SKIN DISEASES AND DISORDERS
WHAT ARE SKIN DISEASES
This is any departure from the normal state of health of the skin
DEFINITIONS
WHAT ARE LESIONS?
A lesion is a pathological change in a bodily organ or tissue
Primary Lesions
Are an initial alternation in the skin
Secondary Lesions Are due to the primary lesion becoming worse in some way
Tertiary Lesions
Only occur with serious diseases, after primary and secondary
Acute Disease
Symptoms have a more violent nature and are short of duration
Chronic Disease
Of long duration, usually mild and recurring
Infections
Pathogenic germs taken into the body due to contact with contaminated
people or objects
Contagious
Disease communicable by contact
Congenital
Disease
Present at birth
Seasonal Disease
Influenced by the weather
Occupational
Disease
Due to constant contact with irritants at work
Parasitic Disease
Caused by vegetable or animal parasite
Pathogenic
Disease
Caused by disease causing bacteria
Systemic Disease
Due to under or over active internal glands
Allergy
A sensitivity developed to normally harmless substances
Inflammation
Showing characteristics of redness, pain, swelling, heat and possible
Itching
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PRIMARY LESIONS
MACULE
A small discoloured spot or patch on the surface of the skin neither raised nor sunken, as
freckles, flat pigmented moles, areas with loss of pigment (leucoderma) and liver spots
(chloasma)
EPHELIDES
True name for a freckle
PAPULE
A small elevated lump in the skin, containing no fluid but which may develop pus
PUSTULE
An elevation of the having an inflamed base, containing pus
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WHEAL
A special type of papule which is usually an acute itchy, swollen lesion that lasts only a few
hours (often associated with hives or the bite of an insect such as a mosquito)
HIVES/URTICARIA
This is a nettle rash type of eruption, producing red and white wheals which cause irritation on
the surface of the skin. This condition is usually related to an allergic reaction or stress and may
produce single wheals or a widespread reaction which will usually subside within a few hours.
VESICLES
A small sac or cyst, especially one containing fluid
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SECONDARY LESIONS
SCALE
An accumulation of epidermal flakes, dry or greasy (example, abnormal or excessive dandruff)
Scales are found on the following:
 Psoriasis – Silvery scales
 Seborrhoeic dermatitis – Yellow greasy scales
 Eczema – Fine shedding scales
SCAR
Tissue that forms when an injury, which has penetrated into the dermis is healing
STAIN
An abnormal discolouration that remains after the disappearance of moles, freckles or liver
spots, also sometimes apparent after certain diseases
KELOID SCAR
After a normal scar has formed as a result of an injury that has penetrated down into the dermis,
additional tissue is produced form the dermis that results in over healing, making the scar raise
above the normal level of the skin. Ethnic skins are prone to keloid scarring.
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BACTERIAL INFECTIONS
IMPETIGO
This is a highly contagious inflammatory bacterial infection. This condition is found especially in
children. During the active stage fresh lesions appear and spread daily, usually on the face and
limbs. The lesions are characterised by the oozing of serum which coagulates into honey
coloured crusts that have a stuck-on appearance.
BOILS (CARBUNCLE)
The result of inflammation of the hair follicle due to staphylococcal infection, and denotes
lowered resistance to infection. It causes a painful swelling with a central core of dead tissue
which is eventually discharged. Boils may be complication of acne in adolescents. The condition
may be painful if it remains localized, but if the bacteria enters the blood stream and causes
blood poisoning, it can be serious.
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FOLLICULITIS
This is the inflammation or infection of the hair follicles of the skin tissue. The affected hair
follicles swell into small pus-filled pimples. Each individual pimple looks like a small, rounded,
yellow-red spot. Folliculitis usually occurs at sites where hair follicles are damaged by friction or
shaving, or where there is blockage of the follicle. Excessive sweating (hyperhidrosis) due to
overactivity of the sweat glands can be another cause.
