because of potential long-term side effects. Dermabrasion . This treatment involves the removal of the surface of the skin with special equipment. Dermabrasion is useful when the scar is raised above the surrounding skin; but, it is less useful for the treatment of sunken scars. Microdermabrasion is a much less invasive form of dermabrasion but is minimally useful for very superficial scars. Laser resurfacing . This procedure, similar to dermabrasion, removes the surface layers of the skin using different types of lasers. Newer types of lasers may achieve more subtle results by working on the collagen in the dermis without removing the upper layers of skin. This advancement results in little down time as opposed to traditional laser resurfacing and dermabrasion, which requires a longer recovery. Filler injections. These treatments can be used to raise sunken scars to the level of surrounding skin. The effects of these injections are only temporary, however, and the procedures may need to be regularly repeated. Newer forms of injectable fillers are now on the market and may be an option for some people. WebMD Medical Reference Reviewed by Stephanie S.

Gardner, MD on June 05, 2015 Sources Cicatrix | definition of cicatrix by Medical dictionary Cicatrix | definition of cicatrix by Medical dictionary scar [skar] a mark remaining after the healing of a wound, such as one caused by injury, illness, smallpox vaccination, or surgery. (See also healing and keloid .) Beneath the skin is a fibrous connective tissue known as subcutaneous tissue, composed of cells called fibroblasts, which after injury are stimulated to grow into granulation tissue, knitting the wound together. Scar tissue is formed by dense masses of granulation tissue. Called also cicatrix . cic·a·trix , pl. cic·a·tri·ces (sik'ă-triks, si-kā'triks; sik'ă-tri'sēz), The classically correct pronunciation is cica'trix but the pronunciation here is more common U.S. usage. A scar. /cic·a·trix/ (sĭ-ka´triks) (sik´ah-triks) pl. cica´trices [L.] scar .

vicious cicatrix one causing deformity or impairing the function of a limb. cicatrix (sĭk′ə-trĭks′, sĭ-kā′trĭks) n. pl. cicatrices (sĭk′ə-trī′sēz, sĭ-kā′trĭ-sēz′) A scar left by the formation of new connective tissue over a healing sore or wound. cic′a·tri′cial (sĭk′ə-trĭsh′əl), ci·cat′ri·cose′ (sĭ-kăt′rĭ-kōs′) adj. cicatrix [sik′ətriks, sikā′triks] pl. cicatrices Etymology: L, scar scar tissue that is avascular, pale, contracted, and firm after the earlier phase of skin healing characterized by redness and softness. Also called scar . cicatricial [sik′ətrish′əl] , adj., cicatrize, v. cicatrix , pl. cicatrices (sikă-triks, -trish ēz) A scar.

[L.] cicatrix (sik´ətriks) (scar), n the result of healing by secondary intention; characterized microscopically by excessive collagenation of the granulation tissue. cicatrix pl. cicatrices [L.] the fibrous tissue left after the healing of a wound; a scar. Patient discussion about cicatrix Q. except for for the scars, are there any more consequence to burns? 10 years ago i was burned in my face and right hand from boiling water. i was hospitalized and was treated with skin grafts from my thighs. In the last four weeks I feel a strange feeling in my scar. Its hard to describe the exact feeling but it kind of a painful lump inside my flesh. 10 years After that accident can it be that my body is still not over this injury? A. burn scars have 3 optional ways of evolving. a) nothing happens - shouldn't hurt at all (this is by far the most common situation) b) nerve trapping (which happened to me. Its usually begins months after the burn and not years. and you dont have a lump) c) skin cancer from the scar. this is a rare syndrome but you must go to your GP do exclude it.

its called marjolin ulcer. Q. what should i do if i got burned from boiling water? how should i take care of my self? will i get a scar? A. ooooOOOooo! i hope you are asking a hypothetic question... a friend wife of mine still got scars from a boiling water accident a few years back. anyway, here is a site that gives instructions on how to react after burns. boiling water is probably second degree burns: What are basal and squamous cell skin cancers? What are basal and squamous cell skin cancers? Key statistics for basal and squamous cell skin cancers What are basal and squamous cell skin cancers? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells. To learn more about how cancers start and spread, see What Is Cancer? Skin cancer begins when cells in the skin start to grow uncontrollably. Types of skin cells There are 3 main types of cells in the top layer of the skin (called the epidermis): Squamous cells: These are flat cells in the outer part of the epidermis that are constantly shed as new ones form.

Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skin’s surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Melanocytes: These cells make the brown pigment called melanin, which gives the skin its tan or brown color. Melanin acts as the body’s natural sunscreen, protecting the deeper layers of the skin from some of the harmful effects of the sun. For most people, when skin is exposed to the sun, melanocytes make more of the pigment, causing the skin to tan or darken. The epidermis is separated from the deeper layers of skin by the basement membrane. When a skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers. Types of skin cancer Basal cell carcinoma This the most common type of skin cancer. About 8 out of 10 skin cancers are basal cell carcinomas (also called basal cell cancers). When seen under a microscope, the cells in these cancers look like cells in the lowest layer of the epidermis, called the basal cell layer.

These cancers usually develop on sun-exposed areas, especially the head and neck. These cancers tend to grow slowly. It’s very rare for a basal cell cancer to spread to other parts of the body. But if a basal cell cancer is left untreated, it can grow into nearby areas and invade the bone or other tissues beneath the skin. If not removed completely, basal cell carcinoma can recur (come back) in the same place on the skin. People who have had basal cell skin cancers are also more likely to get new ones in other places. Squamous cell carcinoma About 2 out of 10 skin cancers are squamous cell carcinomas (also called squamous cell cancers). The cells in these cancers look like abnormal versions of the squamous cells seen in the outer layers of the skin. These cancers commonly appear on sun-exposed areas of the body such as the face, ears, neck, lips, and backs of the hands. They can also develop in scars or chronic skin sores elsewhere. They sometimes start in actinic keratoses (described below). Less often, they form in the skin of the genital area.

Squamous cell cancers are more likely to grow into deeper layers of skin and spread to other parts of the body than basal cell cancers, although this is still uncommon. Keratoacanthomas are dome-shaped tumors that are found on sun-exposed skin. They may start out growing quickly, but their growth usually slows down. Many keratoacanthomas shrink or even go away on their own over time without any treatment. But some continue to grow, and a few may even spread to other parts of the body. Their growth is often hard to predict, so many skin cancer experts consider them a type of squamous cell skin cancer and treat them as such. Melanoma These cancers develop from melanocytes, the pigment-making cells of the skin. Melanocytes can also form benign (non-cancerous) growths called moles. Melanomas are much less common than basal and squamous cell cancers, but they are more likely to grow and spread if left untreated. Melanoma and moles are discussed in Melanoma Skin Cancer . Less common types of skin cancer Other types of skin cancer are much less common and are treated differently. These include: Together, these types account for less than 1% of all skin cancers.

Pre-cancerous and pre-invasive skin conditions These conditions may develop into skin cancer or may be very early stages of skin cancer. Actinic keratosis (solar keratosis) Actinic keratosis (AK), also known as solar keratosis, is a pre-cancerous skin condition caused by too much exposure to the sun. AKs are usually small (less than 1/4 inch across), rough or scaly spots that may be pink-red or flesh-colored. Usually they start on the face, ears, backs of the hands, and arms of middle-aged or older people with fair skin, although they can occur on other sun-exposed areas. People who have them usually develop more than one. AKs tend to grow slowly and usually do not cause any symptoms (although some might be itchy or sore). They sometimes go away on their own, but they may come back. Some AKs may turn into squamous cell skin cancers. Most AKs do not become cancer, but it can be hard sometimes to tell them apart from true skin cancers, so doctors often recommend treating them. If they are not treated, you and your doctor should check them regularly for changes that might be signs of skin cancer.

Squamous cell carcinoma in situ (Bowen disease) Squamous cell carcinoma in situ, also called Bowen disease, is the earliest form of squamous cell skin cancer. “In situ” means that the cells of these cancers are still only in the epidermis (the upper layer of the skin) and have not invaded into deeper layers. Bowen disease appears as reddish patches. Compared with AKs, Bowen disease patches tend to be larger (sometimes over ½ inch across), redder, scalier, and sometimes crusted. Like AK, Bowen disease usually doesn’t cause symptoms, although it might be itchy or sore. Like most other skin cancers (and AKs), these patches most often appear in sun-exposed areas. Bowen disease can also occur in the skin of the anal and genital areas (where it is known as erythroplasia of Queyrat or Bowenoid papulosis). This is often related to sexually transmitted infection with human papilloma viruses (HPVs), the viruses that can also cause genital warts. Bowen disease can sometimes progress to an invasive squamous cell skin cancer, so doctors usually recommend treating it.

