ASK A DERMATOLOGIST

I am 37 and have developed multiple red scaly patches on sun exposed areas of my skin. My GP suggests it could be signs of skin cancer. Please advise.

The red scaly patches on the sun exposed areas of your skin are most likely suggesting a diagnosis of actinic keratosis (AK). These patches clinically represent signs of excessive sun damage to the affected areas of the skin. Chronic sun damage can occur due to repeated excessive sun exposure over the years and can result in causing multiple skin changes including appearance of multiple lesions. AK lesions are mainly caused due to sun damage by UVB radiations. The second most common skin side effect of chronic sun damage is premature aging of the skin. Most of the AK lesions are benign in nature and can easily be treated. A certain percentage of persistent lesions of AK however, need to be treated with care and a skin biopsy may need to be performed to rule out cancers. About four to five per cent of certain histopathologically diagnosed AK lesions have a potential risk of turning into squamous cell carcinoma (SCC) of the skin. In early stages, SCC is completely curable through simple surgical excisions. However, if ignored or misdiagnosed it can turn into metastatic cancer and can become fatal.

My 11-year-old daughter has developed a few bubble-like pinkish red patches on her face and body. Her pediatrician suspects she is suffering from chickenpox. However, she had been vaccinated against chickenpox.

The description of your daughter’s skin lesions is quite likely suggestive of a diagnosis of chickenpox infection. In its classical form, chickenpox-induced skin lesions appear as pinkish red patches, where few of them or in severe cases most of them can develop central vesicular or blistering lesions. The size and depth of these blisters are suggestive of the severity of the disease and are also believed to be an indicator of any probability for post chickenpox skin scarring. In general, chickenpox is considered to be selflimiting and only symptomatic treatment is suggested by most physicians. For example, calamine lotion for drying the weeping lesions, with extra rest and isolation. If the sufferer develops severe productive coughing with heavy phlegm and difficulty breathing, then a course of oral or injectable antivirals and antibiotics becomes necessary to prevent/treat any suspected presence of chickenpox-pneumonia.

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