FUNGAL INFECTIONS
RINGWORM (TINEA)
A vegetable fungus and contagious infection of the skin. Ringworm starts as small reddened
patches of vesicles which spread outwards and heal at the centre without scarring. Contact with
infected articles, pets or people, will spread the condition.
The following variations of the types of ringworm are
TINEA PEDIS
Also known as Athletes Foot or ringworm of the foot. The skin between the
toes appears sodden and is easily knocked off to reveal deep splits/fissures
and raw reddened areas. Occasionally followed by vesicle formation and
swelling of the foot and a characteristic unpleasant odour.
TINEA CAPITIS
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Ringworm of the scalp and hair, characterised by red papules at the follicle
wall. The hair becomes brittle, tending to break off or fall from the enlarged
follicle.
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TINEA CORPORIS Ringworm of the body, characterised as flat scaly ring like lesions. Infection
is by direct or indirect contact.
PITYRIASIS VERSICOLOUR (Tinea Versicolour)
A fungal infection of the epidermis that can be found all over the body, but it is mainly seen on
the trunk. The condition may begin as small pink or red spherical patches that later turn white.
This condition needs medication and is often caught from such places as sun beds or in some
cases, hot, sunny or humid weather seems to trigger the fungus to multiply on the skin.
VIRAL INFECTIONS
VIRAL INFECTIONS OF THE SKIN (Highly Contagious)
HERPES SIMPLEX (Cold Sores)
A highly contagious recurring viral infection, which results in vesicle formation around the mouth
and nostril area. The attack begins as a red itchy patch which is followed by swelling and vesicle
formation. If scratched, the vesicles rupture and ooze serum which rapidly crusts. Only in severe
cases will the condition scar the skin. If the sufferer becomes ill, is under stress, or is exposed to
excessive sun or wind, they will become prone to an attack of cold sores.
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HERPES ZOSTER
This virus causes Shingles, and is the same virus which causes Chicken Pox in children. It is
thought to lay dormant in the body following a childhood infection of Chicken Pox. The onset is
marked by itching and erythema and inflammation occurs along the pathway of a sensory nerve
leading from the spine, and this is characterised by blisters and great pain. The nerves affected
are usually those on the abdomen and chest of one side of the body, sometimes the nerves on
the face can be affected, which can cause serious damage to the eyesight.
WARTS (Verruca Vulgaris)
A contagious viral infection which forms firm papules with a rough surface varying in size. Warts
are usually found on the hands but can spread to other areas of the face and body. Warts can
develop individually or in clusters, and can spontaneously disappear.
VERRUCA (Verruca Plantaris)
Affects the soles of the feet (usually the ball of the foot) and they become flattened by the
pressure of the body. They may be single or multiple and do become painful at some stage of
development and they should be attended to as early as possible in order to avoid spreading
the condition.
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INSECT INFECTION
PEDICULOSIS
A contagious condition caused by the infestation of lice
PEDICULOSIS CAPITIS
An infection of the scalp by lice. The lice lay their eggs (nits) near the base of the hair follicle.
The nit which surrounds the hair then passes up and out of the follicle with the growing hair. The
lice once hatched, cause itching and secondary infections. They are transmitted through use of
infected brushes, combs, hats and other personal articles.
PEDICULOSIS CORPORIS
An infestation of the body by lice. Intense itching is caused from the bite of the lice which may
bring about secondary lesions caused by scratching. Lice are transmitted by clothing; boiling or
dry cleaning will eliminate them.
SCABIES
This is a highly contagious skin disease caused by the infestation if itch mites. Mites burrow
under the skin and lay eggs, they hatch and burrow further. It usually occurs on the hands and
wrists, but can also affect the forearms, underarms, waist, inner thigh, buttocks and ankles,
where papules, pustules, boils and ulcers can develop and produce an itchy sensation.
