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Skin diseases: Lentigo and rosacea 

Lentigo, should I be concerned?

We call simple or senile lentigos the small spots and pigmentations, generally associated with age, that appear in the areas of the skin that have accumulated more exposure to the sun, such as the face and hands.

Simple lentigo is benign and only represents a cosmetic problem. However, it may have a malignant variant that is, in fact, one of the forms of presentation of melanoma, a dangerous skin cancer that must be detected in time to be cured.

WHAT YOU SHOULD KNOW…

  • Lentigo can be benign, which is only a cosmetic problem, or malignant, which is a dangerous skin cancer that must be detected in time to be cured.
  • It usually appears in the same areas as the benign ones, but they are usually larger and have an irregular shape, and various shades of color inside. In addition, its growth is continuous.
  • They are related to the accumulation of sun on the skin over the years.

How to distinguish a benign lentigo from a malignant one?

Benign or simple lentigos are the classic sun spots that men and women present from the age of 50. They are usually distributed on the back of the hands, temples or cheeks, because they are areas that have been touched by the sun throughout life. They are spots of color ranging from light brown to black, but generally have a regular shape, with well-defined edges and a uniform color.

People who have undergone more intense exposure to the sun, whether for work reasons (bricklayers, sailors, field workers) or recreational reasons (fans of the beach, outdoor sports or sailing, for example), they may present more lentigos, and in more areas of the skin.

The malignant lentigo, for its part, usually appears in the same areas as the benign ones, but they are usually larger and have an irregular shape, and various shades of color inside. In addition, its growth is continuous.

What is the diagnostic test?

If you suspect lentigo maligna, you should go to a dermatologist. In many cases, lentigo maligna can be suspected from the shape and color of the spot, but the diagnosis can only be confirmed by performing a biopsy under local anesthesia.

How can they be prevented?

Both simple and malignant lentigos are related to the accumulation of sun on the skin over the years. Prevention therefore consists of sun protection. Avoid the sun in the central hours of the day and use sunscreen creams high enough for each skin type (generally factor 30 or higher). In addition, the use of physical measures such as caps, visors, t-shirts, sunglasses and umbrellas should not be forgotten.

How can benign simple lentigos be treated?

The first consideration should be that treatment can only be done with a good diagnosis. If lentigos are to be removed, a dermatologist must first explore them to rule out that any of them may be melanoma.

If it is confirmed that they are simple or benign lentigos, they can be treated by applying chemical substances (Peeling), laser, intense pulsed light or cryotherapy.

And the malignant lentigo?

Lentigo maligna is a form of melanoma, a skin cancer that can spread, causing metastasis and even death. Treatment by a skin doctor in south delhi should be early, when the invasion phase has not been reached. In general, it is done by surgery, removing the stain with an adequate margin of safety. The biopsy is used to ensure diagnosis and complete removal.

Causes of rosacea skin and its treatment

Rosacea is one of the most frequent dermatological diseases, being a common reason for consultation with the dermatologist. Its initial phases are called couperose.

Rosacea is a chronic and recurrent inflammatory disease of the skin , that is, with periods of improvement that alternate with others of worsening. Although its manifestations can be very spectacular, we are facing a benign disease , but due to its aesthetic repercussions and the associated discomfort, it can cause great emotional discomfort and impact the quality of life of the patient.

How does rosacea manifest?

Rosacea appears on the face, affecting the central area: nose, cheeks, forehead and eyes. The classic skin manifestations of rosacea are:

  • Erythema or redness of the skin
  • Flushing or flushing
  • Telangiectasias , small reddish dilated veins
  • Raised injuries as papules, pustules, nodules. When there are no such lesions, the disease is called couperose and not rosacea.

Depending on the type of lesions that predominate, rosacea is classified into different subtypes , and it is possible for patients to go from suffering from one type of rosacea to another.Patients frequently report a burning sensation and tightness in the skin and swelling (facial edema ), with intolerance to cosmetic creams , which accentuate the symptoms of skin irritation.
In the eye they can affect the conjunctiva (redness) and the cornea, appearing similar symptoms such as itching or a sensation of “foreign body”.
The rinofima is a manifestation of rosacea in which a thickening and deformity of the nose occurs. It is more common in men than in women.

What is its cause and how does it get worse?

The exact cause of rosacea is unknown. Genetic, infectious, immunological, environmental factors and alterations in neurovascularization, among others, have been implicated.
What is known is that there are factors that clearly worsen or aggravate it and can trigger the injuries:

  • Changes in temperature , especially sudden changes in heat and cold.
  • Alcohol and tobacco .
  • Foods : spicy, chocolate, spices like mustard, some fruits like avocado, foods rich in histamine, dairy.
  • Exposure to the sun , worse in summer.
  • Intense physical activity
  • Stress, anxiety.
  • Medicines.
  • Cosmetic products , especially those that have irritants like acetone or propylene glycol.

The diagnosis is clinical, that is, the lesions are characteristic and easy to identify . To differentiate it from acne , an important fact is that comedones (the blackheads and whiteheads typical of acne) are not observed. The patient’s medical history helps determine the factors that worsen it, the time of evolution, flare-ups, and duration, to assess the severity and plan treatment options. The dermatologist is the specialist who diagnoses and treats rosacea.

Treatment to control rosacea

It must be clear that rosacea is a chronic disease and that today there is no definitive curative treatment, but the lesions can be improved and the disease well controlled. Treatment is based on a series of general measures together with a specific treatment .
General measures include:

  • Avoid aggravating / triggering factors identified by the patient.
  • High sun protection (avoiding alcohol-based protectors as they are irritating.
  • Avoid irritating products (soaps, cosmetics) and hydrate the skin daily with emollients.
  • Give up tobacco and alcohol .

The indication for medical treatment (topical or oral) will be determined by the type of rosacea, especially whether it is inflammatory or not.

  • Topical treatment (creams) : indicated in couperose and less inflammatory lesions in general. The main topical treatments are metronidazole cream or gel, ivermectin cream, or bromonidine cream.
  • Oral treatment : indicated in inflammatory rosacea (when there are papules, pustules or nodules). Oral antibiotics such as metronidazole or tetracycline (minoclin, doxycycline) are mainly used
  • Laser : can be used to eliminate redness and capillary dilations (telangiectasias).

Finally, there are specific brands of very comfortable corrective makeup for daily use specific for patients with rosacea with very good aesthetic results to cover the lesions.

What you should know…

  • The classic cutaneous manifestations of rosacea are reddening of the skin, flushing (flushing), telangiectasias (small reddish dilated veins) and raised lesions (papules, pustules, nodules).
  • Although its manifestations can be very spectacular, we are facing a benign disease .
  • There is no curative treatment, but the lesions can be improved and the disease well controlled, with topical (creams), oral (antibiotic) or laser treatment .

 

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