Pronounced “lee-sion” with an emphasis on the “lee,” a lesion can be almost any damage or abnormal change involving any tissue or organ due to physical trauma or disease.
In other words, there are a ton of different ways in which a lesion can be described but it’s essentially when a surface of your body, internal or external, has some damage to it.
Different Types of Lesions
There are numerous types of lesions with different naming classifications.
The word “lesion” comes from the Latin noun “laesio” meaning “an attack or injury” which is related in Latin to the verb “laedere” = “to hurt, strike or wound.”
Because the definition of a lesion is so broad, the varieties of lesions are virtually endless.
Lesions can occur anywhere in the body and are generally classified by their patterns, their sizes, their locations, or their causes.
1. Cancerous Lesions
Lesions can be categorized according to whether or not they are caused by cancer.
A benign lesion is non-cancerous whereas a malignant lesion is cancerous.
For example, a biopsy of a skin lesion may show that the lesion is benign or malignant.
It’s also possible to tell if the lesion is in a state of evolving into a malignant lesion.
In this case, it would be a called a pre-malignant lesion.
2. Variations in Lesion Patterns
Lesions can be defined according to the patterns they form.
The particular pattern which a lesion forms can also form the basis of it’s naming convention. A bullseye, or target, lesion, for example, is one that looks like the bullseye on a target.
An example of its identification is through that of an X-ray of the duodenum where the bullseye lesion can represent a tumour with an ulcer in the centre.
Another distinct, patterned lesion is that of the coin lesion. This lesion is a round shadow resembling a coin on a chest X-ray It, too, is usually due to a tumour.
3. Lesions Named After People
In typical human fashion, we like to name many things after ourselves.
Lesions are not exempt from this. Lesions can be named after the person who first described them.
For instance, a Ghon lesion (or Ghon focus) is the scar-like “signature” in the lungs of adults left by tuberculosis in childhood.
4. Variations in Lesion Sizes
Lesions also vary by name and categorization based on size.
A gross lesion is one that can be seen with the naked eye.
A microscopic or histologic lesion requires the magnification provided by a microscope to be seen.
Lesions on the molecular level have also been classified. The basis of sickle cell disease, for example, is a molecular lesion as it is only detectable on the DNA level.
5. Location-based Lesions
Location is another basis for naming lesions. In neurology, a central lesion involves the brain or spinal cord, i.e., the central nervous system.
This is in contrast to a peripheral lesion which involves the nerves away from the spinal cord and does not involve the central nervous system.
Many Different Names for Many Different Lesions
There is a virtually endless assortment of lesions in medicine:
Primary lesions, secondary lesions, impaction lesions, indiscriminate lesions, irritative lesions, etc.
Many are named after people including the Armanni-Ebstein lesion, a Bankart lesion, a Blumenthal lesion, and so on.
Causes of Lesions
As we’ve already seen, there is a huge multitude of different lesions.
Consequently, naming a single cause for lesions is impossible. Here it is important to restate the definition of a lesion:
“A lesion can be almost any damage or abnormal change involving any tissue or organ due to physical trauma or disease.”
Some possible causes of lesions therefore include but are not limited to:
- Skin damage via lacerations
- Genetic abnormalities
- A whole host of environmental dangers that could cause bodily harm.
Preparing for Treatment of a Lesion
Depending on the type of lesion that you need to be treated, there will be varying levels of preparation and planning you would need to do before your lesion is treated.
1. If you’re having a lesion that requires the use of anaesthetic and certain pain medicine, you will need to arrange for someone to take you home. Medications such as anaesthesia will make it unsafe for you to operate a vehicle or get home on your own.
2. If a procedure has been planned soon to remove or treat the lesion, do your best to understand exactly what procedure is planned. This includes finding out as much as you can about the risks involved, benefits of having it treated, and potential alternative options.
3. The goal here is to be informed. It’s your body and you should be making informed decisions guided by the expertise of your medical healthcare practitioner.
4. If you take aspirin or some other blood thinner, be sure to ask your doctor for advice. Your doctor may tell you to stop taking blood-thinning medication before your procedure. These medications increase the risk of bleeding so be sure to understand exactly what it is that your doctor needs from you.
