Many types of disease can first manifest on the skin, so it is best to never ignore lesions or “oddities” for too long, which should instead be seen by a dermatologist, specify the doctors consulted by Corriere della Sera.
The skin is the largest and most visible organ of the human body, so much so that it alone is worth about 15% of our body mass and performs many crucial tasks: it protects against ultraviolet radiation; it is a shield against germs, bacteria and viruses; balances body temperature and regulates fluids, while also being a reservoir of vitamin D.
When healthy, it fully fulfills its defensive role, but when its stability is compromised, the skin’s ability to act as a barrier against external attacks is also compromised.
“That’s why it’s important to ‘save your skin'”, emphasizes Ketty Peris, former president of the Italian Society of Dermatology and Venereology (SIDeMaST). “Protecting it from infection, dehydration, allergies, sun damage and premature aging is important not only for looking good, but also for the body’s well-being. And it’s best to never overlook any lesions or abnormalities for long, which should be seen by a dermatologist for diagnosis,” says Peris.
Canker sores
The presence of common canker sores in the oral cavity is a fairly common condition among the population. However, a recurrent foot and mouth infection in a young person who reports episodes of diarrhea may be an indication of IBD, or chronic inflammatory bowel disease. For this reason, it is important to assess for the presence of associated anal lesions, signs of malabsorption, or a family history of IBD. Chronic oral ulcers may correspond to lesions specific to Chron’s disease.
Lyme disease
Ticks are annoying “creatures” that no one wants to come home with after a walk outdoors. Although most tick bites do not cause disease, there is a particular type of rash that should prompt a medical examination: “Erythema migrans, which takes its name from its ability to spread rapidly across the skin, is a hallmark of the disease Lyme,” explains Ketty Peris, director of the Dermatology Clinic at the Università Cattolica del Sacro Cuore Policlinico Gemelli in Rome.
“It is a circular rash, occurs in about 70-80% of infected subjects and usually appears at or near the tick bite, several weeks later. Attention must be paid especially if a red swelling has appeared at the site of the bite or if it was necessary to remove the tick from the skin”, states the doctor.
Other typical symptoms of Lyme disease are fluctuating fever, muscle and joint pain, and headache. The disease is treated with antibiotics, which can prevent long-term complications, primarily chronic fatigue.
Purple
The name of this disease comes from a mollusk that was used to produce purple dyes.
“The term refers to a rash of small purple or red dots caused by blood pooling in the dermis—a deeper layer of the skin,” says Peris. “When these points are pressed with a finger (or, rather, with a transparent glass), they do not clear. Purpura may indicate a problem affecting the walls of the small blood vessels that supply the skin or the blood inside them, including a possible platelet deficiency, which in turn may indicate bone marrow failure or an autoimmune condition.”
At its worst, purpura can signal septicemia, a life-threatening condition in which an infection has spread to the blood, possibly spreading to the lungs, kidneys, or even the skin.
Stellate angiomas
There are skin lesions that can take recognizable forms. Star angiomas can be an indication of a problem with the skin arterioles (small arteries that supply blood to the skin).
“Arterioles open and close to control heat loss from the skin surface, but sometimes they can remain open, resulting in a spider-like ‘pattern’, where the open arterioles represent the body of the spider, while the even smaller capillaries that they extend in all directions are thin legs,” explains the expert.
If you squeeze the body with a fingertip, the entire lesion disappears because the pressure temporarily cuts off the blood flow. These are often benign and not associated with any specific condition, especially if a person only has two or three of them.”
However, more than three angiomas in a star can indicate elevated levels of circulating estrogen, often related to liver disease or hormonal changes that occur during pregnancy. By treating the underlying cause of the condition, ‘spider nevi’ often disappear over time, although they may persist or reappear later.
Acanthosis nigricans / black velvet
Changes in body folds, especially in the neck or armpits, especially if the skin is thickened and velvety to the touch: these are possible indicators of acanthosis nigricans, which is more common in those with darker skin.
This condition is usually associated with metabolic disorders, especially type 2 diabetes and polycystic ovary syndrome. If these diseases are treated successfully, acanthosis nigricans may even go away. In rare cases, it can be a sign of gastric cancer, which should be considered in patients without signs of metabolic diseases (obesity and hypertension).
“Butterfly Eruption”
Heart disorders can also be visible on the skin. Heart valves have the important role of directing blood flow through the heart and preventing backflow. The valve between the heart’s left chambers (the mitral valve, so named because of its resemblance to a bishop’s hat or miter) can sometimes narrow, causing heart function to deteriorate.
The body’s natural response is to conserve blood volume by cutting off flow to the skin. The effect of this response can result in a cyanotic red coloration of the cheekbones and nose, like the spread wings of a butterfly.
This is known as “mitral facies” which, depending on the degree of damage to the heart and great vessels, may persist despite treatment.
itch
Diffuse itching, that unpleasant sensation that induces the urge to scratch, can also be an indicator of various diseases.
“The search for causes is often very complex and requires careful attention to its characteristics, as well as the possible presence of associated symptoms,” recalls Peris. “In fact, itching, besides being very common in elderly patients, where it is related to skin dryness and aging, can be associated with various dermatological diseases (atopic dermatitis, psoriasis, urticaria). Or it can be a sign of infectious diseases (such as scabies, which is becoming more and more common), of renal failure, of liver or hematological pathologies (including tumors) for which specific diagnostic investigations are necessary”.
Striae distensae
Stretch marks are very common skin lesions, consisting of multiple linear skin depressions, usually oriented along the lines of skin tension. They frequently appear during pregnancy, puberty and in cases of obesity: when the skin becomes “too stretched” and lacks elasticity. However, they can also be a sign of endocrine disorders, especially Cushing’s syndrome, in which stretch marks appear purple, large and deep, located mostly on the abdomen, breasts and at the base of the limbs.
Diffuse hyperpigmentation
A diffuse increase in skin pigmentation can be the manifestation of systemic pathologies of an endocrinological nature, but also metabolic or tumoral. Primary adrenal insufficiency or Addison’s disease causes browning of body areas that are already physiologically more pigmented (such as breast areolas, genital areas, palm creases). Increased pigmentation also occurs in conditions characterized by iron accumulation, regardless of origin. And it is one of the main signs of hemochromatosis, in which the accumulation of iron leads to a slate-colored pigmentation, with “gray” and atrophic skin. Accumulation of other metals (eg silver) or medications can also be the cause of dark skin discoloration.
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