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DISORDERS OF THE SEBACEOUS GLAND
SEBORRHOEA
Caused by over-activity of the sebaceous gland, producing an excess secretion of sebum and
so creating an abnormal oiliness on the surface of the skin. The main areas affected are face,
chest, scalp and back, due to their high concentration of sebaceous glands. The cause of the
imbalance is usually hormonal, and usually found in puberty. The characteristics of the condition
are that the skin takes on a shiny appearance with a sallow colour and the pores appear
enlarged, giving a coarse look to the skin. Seborrhoea is the basis of several other skin
disorders, particularly acne vulgaris.
SEBACEOUS CYST (Steatoma)
A small retention of sebum under the skin that is usually blocked by an overgrowth of surface
skin called a sebaceous cyst. The size of the cyst can vary from a pea to an egg and the areas
are most affected are those where there are more sebaceous glands, i.e. face, chest, scalp and
back, although sometimes also appearing on the underarm. Cysts may have an open or a
closed top and may need medical removal.
COMEDONE (Blackhead)
Worm like masses of hardened sebum form plugs in the hair follicle, appearing most frequently
on the face, forehead and nose, creating a blockage at the mouth of the follicle. The exposed
sebum at the entrance of the follicle turns black in time, due to dirt on the surface and the
sebum being oxidised by the air. The follicle of the sebaceous gland may become inflamed,
creating an acne condition.
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MILIA
These appear mostly on the cheekbones near to the eye and are formed when sebum becomes
trapped in a blind duct, with no surface opening. Milia appear as pearly white rounded lumps
under the skin or raised above, depending upon their size and are usually seen on dry skinned
people. The cause is unknown, but may be due to the diet or using products on the face which
are too strong. Milia can disappear spontaneously after a period of regular massage, or
removed by piercing the surface of the skin and releasing the fatty material inside.
DISORDERS OF THE SKIN DUE TO COLOUR
HYPERPIGMENTATION
Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. It is
associated with a number of diseases or conditions, including but not limited to the following:
 Addison's disease and other sources of adrenal insufficiency
 Cushing's disease
 Melasma, also known as chloasma – patchy hyperpigmentation often found in pregnant
women.
 Linea nigra – a hyperpigmented line found on the abdomen during pregnancy.
 Smoker's melanosis
 Celiac disease
 Tinea fungal infections such as ringworm
 Mercury poisoning
Hyperpigmentation can sometimes be induced by dermatological laser procedures.
HYPOPIGMENTATION
Hypopigmentation is the loss of skin color. It is caused by melanocyte or melanin depletion, or a
decrease in the amino acid tyrosine, which is used by melanocytes to make melanin. It is seen
in:
 albinism
 idiopathic guttate hypomelanosis
 leprosy
 leucism
 Phenylketonuria
 pityriasis alba
 vitiligo
 Angelman syndrome
 tinea versicolor
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PORT WINE STAIN (Haemangioma)
A port wine stain consists of a large area of dilated capillaries, resulting in a skin colour ranging
from pink to purple, which presents a vivid contrast with the surrounding skin. The stain is
commonly found on the face and often covers all of one side, as the skin texture is usually
normal, cosmetic camouflage is very successful. The port wine stain is present at birth and
persists throughout life.
STRAWBERRY MARK
A brightly pigmented area on the skin, present at birth or developing soon after. The mark
usually disappears by about the fifth year of life or soon after.
CHLOASMA
This pigmentation condition consists of harmless light brown patches of irregular size and shape
of the skin. It is most frequently associated with hormonal changes such as pregnancy, involving
the upper cheeks, nose and occasionally the forehead areas of the face. The discolouration
usually disappears spontaneously after the baby is born.
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DEMATOSIS PAPULOSA NIGRA
Dermatosis papulosa nigra (DPN) is a condition of many small, benign skin lesions on that face,
a condition generally presenting on dark-skinned individuals. The papules are symptomless but
may be regarded as unsightly.
