Skin Lesion
A skin lesion is any area of skin that differs from the surrounding skin in appearance, color, or texture. These can range from harmless birthmarks and age spots to potentially serious conditions like skin cancer. Understanding different types of lesions, recognizing warning signs, and knowing when to seek medical evaluation are crucial for maintaining skin health and catching serious conditions early.
⚠️ Seek Medical Evaluation For:
- New or changing mole (ABCDE signs - see below)
- Lesion that bleeds, crusts, or doesn't heal
- Rapidly growing skin growth
- Multiple new lesions appearing
- Painful or tender lesions
- Black or multicolored lesions
- Lesions with irregular borders
- Any lesion you're concerned about
- Family history of skin cancer
- Lesions in hard-to-see areas
The ABCDE Rule for Melanoma
- A - Asymmetry: One half doesn't match the other
- B - Border: Irregular, ragged, or blurred edges
- C - Color: Multiple colors or uneven distribution
- D - Diameter: Larger than 6mm (pencil eraser)
- E - Evolving: Changes in size, shape, or color
Remember: Any changing lesion should be evaluated by a healthcare provider.
Types of Skin Lesions
Primary Lesions
- Macule: Flat spot (freckle)
- Papule: Small raised bump
- Nodule: Larger solid bump
- Vesicle: Small fluid-filled blister
- Bulla: Large blister
- Pustule: Pus-filled bump
- Plaque: Raised, flat-topped area
- Wheal: Hive-like swelling
Secondary Lesions
- Scale: Flaking skin
- Crust: Dried fluid/blood
- Erosion: Loss of skin surface
- Ulcer: Deep skin loss
- Fissure: Linear crack
- Scar: Fibrous tissue
- Atrophy: Thinning skin
- Lichenification: Thickened skin
Common Benign Lesions
Pigmented Lesions
- Moles (nevi): Common brown spots
- Freckles: Small flat brown spots
- Age spots: Sun-induced brown patches
- Birthmarks: Present from birth
Growths
- Skin tags: Small hanging growths
- Seborrheic keratoses: Waxy, stuck-on appearance
- Cherry angiomas: Small red bumps
- Dermatofibromas: Firm brown nodules
Cysts and Bumps
- Epidermoid cysts: Under-skin bumps
- Lipomas: Soft fatty lumps
- Milia: Tiny white bumps
- Keloids: Raised scars
Potentially Serious Lesions
Skin Cancers
- Basal cell carcinoma: Pearly bump or flat lesion
- Squamous cell carcinoma: Firm red nodule or flat scaly patch
- Melanoma: Changing mole or new dark spot
- Merkel cell carcinoma: Flesh-colored or red nodule
Precancerous Lesions
- Actinic keratoses: Rough, scaly patches
- Dysplastic nevi: Atypical moles
- Bowen's disease: Red, scaly patch
Common Causes of Skin Lesions
Infections
- Bacterial (impetigo, cellulitis)
- Viral (warts, herpes, shingles)
- Fungal (ringworm, candida)
- Parasitic (scabies, lice)
Inflammatory Conditions
- Psoriasis
- Eczema/dermatitis
- Rosacea
- Lichen planus
Allergic Reactions
- Contact dermatitis
- Drug eruptions
- Urticaria (hives)
- Insect bites
Other Causes
- Sun damage
- Aging
- Genetics
- Trauma/injury
Risk Factors for Skin Cancer
- Sun exposure: UV radiation damage
- Fair skin: Less protective melanin
- History of sunburns: Especially blistering ones
- Tanning beds: Artificial UV exposure
- Many moles: Or atypical moles
- Family history: Genetic predisposition
- Previous skin cancer: Increased risk
- Weakened immune system: Less cancer surveillance
- Age: Cumulative sun damage
- Certain medications: Photosensitizing drugs
Medical Evaluation
What to Expect
- Visual examination of lesion
- Dermoscopy (magnified viewing)
- Medical history questions
- Full skin examination
- Photography for monitoring
Diagnostic Procedures
- Biopsy: Tissue sample for testing
- Shave biopsy: Surface removal
- Punch biopsy: Deep sample
- Excisional biopsy: Complete removal
- Wood's lamp: Special UV light
Treatment Options
Non-Invasive Treatments
- Observation/monitoring
- Topical medications
- Phototherapy
- Chemical peels
- Laser therapy
- Photodynamic therapy
Removal Procedures
- Cryotherapy (freezing)
- Electrodesiccation
- Surgical excision
- Mohs surgery
- Curettage
- Radiation therapy
Prevention and Sun Protection
- Sunscreen: SPF 30+ daily, reapply every 2 hours
- Protective clothing: Long sleeves, wide-brim hats
- Seek shade: Especially 10 AM - 4 PM
- Avoid tanning beds: No safe UV tanning
- Regular skin checks: Monthly self-exams
- Annual dermatology visits: Professional screening
- Know your skin: Notice changes early
- Protect children: Early sun damage matters
How to Perform Skin Self-Exam
- Examine entire body monthly
- Use mirrors for hard-to-see areas
- Check scalp, between toes, under nails
- Have partner check back/scalp
- Take photos of concerning lesions
- Note any new or changing spots
- Use good lighting
- Be systematic - same routine each time