People who have these are also at higher risk for other skin cancers, so close follow-up with a doctor is important. Benign skin tumors Most skin tumors are benign (not cancerous) and rarely if ever turn into cancers. There are many kinds of benign skin tumors, including: Most types of moles (see Melanoma Skin Cancer for more about moles) Seborrheic keratoses: tan, brown, or black raised spots with a waxy texture or occasionally a slightly rough and crumbly surface when they are on the legs (also known as stucco keratosis) Hemangiomas: benign blood vessel growths, often called strawberry spots Lipomas: soft tumors made up of fat cells Warts: rough-surfaced growths caused by some types of human papilloma virus (HPV) <!-- SS_END_OPENREGIONMARKER(region1)--> <!-- SS_BEGIN_CLOSEREGIONMARKER(region1)--> Description of Scar Types And Treatment, Healing, Removal, Revision, Management Description of Scar Types And Treatment Types Of Scarring Scars form when wounds heal from causes like burns, surgery, accidents, insect bites, and acne to name a few.

Scar formation is a balance between the building up of collagen and the degradation of collagen in what are called healing cascades. The desired result is a flat even colored scar that blends in with the surrounding skin. Problem scarring occurs when healing becomes out of balance resulting in bumpy, indented, keloid, itchy, soreness and/or discolored scars (darker or lighter). Hypertrophic or Keloidal Scars (Lumpy - Bumpy - Raised Scarring) These types are scarred tissues that are raised above the skin surface and are essentially tissue overgrowth that can result with an overproduction of collagen fibers that produce more tissue within what essentially is an unhealed wound. The problem with both keloids and hypertrophic scars is they have a compromised top layer of skin covering them. Once that top covering of skin, called the stratum corneum , is reestablished then proper healing commences and scar will flatten and resume normal color. As well as being raised and darker than the surrounding skin they can also be painful and itch. Treatment: ReJuveness silicone sheeting works very well at flattening and restoring normal color back to these types of scars, add Hyper Heal scar cream to achieve quicker and accelerated results.

We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Hyper-pigmentation (Skin Discoloration that is darker) Skin discoloration ranging from pink, red, brown or purple that happens as some assaults to the skin such as acne attacks or minor burns start to heal. For example, hyper-pigmentation is the skinï¿½s natural response after the inflammation caused by acne. It is not a true scar and is directly attributed to the production of melanin, the protein responsible for skin pigmentation and excess production in the area can darken it while healing. Unfortunately, it can remain discolored for an extended period of time. This can occur in all skin types after a scar of any type is incurred. Treatment: Hyper Heal scar cream works very well at returning skin to it's natural color, add ReJuveness silicone sheeting to the regiment for quicker and more effective results. We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Hypopigmentation (White scarring) A thin white scar is the result of natural healing. Non-responsive to any traditional scar treatment Prevention and management of hypo-pigmentation is one of the frontiers of scar management.

Extended areas of hypo-pigmentation can occur after skin abrasion and resurfacing. Prevention of hypo-pigmentation can be accomplished by early usage of silicone sheeting. Treatment of already established hypo-pigmentation can only occur if the wound is reactivated. Treatment:Using the ReJuveness Rejuva Roller the wound can be reactivated and then properly treated. We recommend combining roller treatment with our Hyper Heal scar cream . Atrophic scarring (Indented Scarring) (Missing Skin Layers) Atrophic scars are depressed and cause a valley or hole in the skin, these scars are dermal depressions most commonly caused by collagen destruction during the course of an inflammatory skin disease such as cystic acne. Scarring after inflammatory or cystic acne can manifest as atrophic, saucer zed, ice pick, or boxcar scars. This condition involves missing layers of skin. In order for correction to occur this missing layers need to be re-established. This type of scarring generally takes the longest to heal. Treatment: ReJuveness silicone sheeting works very well at filling in indented scarring, add Hyper Heal scar cream to the regiment when scarring includes discoloration.