LEUCODERMA
An abnormal whiteness of the skin due to the absence of pigmentation occurring either in
patches or over the entire surface of the skin. There are two types
 Albinism – a congenital absence of pigment in the skin, hair and iris of the eyes. Albinos
are extremely sensitive to light and they lack the ability to tan

Vitiligo – a complete loss of colour in the skin in well-defined areas of the body, face and
limbs. It begins as small patches which may converge to form fairly large areas. The skin
around the patches sometimes appears hyper pigmented and the condition is most
obvious on darker skinned individual. The basal cells are no longer able to produce
melanin pigment to protect against ultra violet light. Camouflage make –up can be used
to disguise prominent areas on the face, neck and hands.
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LIVER SPOTS
Brown patches commonly seen on the backs of elderly peoples’ hands. The patch is flat and
smooth like a large freckle.
EPHELIDES
Freckles, brown small patches on any area of the skin, more commonly on exposed areas of the
skin. Freckles can become darker and larger when exposed to sunlight.
LENTIGINES
Brown patches on the skin, similar to freckles, but they are not affected by exposure to sunlight.
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NAEVUS
This is the collective name for vascular and pigmented birthmarks. A coloured malformation of
the skin resulting from a congenital alteration of pigment or dilation of superficial capillaries.
PAPILLOMAS (Moles)
A form of pigmented naevi that are commonly found on the face and body. Moles vary in size
and colour from pale tan to brown bluish black and often develop deep terminal hairs in them
because of a well-developed vascular supply.
SPIDER NAEVUS
This is the central dilated blood vessel, with smaller capillaries radiating from it like the legs of a
spider. Spider naevus may be found in isolation or gathered together in clumps on such areas
as the cheeks, and usually do not develop until adult life. Certain conditions can make these
worse such as extreme heat and cold, obesity and pregnancy.
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TELANGIECTASIA
Broken or dilated capillaries on the surface of the skin, usually found on more exposed areas of
the skin such as the nose and cheeks. The skin looks like it has little blood lines on it, which are
usually red but become darker in colour as they get worse. Certain conditions will worsen
broken capillaries and they include extreme heat and cold, obesity and pregnancy.
ERYTHEMA
A superficial redness of the skin. This is a common occurrence after stimulation to the skin, as
blood rises to the surface of the skin.
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SKIN DISORDERS DUE TO SWEAT GLANDS
PRICKLY HEAT (Milaria Rubra)
An acute inflammation condition that causes itching of the skin and the production of small red
vesicles with inflammation of the sweat glands. This condition may be caused by exposure to
excessive heat, or by closure of the sweat ducts by keratin plugs, particularly seen in the folds
of the skin.
ANIDROSIS
A lack of perspiration, frequently caused by fever or underlying disease.
SKIN CANCERS
DEFINITION
MALIGNANT
A term for diseases in which abnormal cells divide without control and can invade nearby
tissues. Malignant cells can also spread to other parts of the body through the blood and lymph
systems.
BENIGN
In medicine, benign refers to a condition that is not dangerous to health. While most people are
most familiar with its use to describe a condition that is not cancerous, benign is used to
describe many health conditions that could be either non-threatening (benign), or of more
concern. With regard to lumps and nodules, a benign tumor is one that does not spread to other
parts of the body.
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MALIGNANT MELANOMA
This is the most serious type of skin cancer which often spreads to internal organs. It is usually
blue/black, slate or black coloured, arising from cells which normally produce melanin, lacking in
hair with a smooth shiny surface. Because moles which have been normal for years may
suddenly become malignant, any mole of any colour with the following symptoms should receive
immediate medical attention:
1. Increase in size
2. Increase in depth of pigmentation or its extension into the surrounding skin
3. Crust formation
4. Bleeding
5. Inflammatory ring of colour around the mole
6. Any other symptom not seen or felt before
Early diagnosis and treatment is essential.
