medical English 專欄(八)

SKIN

(I)               Case

Hubert was a 65-year-old diabetic who developed a skin infection on the back of his short, bull neck. The infection rapidly progressed from a “boil” to a large, deep, spreading abscess. His diabetes went out of control and he developed shaking chills and a fever of 104 degrees. Under general anesthesia, a doctor removed a large area of dead tissue. His incision measured three by six inches, by three inches deep. However, “all’s well that ends well.” He was discharged after three days in the hospital, and managed his own care of the incision, with the help of his wife, obtaining complete healing six weeks later. 

(II)           Q&A

  Q: What seems to be the problem?

   A: 1. She has red spots and blisters.

      2. The skin of my arms and feet itch all the time.

      3. I have rash that develops over chest after wearing clothing.

      4. The mole on my face became larger gradually and it changed color too.

      5. He had raised, red, itchy welts over both arms after taking a drug.

      6. I have cracked, itchy, peeling skin between the toes of my feet.

   Q: How long has she had this problem?

   A: 1. She had a few blisters two days ago. I thought it wasn’t serious.

      2. In the beginning, we found few red spots on her face 3 days ago, but now they are all over her body. 

      3. We found a crusty rash between her nose and upper lip 2 days ago.

      4. It progressed rapidly since two days ago.

(III) What he said

   Eczema often causes a very intense itch reaction, so the person is always rubbing and scratching. You always have to be aware of it, plan your day around it. You start thinking of your skin as a separate entity. You ask yourself, “Today, can I garden? No, my hands won’t let me do it. Your skin is the largest organ of the body, and you become very aware of it.

   In dry climates like we have here in Minnesota, especially in the winter, we use fair Emollients, even Vaseline. At night, I sleep with my hands in a light pair of cotton gloves, and I put vinyl exam gloves over that.

(IV)        Skin Infection

A skin infection usually starts when bacteria gain entrance into or through the skin’s surface by way of a hair follicle, sweat gland, cut or scrape, or surgical incision. Your immune defence begins with an inflammatory response, which brings increased blood flow to the involved area. Your white blood cells arrive to engulf the bacteria, while your circulating antibodies kill them directly. The classic sign of infection – redness, warmth, swelling, and tenderness – develop during the time the invading bacteria are being battled.

(V)           Hives

Hives are raised, red, itchy, often fluid-filled patches of skin called wheals or welts that may appear and disappear at random. They range in size from less than 0.6 cm to 7.5 cm across or more, and they may last a few minutes or a few days.

A single hive commonly develops after an insect sting. Multiple hives often develop in response to a medication, food, or infection. Other possible causes of hives include plant allergies, inhaled allergens, stress, cosmetics, and exposure to heat, cold, sunlight, or natural rubber latex. Often a cause cannot be found.

(VI)        When to Call Your Doctor

Call your doctor if you notice any unusual skin changes or growths, especially if they bleed and continue to change.

l   Asymmetrical shape: One half does not match the other half.

l   Border irregularity: The edges are ragged, notched, or blurred.

l   Colour not uniform: Watch for shades of red and black, or a red, white, and blue mottled appearance.

l   Diameter: A mole is larger than a pencil eraser. (Harmless moles are usually smaller than this.)

And also call if you notice:

1.      Scaliness, oozing, bleeding, or spreading of pigment into surrounding skin.

2.      Appearance of a bump or nodule on the mole.

(VII)    Vocabularies

                  Skin swelling / Puffiness

                      Severe itching

                      Skin irritation

                      Fungus infection

                      Blister

                      Skin rash

                      Eczema

                      Urticaria

                      Bruise

                      Mole

                      Warts / Corn

                      Puncture wound

(VIII)  Dialogues

P: The toes and soles of my foot itch all the time. Cracks on my heel here hurt, too. Have I got so called athlete’s foot?

N: Yes. We call it Tinea Pedis. Rub this ointment of the infected area each night after washing and drying your feet. Keep it on overnight. Wash your feet again each morning, dry them and then spread this powder on your feet and socks if you have to wear shoes.

P: Is it easy to cure this fungal infection?

N: Not easy. You have to keep applying the ointment for many weeks. The ointment is effective. It penetrates your skin and removes irritation.

P: There are pimples on my leg here. They scale, crust and ooze fluid, accompanied by intense itching and burning.

D: They are eczema …… Don’t scratch. The more you do, the more they spread. The eczema is usually caused by a variety of irritants acting outside on the skin or circulating in the blood. Are you sensitive to any allergens?

P: I don’t know. Can’t you detect the cause of my allergy by some tests?

D: Medical tests are performed by the lab. Take this form to the technicians. They will find the cause of your allergy.

P: Shall I go to the lab now?

D: Wait a moment. I’m giving you a tube of anti-inflammatory ointment. It alleviates inflammation, relieves your itch and restricts the secretion of fluids. Now you can go to the lab. Come back next week to see the result of the laboratory report.