We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Ice Pick Scars (Deep Skin Depressions) By far the most common scarring caused by acne attacks that produce the classic pimple scars, the Ice Pick scars are deep and narrow pinpoint skin depressions that pit the skin where the pimples used to be. The name comes from the look on the scars as if a sharp ice pick had caused ï¿½holesï¿½ on the skin. Unlike keloid scarring caused by an overproduction of tissue, ice pick scars are caused by the loss of tissue under the skin which has been destroyed in cystic or moderately inflamed acne pimples that ruptured to spill out its damages tissue under the skin. Treatment: ReJuveness silicone sheeting works very well at filling in ice pick scarring, add Hyper Heal scar cream to the regiment when scarring includes discoloration. We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Boxcar Scars (Long Continuous Skin Break) These are often round or irregularly shaped skin depressions with steep vertical sides formed with normal skin and are the next most common scar formation after ice pick scars caused by acne outbreaks.

Wider than ice pick scars, boxcar scars account for what makes the skin look like the lunar surface from a telescope and are similarly caused by a loss of tissue under the skin when two or more adjoining pimples sill out their damage tissues and form a continues skin break. Treatment: ReJuveness silicone sheeting works very well at filling in box car scarring, add Hyper Heal scar cream to the regiment when scarring includes discoloration. We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Rolling Scars (Rolling Skin Depressions) This type of scarring produce a wave-like undulations on what should otherwise be a smooth skin surface. They produce depressions that have smoother edge with normal skin and are often caused by fibrous bands of tissues developing between the skin and subcutaneous tissue layer under it to pull the epidermal layer to the lower structures of the skin to cause the rolling appearance. This type of scarring caused by acne is likewise seldom seen and are more commonly found elsewhere in the body than on the face. Treatment: ReJuveness silicone sheeting works very well at filling in rolling scars, add Hyper Heal scar cream to the regiment when scarring includes discoloration.

We also offer convenient ReJuveness Scar Treatment Kits for easy ordering. Scar contraction Scar contraction can occur after severe burns, scar revision and skin grafting. The scar contracts and range of movement is inhibited. Treatment : Our ReJuveness silicone sheeting can give instant relief to pain and itching, in most cases the combination of Hyper Heal scar cream works even better. Stretch Marks Although stretch marks is a misleading term for this type of scarring they do often occur as a result of stretching it is more of a hormonal origins and can occur spontaneously without stretching. Stretch marks are indented atrophic type of scar which start out red then proceed to dark brown and white. Silicone sheeting and Hyper-Heal can be effectively used on early red stretch marks. Once stretch marks become brown and white they can be treated by reactivation (ablation)of the area. Skin Grafting & Flap Surgery | Plastic, Aesthetic and Reconstructive Surgery at Miller School of Medicine Skin Grafting & Flap Surgery Skin Grafting & Flap Surgery Skin Grafting & Flap Surgery Skin grafting is a type of medical grafting involving the transplantation of skin. The transplanted tissue is called a skin graft.

Skin grafting is often used to treat: Extensive wounding or trauma Burns Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans Specific surgeries that may require skin grafts for healing to occur – most commonly removal of skin cancers. Skin grafts are often employed after serious injuries when some of the body’s skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: it can reduce the course of treatment needed (and time in the hospital), and it can improve the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section), like peeling a potato, or a full thickness skin graft, which involves pitching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar.

For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft. Flap Surgery Flap surgery is a piece of tissue that is still attached to the body by a major artery and vein or at its base. This piece of tissue with its attached blood supply is used in reconstructive surgery by being set into a recipient site (injured area onto which a flap or graft is placed). Sometimes, the flap is comprised of skin and fatty tissue only, but a flap may also include muscle from the donor site (the area from which the flap is raised). Who Might Need Flap Surgery? If you have suffered tissue loss over any area of your body, you may be a candidate for flap surgery. This type of reconstructive plastic surgery is typically used to repair defects left behind after traumatic injury or mastectomy. Flap techniques can also produce excellent results in facial reconstruction after skin cancer excision.(Mohs surgery). There are as many types of flaps as there are types of injuries which might require the use of a flap. Flaps come from many different locations, and are used in many different ways to accomplish the desired result.