5. Regardless of the severity of your lesion, when you are getting treatment from a doctor, you should disclose all the medicines you take. Some of these, unbeknownst to you, may increase the risk of problems and complications during your procedure. Your doctor will then be able to tell you if, and what, you should stop taking before the procedure and how soon to do so.
The important thing to remember here is full disclosure. You want to be clear with your doctor, arrange transport home for after the procedure, and stick to the medical instructions from your doctor for procedure preparation.
General Treatment for a Lesion
Lesion treatments vary depending on the type in question.
Some lesion treatments require surgery such as the case with malignant lesions. This is a more serious procedure than, say, a skin lesion removal.
Even skin lesion treatment has a large variety of treatments. Let’s take a look at a few.
Skin Lesion Treatment
A skin lesion can be an area of skin that is different from surrounding skin such as a lump, sore, or skin cancer.
Most skin lesions are removed and then sent to a lab for examination.
There are several treatments, or ways, in which the skin lesion is removed.
1. Shave Excision
This technique is used for skin lesions that are on the upper layer of skin.
Your doctor will use a small blade to remove all or some of the lesion. Stitches are usually not required. Following the lesion removal, medicine will be applied to the area to stop any bleeding.
2. Simple Scissor Excision
This technique is also used to remove a lesion on the upper layer of skin.
Your doctor will get a hold of the skin lesion with small forceps and lightly pull up. Small, curved scissors will then be used to carefully cut around and under the lesion.
A special instrument, called a curette, may be used to remove any remaining parts of the lesion. SA with the shave excision, you rarely require stitches with medicine being applied to the area to stop bleeding.
3. Skin Excision – Full Thickness
With this technique, a skin lesion in the deeper levels of the skin is removed. A small amount of normal tissue surrounding the lesion may be removed to ensure it’s clear of any possible cancerous cells however this will be done only if there are cause and concern for it.
Most often, an area the shape of an ellipse (an American football) is removed, as this makes it easier to close with stitches.
If a larger area is removed, a skin graft or normal may be required.
4. Curettage and Electrodesiccation
This procedure involves scraping or scooping out a skin lesion. A technique that uses high-frequency electrical current, called electrodesiccation, may be used before or after.
It may be used for superficial lesions that do not need a full-thickness excision.
5. Laser Excision
A laser is a light beam that can be focused on a very small area and can treat very specific types of cells. The laser heats the cells in the area being treated until they are broken down. There are several types of lasers with each type having a specific use case.
Cryotherapy is a method of super-freezing tissue to destroy it.
Cryotherapy is performed using either a cotton swab that has been dipped into liquid nitrogen, with a spray canister containing liquid nitrogen or with a probe that has liquid nitrogen flowing through it. The procedure usually takes less than a minute.
The freezing may cause some discomfort. Your doctor may apply a numbing medicine to the area first. After the procedure, the treated area may blister and the destroyed lesion will peel away.
7. Mohs Surgery
Mohs surgery is a way to treat and cure certain skin cancers. It is a skin-sparing technique that allows skin cancer to be removed with less damage to the healthy skin around it.
General lesion treatment is impossible to define as there are so many different ways to do it depending on the type of lesion.
In general, the lesion will be fixed or removed, if possible.
How to Prevent a Lesion
You cannot always predict and therefore prevent lesions. It’s true to say that often a lesion such as a skin lesion can occur through an accident of some kind.
Ultimately, there is not all that much you can do to ensure you never experience a lesion. Chances are, you already have experienced one, however minor, at some point in your life.
There are some lesions which you can reduce the probability of occurrence of.
Cancerous lesions, for example, may be less likely to occur if you follow a healthy lifestyle.
By “healthy lifestyle” I mean the age-old yet perfectly-sound advice of the following:
- Follow a regular exercise routine.
- Eat according to a healthy meal plan with lots of fruit and vegetables.
- Avoid smoking and drinking alcohol.
- Establish and stick to a consistent sleep routine.
- Reduce stress where possible through practices such as meditation.
Where to Have a GI Bleeding Lesion Treated
Gi Doc Capetown is a practice founded to provide medical solutions in the area of gastroenterology.
Over the years, Dr Eduan Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond.
Book an appointment online or give Dr Deetlefs a call at 021 551 8678.
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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town
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