| Skin
is the tough layer of tissue that covers the body.
It is the largest organ of the body and is divided
into an outer layer of cells (epidermis) and a deeper
layer containing blood and lymphatic vessels, nerves,
and hair follicles (dermis). Subcutaneous tissue,
or soft tissue, lies beneath the skin and contains
fat tissue, blood vessels, and nerves. It is the third
of the three layers of skin and is important is the
regulation of temperature of the skin itself and the
body.
A
skin lesion is any visible abnormality of the skin,
including wounds, sores, rashes, boils, cysts, moles,
vascular birthmarks, vascular, nerve, or fat tumors,
excessive scar tissue (keloids, hypertrophic scars),
and malignant tumors. Sometimes, there can be microscopic
invasion of apparently healthy tissue by a lesion
such as skin cancer.
The
surgeons at Surgical Specialists are highly experienced
in the evaluation and treatment of the following conditions:
Benign
(Noncancerous) Skin Lesions
Chronic Wounds
Lymphadenitis
Skin Cancer and Melanoma
Soft Tissue Infections
Benign
(Noncancerous) Skin Lesions
Cells of the skin and underlying tissue may accumulate
and cause growths. Growths may be raised or flat and
range in color from dark brown or black to flesh-colored
to red. They 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). Noncancerous skin
growths are often more of a cosmetic problem than
anything else.
The cause of most noncancerous skin growths is not
known, but some growths are known to be caused by
viruses (for example, warts), systemic disease and
environmental factors (for example, moles or milia
stimulated by sunlight).
Chronic
wounds
Chronic wounds, also known as ulcers, are wounds that
have a biological or physiological reason for not
healing. The fact that a wound is chronic has nothing
to do with the amount of time the wound has been present.
If unrecognized and untreated, chronic wounds—such
as a leg ulcer from a vein problem, a foot wound in
a person with diabetes, a bed sore, or an infected
wound—can have serious health complications.
Chronic
wounds can be recognized by the loss of skin and/or
tissue surrounding the wound. Once a wound has become
chronic, intensive medical intervention is required
to make the wound heal. There are a variety of types
of chronic wounds and each has its own causes and
treatment regimens.
Lymphadenitis
Overview
Symptoms
Exams and Tests
Treatment
Outlook (Prognosis)
(jump down links to each)
Overview
Lymphadenitis is an infection of the lymph nodes (also
called lymph glands). It is a common complication
of certain bacterial infections.
The
lymph system is a network of organs, lymph nodes,
lymph ducts, and lymph vessels (or channels) that
produce and move a fluid called lymph from tissues
to the bloodstream. For more information on this part
of the body, see lymph system.
The lymph glands, or nodes, are small structures that
filter the lymph fluid. There are many white blood
cells in the lymph nodes to help fight infection.
Lymphadenitis
occurs when the glands become overwhelmed by bacteria,
virus, fungi, cancer cells, or inflamation. The swollen
glands are usually found near the site of an underlying
infection, tumor, or inflammation.
Lymphadenitis
may occur after cellulitis or other bacterial infections,
particularly those due to streptococcus or staphylococcus.
Sometimes it's due to rare infections such as tuberculosis
or cat scratch disease (Bartonella).
Symptoms
-
Swollen, tender, or hard lymph nodes
-
Red, tender skin over lymph node
-
Lymph nodes may feel soft and rubbery if an abscess
has formed.
Exams
and Tests
The doctor will perform a physical exam, which includes
feeling your lymph nodes. The doctor may look for
signs of injury around swollen lymph nodes.
A
biopsy and culture of the affected area or node may
reveal the cause of the inflammation. Blood cultures
may reveal spread of infection to the bloodstream.
Treatment
Lymphadenitis may spread within hours. Treatment should
begin promptly. Treatment may include:
- Antibiotics
to treat any underlying infection
- Analgesics
to control pain
- Anti-inflammatory
medications to reduce inflammation and swelling
- Hot
moist compresses to reduce inflammation and pain
Surgery
may be needed to drain any abscess.
Outlook
(Prognosis)
Prompt treatment with antibiotics may result in complete
recovery, though it may take weeks, or even months,
for swelling to disappear. The amount of time until
recovery occurs will vary depending on the underlying
cause.
Soft
Tissue Infections
Viruses, bacteria, and fungi generally cause skin
and soft tissue infections by entering the body at
a spot where a cut, scrape, bite, or other wound has
broken the skin; some infections are even the result
of bacteria that normally live on the body. These
infections can affect the layers of the skin or deeper
tissues, such as muscle and connective tissue (the
interlacing framework of tissue that forms ligaments,
tendons, and other supporting structures of the body),
and they may bring about symptoms in other parts of
the body.
Cellulitis
Cellulitis is an inflammation of the skin and/or the
tissues beneath it. The culprits behind the infection
are almost always group A streptococcus or Staphylococcus
aureus bacteria. Cellulitis may occur in people with
diabetes or those who have immune system problems
even if they do not have a skin injury. The infection
can occur anywhere on the body, but it is found most
frequently on the face and lower legs. It appears
as tender, red, swollen areas of skin. The skin in
the infected area may feel stretched and warm. A few
days after the first symptoms, patients may experience
fever, chills, and muscle aches. Red streaks also
may appear on the skin, signaling the spread of the
infection. Antibiotics are used to treat cellulitis.
Even after the infection is gone, the skin may look
different for several weeks. Complications are rare,
but they can include sepsis, gangrene and lymphangitis.
Cellulitis may involve infection of deeper tissue
called the fascia. Infection in this layer can be
very serious or even life threatening and often requires
surgery to remove the infected tissue.
Necrotizing
Fasciitis
Necrotizing fasciitis, also called flesh-eating disease,
is a rare but potentially fatal disease caused by
group A streptococcus bacteria infection. It affects
the deeper layers of skin and tissues beneath the
skin. Necrotizing fasciitis starts with sudden painful
swelling and discoloration (red, purple, or bronze)
of the skin. Often, the appearance of the affected
skin does not reflect how far the infection has spread
into the deeper layers of tissue. The disease can
spread rapidly, with the infected area growing larger
and darker. The ability to feel in the infected area
disappears as the skin tissue dies. As the infection
quickly progresses, the patient can become very ill.
Early treatment with antibiotics and surgery to remove
the damaged tissue is extremely important. Recovery
may take several months.
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