However, flaps used for reconstructive plastic surgery can be broken down into two main categories. Local (Pedicled) Flap: Tissue is freed and rotated or moved in some manner from an adjacent area to cover the defect, yet remains attached to the body at its base and has blood vessels that enter into the flap from the donor site. The type of flap movement required determines which of the four main types of local flaps is used. The four major types of local flaps include the advancement flap (moves directly forward with no lateral movement), the rotation flap (rotates around a pivot point to be positioned into an adjacent defect), the transposition flap (moves laterally in relation to a pivot point to be positioned into an adjacent defect) and the interpolation flap. The interpolation flap is different from the others in that it rotates around a pivot point to be positioned into a nearby (but not adjacent) defect. The result is that a portion of the flap passes above or below a section of intact tissue, forming a sort of “skin bridge.” This type of flap is intended to be sectioned (separated) from the donor site in a subsequent procedure.

Free Flap: Tissue from another area of the body is detached and transplanted to the recipient site and the blood supply is surgically reconnected to blood vessels adjacent to the wound. University of Miami Keloid scarring - Live Well - NHS Choices limited movement if located on a joint Some people feel embarrassed or upset if they think the scar is disfiguring them. Experts don't fully understand why keloid scarring happens. They are not contagious or cancerous. Keloid scars can sometimes develop after minor skin damage, such as burns, acne scars and even chicken pox, but they can sometimes happen spontaneously with no history of skin trauma. If you've had a keloid scar before, you're more likely to get another. Who gets keloid scars? Keloid scars can affect anyone, but they're more common in people with dark skin and it's thought they may run in families. Younger people between the ages of 10 and 30 are more likely to develop them. Can you prevent keloid scars? You can't completely prevent keloid scars, but you can avoid any deliberate cuts or breaks in the skin, such as tattoos or piercings, including on the earlobes.

Treating acne will reduce the likelihood of acne scars appearing. Avoid minor skin surgery to areas more prone to keloid scarring – the upper chest, back and upper arms – if possible. Treatments for keloid scars There are several treatments available, but none have been shown to be more effective than others. Treatment can be difficult and isn't always successful. Treatments that may help flatten a keloid include: steroid injections applying steroid-impregnated tape for 12 hours a day applying silicone gel sheeting for several months Other options include: freezing early keloids with liquid nitrogen to stop them growing laser treatment to reduce redness – but this won't make the scar any smaller surgery, sometimes followed by radiotherapy, to remove the keloid – although the keloid can grow back and may be larger than before If you're bothered by a keloid scar and want help, see your GP. Scars: skin camouflage An expert explains how skin camouflage is used to cover marks and scars. Dina, who has hyperpigmentation, describes how it improved her confidence.

Media last reviewed: 19/07/2015 Skin Lesions | definition of Skin Lesions by Medical dictionary Skin Lesions | definition of Skin Lesions by Medical dictionary Definition A skin lesion is a superficial growth or patch of the skin that does not resemble the area surrounding it. Description Skin lesions can be grouped into two categories: primary and secondary. Primary skin lesions are variations in color or texture that may be present at birth, such as moles or birthmarks , or that may be acquired during a person's lifetime, such as those associated with infectious diseases (e.g. warts , acne, or psoriasis ), allergic reactions (e.g. hives or contact dermatitis ), or environmental agents (e.g. sunburn , pressure, or temperature extremes). Secondary skin lesions are those changes in the skin that result from primary skin lesions, either as a natural progression or as a result of a person manipulating (e.g. scratching or picking at) a primary lesion. The major types of primary lesions are: Macule. A small, circular, flat spot less than 2/5 in (1 cm) in diameter. The color of a macule is not the same as that of nearby skin.

Macules come in a variety of shapes and are usually brown, white, or red. Examples of macules include freckles and flat moles. A macule more than 2/5 in (1 cm) in diameter is called a patch. Vesicle. A raised lesion less than 1/5 in (5 mm) across and filled with a clear fluid. Vesicles that are more than 1/5 in (5 mm) across are called bullae or blisters. These lesions may may be the result of sunburns, insect bites, chemical irritation, or certain viral infections, such as herpes. Pustule. A raised lesion filled with pus. A pustule is usually the result of an infection, such as acne, imptigeo, or boils . Papule. A solid, raised lesion less than 2/5 in (1 cm) across. A patch of closely grouped papules more than 2/5 in (1 cm) across is called a plaque. Papules and plaques can be rough in texture and red, pink, or brown in color.