Childhood exposure to sun is an important factor. Risk of malignant melanoma is increased in
individuals who have high levels of intermittent intense exposure to sun. Studies have also
shown individuals who tend to burn easily have difficulty in tanning, have light coloured hair,
skin and eyes, and who have increased numbers if benign pigmented naevi, have a greater risk
of melanoma than darker skinned individuals..
SQUAMOUS CELL CARCINOMA
Squamous cell carcinoma usually appears as an enlarged red scaly rough dot, about 1/2 “ or
larger in diameter and raised above the skins surface. An irregular rough edge and a scab
partially covering a portion of the growth are two observed characteristics. Most squamous cell
cancers are caused by sun exposure and therefore appear regularly on the face, backs of the
hands or other sun-exposed areas. The treatment is surgically removal.
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BASAL CELL CARCINOMA (Rodent Ulcer)
This is a type of cancerous tumour that appears on the face generally fringing the lips, nostrils
or eyelids. Rodent ulcers develop in the later stages of the condition; they spread slowly and if
untreated, can lead to mutilating destruction of the skin, muscle and bone. However, this type of
cancer does not spread to other parts of the body via the bloodstream.
SKIN CONDITIONS
ROSACEA
A common chronic disease of unknown cause, characterised by erythema with inflamed
papules and pustules (although scarring is not present). The skin appears tense and shiny and
on close inspection often reveals telangiectasia. Seborrhoea is not present with this condition
and the skin looks shiny simply because of lymphoedema, which can be very marked, causing
considerable swelling of the forehead and periorbital areas. Rosacea is usually confined to the
face, though it may spread onto bald scalps and rarely even onto the upper arms. It is usually
middle aged and elderly people who are affected. This condition is often exacerbated by
exposure to sunshine or heat. People sometimes complain of facial flushing which may be
brought on by emotion, alcohol or hot foods.
ACNE
An inflammatory skin disease of the pilo-sebaceous unit, affecting areas of the skin in which
sebaceous glands are very large and have tiny soft (vellus) hairs in their follicles. Acne begins at
puberty when the levels of androgens increases in the body and causes changes in the pilosebaceous units. The sebaceous glands produce increased amounts of sebum, due to
testosterone stimulation and acne forms low in the follicle. The lining part of the follicle has an
altered pattern of turnover of cells and or keratin formation in the area, leading to the production
of a thick dense plug of sebum, keratin and cells within deeper parts of the follicle. Gradually the
lower part of the follicle becomes filled and swells with the keratinous plug, forming the
whitehead or closed comedone. As the process continues, sheets of cells form in the plug, like
layers of an onion, forcing the mouth of the follicle to open. The surface layer of the plug
becomes stained black from the melanin pigment, forming the open comedone or blackhead.
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The bacteria (proprioneum bacterium acnes) are normally present on the skin and mouths of
follicles and are able to enter the follicles during comedone formation, leading to the inflamed
skin of acne. These bacteria begin to live on the skin at puberty, when sebum levels increase in
people with or without acne, but people with acne have more bacteria in the follicle.
ACNE VULGARIS
The skin appears greasy, with a dull sallow colour, blackheads, papules, pustules and scars are
also present. This condition is mostly found in adolescents, and my involve the entire face,
chest and shoulder gurdle, or just one of these areas. Seborrhoea is present and forms
comedones in varying intensities. Secondary infection of the comedone is sometimes present
due to staphyloccal infection, with inflammation and pustules forming around the blackhead.
The infection may spread to involve other sebaceous glands, and a deep seated pustular
condition becomes established.
SKIN TAGS
These are usually found on the neck, underarm, eye area and lips. These vary in size and have
the appearance of skin on a stalk which move when touched. These are not painful or
dangerous.
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CYST
A cyst is a closed sac, having a distinct membrane and division compared to the nearby tissue.
It may contain air, fluids, or semi-solid material. Once formed, a cyst could go away on its own
or may have to be removed through surgery.
ECZEMA
A non infectious skin disorder which starts as redness and blisters. The condition is very itchy.
