Do you have a new or changing growth? Don’t wait to get it checked out!

Pigmented Lesion - MelanomaToo frequently, I meet new patients who come in noting they’ve had a skin growth they’ve been concerned about for months, a year, or even years.  Some have had growths that have continued to grow in size, bleed, break open and even take over the face — growing into the eye, ear, or lip.  Not surprisingly, these were skin cancer.

Why this wait before seeking care?

Is it because it takes so long to get in to see doctor?  Certainly, access to a physician, and specifically a dermatologist, can be difficult and healthcare systems need to work on this problem, but wait times will rarely be over a year!  Many practices also triage their calls to get patients who may have skin cancers in earlier.

In several of my interactions, people have been reluctant and even scared to seek care.  Reasons I’ve heard include: 1) the growth wasn’t bothering them that much, 2) they didn’t think it would be anything serious, and 3) they were scared about what would happen if they did have a skin cancer.

Interestingly, I think back to why people do seek care for a new or changing growth.  Oftentimes, it is a spot that the patient has picked up him/herself, but often, it’s someone else — most commonly a spouse — who has encouraged the patient to seek care.  I’ve also had a handful of patients whose hairdressers kept pressing the patient to seek care.  And guess what?  Turned out that they did have skin cancer.

Have you waited before seeking care for a new or changing growth?  If so, why? 

Is there enough awareness about getting skin checks from your doctor, doing your own self skin checks, or when to seek care?

If you do have a new or changing growth on your skin, don’t wait.  Pick up the phone and call a/your dermatologist or your primary physician to get it checked out.  Explain your concerns about having skin cancer.  When skin cancers are caught early, they can be very curable.  However, there are many types of skin cancers, and some unfortunately are aggressive and not easy to cure once they have progressed or traveled to other parts of the body.

Signs of a skin infection (cellulitis) from a cut or scrape

Skin infection after a scrape of the hand. The red streaks are a sign of the infection. Image by Dr James Heilman.
Skin infection after a scrape of the hand. The red streaks are a sign of the infection. Image by Dr James Heilman.

Our last post covered the basics about treating a minor cut or scrape.  One reason you should call your doctor after getting a cut or scrape is if you think your skin has developed an infection (aka cellulitis).  It’s normal for there to be a little redness around the cut or scrape, but here are signs to look for that can suggest that you have a skin infection.

  • Redness that spreads beyond the few millimeters around your cut or scrape
  • Redness that “streaks” in lines from your wound (aka lymphangitis)
  • A lot of pain over the area
  • Pus (a thicker whitish or yellowish discharge)
  • Swelling
  • Warmth
  • Fever or chills

The signs of infection are not immediately visible and may develop days after the initial injury.  A common mimicker of an infection around the wound is a contact allergy, most commonly from the bandaid/bandage used. In this case, the redness will be in the shape of the bandage.

Regardless, if you suspect you have a skin infection, seek medical attention. You may need a procedure to clean your wound and/or antibiotics.

Treating a minor scrape or cut

Scrape (abrasion) of the hand after a fall from a bicycle
Scrape (abrasion) of the hand after a fall from a bicycle

Alas, it is snowing up here in Boston yet again!  With all the icy streets and sidewalks, it’s no surprise that many of us have shared the common plight of slipping, falling and scraping an elbow, knee, hand, or other body part.

So how should you treat a minor scrape (aka abrasion) or cut (aka laceration)?

First off, take a look at your scrape or cut.

Did something puncture your skin?

Did you skin fall on something dirty like rusty metal? Did dirt get lodged in the area?

Are you left with a wound more than a few millimeters deep?

Is your scrape bleeding profusely and not stopping with pressure?

If you answered yes to the above, you may need to see your doctor to see if you need special cleansing of the skin, a tetanus shot, stitches or other treatment.

If the scrape is otherwise minor — e.g. clean, not actively bleeding, etc, you can clean it off with running water.

Next, gently pat the area dry.

You can cover the area with petroleum jelly.  A lot of people like using Neosporin or bacitracin ointment — just keep in mind that these are also common causes of contact allergies which can delay healing.  For minor cuts, liquid bandage can be used.

You can also apply a regular bandaid/bandage over the area to protect the area.

If there are any signs of a skin infection, let your doctor know.  Stay tuned for a future post on signs of skin infection.

Erythema ab igne – rash from your laptop or space heater?

These days, erythema ab igne is often caused by laptop users placing the laptops on their thighs. The rash then shows up on the thighs.
These days, erythema ab igne is often caused by laptop users placing the laptops on their thighs. The rash then shows up on the thighs.

Erythema ab igne, aka fire stains, toasted skin syndrome, or hot water bottle rash, is a rash that occurs after exposure to heat.  A reddish, purplish, or brownish discoloration appears in a lacy pattern.  The rash is caused by repeated exposure to a heat source.

Some examples of these heat sources include:

– laptops – The rash occurs on the thighs where people rest their laptops.

– space heaters, infrared heaters – These direct heat to a confined area.

– hot water soaks – For example, frequent soaking of the feet in hot water.

– heating pads

– hot compresses

This patient had erythema ab igne on the belly from using heat to relieve belly pain. Photo by Dr. James Heilman.
This patient had erythema ab igne on the belly from using heat to relieve belly pain. Photo by Dr. James Heilman.

– hot water bottles

– chair heaters, car seat heaters

– fire/fireplace

– hot stove

In most cases, the pigmentation from erythema ab igne eventually goes away. However, in some longstanding cases, the pigmentation does not resolve.  In these longstanding cases, the skin may have a different texture as well.  If you are diagnosed with erythema ab igne, your doctor will likely advise you to avoid continued use of the focal heat source that you are being exposed to.