Papules are associated with such conditions as warts, syphilis , psoriasis, seborrheic and actinic keratoses, lichen planus , and skin cancer . Nodule. A solid lesion that has distinct edges and that is usually more deeply rooted than a papule. Doctors often describe a nodule as "palpable," meaning that, when examined by touch, it can be felt as a hard mass distinct from the tissue surrounding it. A nodule more than 2 cm in diameter is called a tumor. Nodules are associated with, among other conditions, keratinous cysts, lipomas, fibromas, and some types of lymphomas. Wheal. A skin elevation caused by swelling that can be itchy and usually disappears soon after erupting. Wheals are generally associated with an allergic reaction, such as to a drug or an insect bite. Telangiectasia. Small, dilated blood vessels that appear close to the surface of the skin. Telangiectasia is often a symptom of such diseases as rosacea or scleroderma . The major types of secondary skin lesions are: Ulcer.

Lesion that involves loss of the upper portion of the skin (epidermis) and part of the lower portion (dermis). Ulcers can result from acute conditions such as bacterial infection or trauma, or from more chronic conditions, such as scleroderma or disorders involving peripheral veins and arteries. An ulcer that appears as a deep crack that extends to the dermis is called a fissure. Scale. A dry, horny build-up of dead skin cells that often flakes off the surface of the skin. Diseases that promote scale include fungal infections, psoriasis, and seborrheic dermatitis . Crust. A dried collection of blood, serum, or pus. Also called a scab, a crust is often part of the normal healing process of many infectious lesions. Erosion. Lesion that involves loss of the epidermis. Excoriation. A hollow, crusted area caused by scratching or picking at a primary lesion. Scar. Discolored, fibrous tissue that permanently replaces normal skin after destruction of the dermis. A very thick and raised scar is called a keloid. Lichenification. Rough, thick epidermis with exaggerated skin lines.

This is often a characteristic of scratch dermatitis and atopic dermatitis . Atrophy. An area of skin that has become very thin and wrinkled. Normally seen in older individuals and people who are using very strong topical corticosteroid medication. Causes and symptoms Skin lesions can be caused by a wide variety of conditions and diseases. A tendency toward developing moles, freckles, or birthmarks may be inherited. Infection of the skin itself by bacteria, viruses, fungi, or parasites is the most common cause of skin lesions. Acne, athlete's foot (tinea pedis), warts, and scabies are examples of skin infections that cause lesions. Allergic reactions and sensitivity to outside environmental factors can also lead to the formation of skin lesions. Underlying conditions can also precipitate the appearance of skin lesions. For example, the decreased sensitivity and poor circulation that accompanies diabetes mellitus can contribute to the formation of extensive ulcers on extremities such as the feet. Infections of body's entire system can cause the sudden onset of skin lesions. For example, skin lesions are a hallmark symptom of such diseases as chicken pox, herpes, and small pox.

Cancers affecting the skin, including basal cell carcinoma, squamous cell carcinoma, malignant melanoma , and Kaposi's sarcoma, are recognized by their lesions. Diagnosis Diagnosis of the underlying cause of skin lesions is usually based on patient history, characteristics of the lesion, and where and how it appears on the patient's body (e.g. pustules confined to the face, neck and upper back can indicate acne, while scales appearing on the scalp and face may indicate seborrheic dermatitis). To determine the cause of an infection, doctors may also take scrapings or swab samples from lesions for examination under a microscope or for use in bacterial, fungal, or viral cultures. In cases where a fungal infection is suspected, a doctor may examine a patient's skin under ultraviolet light using a filter device called a Woods light-under these conditions, certain species will taken on specific fluorescent colors. Dermatologists may also use contrast lighting and subdued lighting to detect variations in the skin. When involvement of the immune system is suspected, doctors may order a immunofluorescence test, which detects antibodies to specific antigens using a fluorescent chemical.

