This document describes several different skin conditions: - Lipoma is a benign fat cell tumor that can occur anywhere there is fat tissue, except the brain. Sebaceous cysts are retention cysts in sebaceous glands containing keratin. Furuncles are hair follicle infections caused by Staphylococcus aureus. Carbuncles are clusters of furuncles caused by S. aureus. Cellulitis is a spreading skin infection typically caused by streptococcus that presents with pain, fever and swelling. Squamous cell carcinoma is a malignant skin tumor arising from keratinocytes, usually occurring on sun exposed areas in elderly patients.

1. Lipoma, sebaceous cyst, furuncle, carbuncle,
cellulitis and abcess, squamous cell CA

2.  Inspection and palpation
◦ Site
◦ Size
◦ Shape
◦ Skin
◦ Surface
◦ Scar
◦ Temperature
◦ Tenderness
◦ Translumination
◦ Attachment- relation to skin
◦ Edge/ Margin
◦ Consistency
◦ Mobility/Fixation
◦ Pulsation
◦ Fluctuation
◦ Irreducibility-Reducibility or compressibility
◦ Regional Lymph Node

3. Acute spreading subcutaneous
inflammation caused by
haemolytic Streptococcus

4.  Etiology: Streptococcus (group A), S. aureus,
H. influenzae, fungi-cryptococcus
neoformans, G- rods
 Source of infection: Injuries, scratch/ graze,
bite (scorpion/snake)
 Risk factor: Immunocompromised host, DM,
venous and lymphatic block pt
 Common site- LL, face and scrotum
 S+S: Pain, fever, erythema (blanches when
palpation), diffuse swelling, lymphadenopathy

5.  Complication: necrotizing faciitis, abcess,
toxaemia and septicaemia, percipitates
ketoacidosis (DM pt)
 Treatment:
a) Bed rest, elevated leg
b) Glycerine MgSO4
c) Antibiotics- cephalosporin
d) Antisnake venom
e) Insulin- DM pt

6. Localised collection of pus
(dead and dying neutrophils
plus proteinaceous exudate)

7.  Classification:
◦ Pyogenic (staphylococcal infection)
 Commonest form of an abscess
 Can be subcutaneous, deep or can occur within the viscera
such as liver or kidney
 Sign- calor, rubor, dalor, tumour, loss of fx, fluctuation (-ve in
deep seated abcess, eg: breast abcess)
◦ Pyemic
 Occurs due to circulation of pyaemic emboli in the blood
(pyaemia).
◦ Cold: Usually refers to tubercular abscess due to
involvement of either lymph nodes or spine
 Tx: antibiotic and I+D

9. hair follicle infection caused
by Staphylococcus aureus or
secondary infection of a
sebaceous cyst

10.  Risk factor: Immunocompromised and poor
hygiene
 Etiology: S. aureus
 Painful indurated swelling with surrounding
oedema. After about 1-2 days, pustule develops
which bursts spontaneously discharging pus.
 Necrosis of subcutaneous tissues produces a
greenish slough. Skin overlying the boil also
undergoes necrosis, under acute infective
gangrene.
 Incision and drainage with excision of slough.
Antibiotic cloxacillin is given.

11. This is an infective gangrene
of the subcutaneous tissue
caused by Staphylococcus
aureus. Common in DM pt.

12.  Common site: nape of neck, back, shoulder
region and thigh
 Clinical features:
 Severe pain and sweeling at the nape of neck
 Fever, malaise and pt quite ill
 Surface red- red hot coal
 Later, skin on the centre of carbuncle softens and
peripheral satellite vesicles appear, which rupture
discharging pus and giving rise to a cribriform/
honeycomb appearance
 The end result is development of a large crateriform
ulcer with central slough.

13.  Complication
◦ DKA
◦ Osteomyelitis
◦ Septicaemia, toxaemia (sepsis)
◦ Acute infective gangrene
 Management
1. Start antibiotic, send pus for C+S
2. Saucerization
3. Cleaning with hydrogen peroxide, dressing daily
4. Antibiotic- cloxacilin
5. DM control

17. benign tumour arising from
fat cells of adult type
also called 'universal tumour'
because it can occur anywhere
in the body where there is fat,
EXCEPT BRAIN

18.  Clinical feature:
a) Slippage sign
b) Pseudofluctuant, pseudottransluminable
c) Soft and rubbery consistency
d) Lobular surface, non tender (except neurolipoma)
e) Overlying skin normal
 Complication
◦ Liposarcoma
◦ Calcification
◦ Myxomatous degeneration
◦ Intussusception
◦ Saponification
◦ Ulceration

19.  Investigation
◦ CT
◦ MRI
◦ FNAC
 Management
Non-surgical: wait for FNAC confirmation
Surgical: Incision (LA/GA); R/O liposarcoma
Liposuction

22. It is a retention cyst
containing keratin and its
breakdown products resulting
from obstruction to the duct
of the sebaceous gland .
AKA- epidermal cyst

23.  NEVER IN PALM N SORES!! Common at hairy
area- groin, neck, scalp, scrotum
 Diagnostic feature: rounded / hemispherical ,
smooth surface , cystic in consistency ,
overlying skin can’t be pinched , centrally
placed bluish punctum , mobile , indentation
sign + ve , lobulation sign – ve , slipping sign
–ve , fluctuation test + ve , transillumination
test –ve
 Complications: trauma, ulceration, infection,
Cock’s peculiar tumour, sebaceous horn

25. Cock’s Peculiar Tumor Sebaceous Horn

26. Aka= epithelioma
Maglinant tumor arise frm
keratinocytes
Common in elderly and man

27.  Etiology/ risk factor: de novo; precancerous
lesion (Bowen’s dz, Marjolin ulcer, senile
keratosis etc)
 Sites: skin of face, lower lip, dorsum of hand and
forearm, anus and anal canal, vulva and vagina,
penis, tongue, oral cavity and oesophagus
 Spread: local, lymphatic, blood
 Clinical features:
◦ ulcer with raised and everted edge
◦ irregular shape, ill-defined margin, raised and everted
edge , floor is covered with friable tumour tissue, bleed
on touch with blood stained discharge, no mobility, no
tenderness , L/N enlargement is present

28.  Investigations – Wedge biopsy , Excisional
biopsy
 Microscopy: epithelial pearl/cell nest
appearance