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When evaluating a patient for a skin disorder, there are generally three broad categories that we use to guide our approach to diagnosis your condition or conditions: Inflammatory Skin Conditions, Neoplastic Growths, and Infectious Processes. Of course, many different skin conditions within the three categories will overlap between categories but understanding the classic features of each of the categories will guide the basic management approach.

Inflammatory Skin Conditions

The first category is the Inflammatory Skin Conditions. Within this category, the predominant feature is that your body’s immune system is dysfunctional in the skin. There are multiple ways in which this can occur, with each presenting in slightly different patterns. The primary approach within this category is to control the abnormal immune response and look for any underlying systemic disease. Classic inflammatory skin conditions include:

  • Acne / Rosacea
  • Eczema
  • Psoriasis
  • Lichen Planus
  • Granuloma Annulare
  • Vasculitis
  • Hives
  • Pigmentation Disorders
  • Blistering Disorders
  • Hair Abnormalities
  • Panniculitis

Neoplastic Skin Growths

The second category is Neoplastic Skin Growths. This category can be separated into benign and malignant growths. The unfortunate reality is that every cell in the body has the potential to grow abnormally. Sometimes the abnormal growth is somewhat controlled and stops before it causes a problem – these are the benign lesions. Unfortunately, abnormal growth can also be excessive and harmful – these are malignant lesions. When approaching the conditions in this category, the primary question is whether the neoplastic growth needs to be removed. Sometimes benign lesions do need to be removed because although they are rarely life-threatening, they can be bothersome and cause dysfunction to the structures in the surrounding area. However, if a lesion does not need to be removed, we always recommend not undergoing a surgical procedure if it is not necessary. Regarding malignant conditions, the first step in management is to biopsy the lesion to identify whether it is truly malignant and if it is malignant, how to best treat it. Different malignant growths are best treated in a specific way, so prior to treating any potential cancerous growth, you should always know what you are dealing with. Common neoplastic growths include:

  • Actinic Keratosis
  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Melanoma
  • Moles
  • Cyst
  • Lipoma

Infectious Processes

Infections generally come in four types: bacterial, fungal, parasitic, and viral. This category of skin conditions frequently overlaps with the other two categories. When addressing conditions in this category, the most important question to ask is “why is the infection occurring?” Common infections are treated with appropriate antimicrobial medication. Uncommon or atypical infections need to be cultured to determine the infectious agent and how best to treat it. Common infectious processes include:

  • Warts
  • Tinea
  • Molluscum Contagiosum
  • Folliculitis
  • Abscess
  • Scabies

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