In cases of contact dermatitis, a condition in which a allergic reaction to something irritates the skin, doctors may use patch tests, in which samples of specific antigens are introduced into the skin via a scratch or a needle prick, to determine what substances are provoking the reaction. The vast majority of skin lesions are noncancerous. However, doctors will determine whether or not a particular lesion or lesions are cancerous based on observation and the results of an excisional or punch biopsy, in which a tissue sample is excised for microscopic analysis. Since early detection is a key to successful treatment, individuals should examine their skin on a monthly basis for changes to existing moles, the presence of new moles, or a change in a certain area of skin. When examining moles, factors to look for include: Asymmetry. A normal mole is round, whereas a suspicious mole is uneven. Border. A normal mole has a clear-cut border with the surrounding skin, whereas the edges of a suspect mole may be irregular. Color. Normal moles are uniformly tan or brown, but cancerous moles may appear as mixtures of red, white, blue, brown, purple, or black.

A skin lesion is an abnormal growth or an area of skin that does not resemble the skin surrounding it. The illustrations above feature some of the different types of skin lesions. (Illustration by Electronic Illustrators Group.) Diameter. Normal moles are usually less than 1/5 in (5 mm) in diameter, a skin lesion greater than this may be suspected as cancerous. Treatment Treatment of skin lesions depends upon the underlying cause, what type of lesions they are, and the patient's overall health. If the cause of the lesions is an allergic reaction, removing the allergen from the patient's environment is the most effective treatment. Topical preparations can also be used to clean and protect irritated skin as well as to remove dead skin cells and scales. These may come in a variety of forms, including ointments, creams, lotions, and solutions. Topical antibiotics, fungicides, pediculicides (agents that kill lice), and scabicides (agents that kill the scabies parasite) can be applied to treat appropriate skin infections. Oral medications may be taken to address systemic infections or conditions. Deeply infected lesions may require minor surgery to lance and drain pus.

Topical agents to sooth irritated skin and reduce inflammation may also be applied. Corticosteroids are particularly effective in reducing inflammation and itching (puritis). Oatmeal baths, baking soda mixtures, and calamine lotion are also recommended for the relief of these symptoms. A type of corticosteroid may be used to reduce the appearance of keloid scars . Absorbent powders may also be used to reduce moisture and prevent the spread of infection. In cases of ulcers that are slow to heal, pressure dressings may be used. At times, surgical removal of a lesion may be recommended-this is the usual course of therapy for skin cancer. Surgical removal usually involves a simple excision under local anesthetic, but it may also be accomplished through freezing ( cryotherapy ) or laser surgery . Prognosis Skin lesions such as moles, freckles, and birthmarks are a normal part of skin and will not disappear unless deliberately removed by a surgical procedure. Lesions due to an allergic reaction often subside soon after the offending agent is removed. Healing of lesions due to infections or disorders depends upon the type of infection or disorder and the overall health of the individual.

Prognosis for skin cancer primarily depends upon whether or not the lesion is localized and whether or not it has spread to other areas of the body, such as the lymph nodes. In cases where the lesion is localized and has not spread to other parts of the body, the cure rate is 95-100%. Prevention Not all skin lesions are preventable; moles and freckles, for example, are benign growths that are common and unavoidable. However others can be avoided or minimized by taking certain precautions. Skin lesions caused by an allergic reaction can be avoided by determining what the offending agent is and removing it from the home or workplace, or, if this is impossible, developing strategies for safely handling it, such as with gloves and protective clothing. Keeping the skin, nails, and scalp clean and moisturized can help reduce or prevent the incidence of infectious skin diseases, as can not sharing personal care items such as combs and make-up with others. Skin lesions associated with sexually transmitted diseases can be prevented by the use of condoms. Scratching or picking at existing lesions should be avoided since this usually serves only to spread infection and may result in scarring.

Individuals who have systemic conditions, such as diabetes mellitus or poor circulation, that could lead to serious skin lesions should inspect their bodies regularly for changes in their skin's condition. Regular visual inspection of the skin is also a key to preventing or minimizing the occurrence of skin cancer, as is the regular use of sun screens with an SPF of 15 or more. Resources Books Rosen, Theodore, Marilyn B. Lanning, and Marcia J. Hill. The Nurse's Atlas of Dermatology. Boston: Little Brown & Co., 1983. Key terms

Question: A cicatrix on the skin is more commonly called a what?
Answer: Scar