Skin changes

The etiology of skin changes is complex and often multifactorial. The most common causes include both external and internal factors that directly or indirectly affect the skin structure.
 

• Genetic factors – predispositions to pigmentary nevi, keratinization disorders, psoriasis, atopic dermatitis.
• UV radiation – chronic exposure leads to photoaging, actinic keratosis, and skin cancers.
• Hormonal disorders – acne, melasma, hirsutism, vascular changes.
• Infections:
  • bacterial (e.g., impetigo),
  • viral (warts, herpes),
  • fungal (dermatophytosis, candidiasis),
  • parasitic.
• Autoimmune and inflammatory diseases – systemic lupus erythematosus, psoriasis, scleroderma.
• Mechanical and chemical factors – chronic skin irritation, injuries, contact with allergens.
• Skin cancers – both benign and malignant.
• Systemic diseases – liver, thyroid, cardiovascular, gastrointestinal.

In clinical practice, the duration of the change, the dynamics of its growth, and accompanying general symptoms are of key importance.

Skin lesions are classified based on their morphological structure and biological nature.
 

• Macules – pigmented or vascular changes without elevation (e.g., discoloration, erythema).
• Papules – solid skin elevations up to 1 cm.
• Nodules – deeper, larger changes involving the dermis.
• Blisters and vesicles – filled with serous or purulent fluid.
• Pustules – inflammatory changes with purulent content.
• Ulcers – tissue loss with a tendency for chronic healing.
   

• Benign lesions:
  • seborrheic warts,
  • fibromas,
  • hemangiomas,
  • pigmented moles.
• Inflammatory lesions:
  • acne,
  • eczema,
  • psoriasis.
• Infectious lesions:
  • viral warts,
  • molluscum contagiosum,
  • skin fungal infections.
• Pre-cancerous lesions:
  • actinic keratosis.
• Neoplastic lesions:
  • basal cell carcinoma,
  • squamous cell carcinoma,
  • melanoma.

Any new, rapidly growing, or changing lesion requires specialist assessment.

The symptoms of skin changes are varied and depend on their type, location, and biological activity. They can be purely aesthetic or associated with significant general discomfort.

Most commonly observed symptoms:

• change in skin color (brown, black, red, bluish),
• asymmetry and irregular edges,
• rapid enlargement of the lesion,
• itching, burning, pain,
• bleeding or oozing,
• peeling of the surface,
• hardening or ulceration,
• localized inflammation.

Warning symptoms (requiring urgent diagnostics):

• sudden change in the appearance of a mole,
• bleeding without injury,
• uneven pigmentation,
• pain and tissue infiltration,
• non-healing ulcers.

Early recognition of symptoms significantly increases the effectiveness of treatment and reduces the risk of complications.

The treatment of skin lesions always depends on their nature, clinical diagnosis, and additional test results. The foundation of the procedure is a thorough dermatological diagnosis, often supplemented by dermatoscopy or histopathological examination.
 

Pharmacological treatment:

• topical preparations (keratolytic, anti-inflammatory, antibacterial),
• systemic treatment in inflammatory and infectious diseases.

Surgical treatment:

• cryotherapy,
• electrocoagulation,
• laser therapy,
• surgical removal of the lesion.

Clinical observation:

• in the case of benign lesions without signs of progression.

In cancerous and precancerous lesions, complete removal of the lesion with a safety margin and further dermatological monitoring are crucial.

Procedural removal of skin lesions is an effective and safe treatment method for both benign and selected pathological changes, provided the patient is properly qualified.
 

• Laser removal of skin lesions – precise tissue ablation with minimal damage to surrounding structures; often used for benign and superficial lesions.
• Electrocoagulation – uses high-frequency current for protein coagulation; effective in treating small vascular lesions, warts, and fibromas.
• Cryotherapy – destruction of the lesion through controlled low-temperature exposure (commonly liquid nitrogen), leading to necrosis of pathological cells.
• Plasma – nitrogen plasma technology causing tissue sublimation without disrupting the integrity of the dermis; used for treating selected superficial lesions, particularly in areas requiring high precision.
• Surgical excision of the lesion – method of choice when there is suspicion of malignant or premalignant lesions and in situations requiring histopathological examination of the entire lesion.

The choice of method depends on:

• the type and size of the lesion,
• its location,
• the risk of malignant transformation,
• the patient's aesthetic expectations.

Professional removal of skin lesions should always be preceded by a specialist consultation and conducted in conditions that meet medical standards.