Scratching results in the oozing of lymph and then the formation of crusts along with further
itching and burning. This progresses to dry scaly patches with continued vesicle formation and
weeping. Eczema is commonly found on the thin skin inside joints. The following are variation of
the types of eczema:
Atopic Eczema
This familial condition is seen in infancy and childhood and is
also linked with asthma, hay fever and migraine. Patches break
out on the face, forearms and backs of the legs. In most cases
the child often grows out of the condition at about puberty, but it
will persist in some.
Allergic Eczema
This is usually caused by a food allergy and can be controlled.
Occupational Eczema
This may be caused by skin irritants typically mineral oil,
detergents, degreasing agents, soap and some cosmetics.
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DERMATITIS
A non infectious inflammatory skin disorder that may result from infection or an allergy. The
condition may be acute with swelling, redness and the formation of vesicles or chronic which
persists over a length of time with the result of a thickened skin with a leathery appearance. The
following are variations of the types of dermatitis:
Contact Dermatitis
Arises from touching substances to which the person is
sensitive.
Exfoliative
Widespread scaling and itching of the skin, sometimes
occurring as a reaction to dermatitis and certain drugs.
Occupational/Industrial
Caused by an exposure to certain chemicals or other
substances in the workplace.
Sensation Dermatitis
Caused by an allergic reaction to sunlight.
Traumatic Dermatitis
Inflammation due to injury.
Varicose Dermatitis
Usually found on the lower legs due to the smaller veins
becoming varicosed.
PSORIASIS
A non contagious condition that can affect varying degrees of the whole face and body. The
cause of the condition is unknown but is thought to be linked to emotion and hereditary factors,
and can have good and bad spells throughout the individuals life.
The lesions of psoriasis start as dull red papules the size of pinheads, and develop into bright
red patches with flaky silvery white scales overlaying the surface, typically found on areas of
thicker skin of the body such as the knees and elbows.
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ALLERGIES
Allergy is the word used to describe a bad reaction that the body has to a particular food or
substance in the environment.
Most substances that cause allergies are not harmful and have no effect on people who are not
allergic.
Any substance that triggers an allergic reaction is called an allergen. Some of the most common
allergens include pollen, house dust mites, mould and pets. Less common allergens include
nuts, fruit and latex.
An allergy develops when the body’s immune system reacts to an allergen as though it is a
threat, like an infection. It produces antibodies to fight off the allergen, in a reaction called the
immune response.
The next time a person comes into contact with the allergen, the body "remembers" the
previous exposure and produces more of the antibodies. This causes the release of chemicals
in the body that lead to an allergic reaction.
Common allergic disorders include asthma, eczema and hay fever. Symptoms of an allergy
include sneezing, wheezing, coughing and skin rashes.
HYPERKERATOSIS
Hyperkeratosis is a thickening of the outer layer of the skin. This outer layer contains a tough,
protective protein called keratin. This skin thickening is often part of the skin's normal protection
against rubbing, pressure and other forms of local irritation. It causes calluses and corns on
hands and feet.
Other forms of hyperkeratosis can occur as part of the skin's defense against:
 Chronic (long-lasting) inflammation
 Infection
 Radiation of sunlight
 Irritating chemicals
 It can be caused by vitamin A deficiency or chronic exposure to arsenic
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URTICARIA (HIVES)
This is a kind of skin rash notable for pale red, raised, itchy bumps. Hives might also cause a
burning or stinging sensation. Hives are frequently caused by allergic reactions; however, there
are many non allergic causes.
UV DAMAGE
A sunburn is a form of radiation burn that affects living tissue, such as skin, that results
from an overexposure to ultraviolet (UV) radiation, commonly from the sun. Usually,
normal symptoms consist of red or reddish skin that is hot to the touch, general fatigue,
and mild dizziness. An excess of UV radiation can be life-threatening in extreme cases
and is the leading cause of primarily non-malignant skin tumors.
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