Black and Red Skin Lesions: Possible Causes and Treatments

A skin lesion appears with a dark center and a red surrounding area?

Hello Doctor: I have noticed a raised bump on the lower edge of my right breast.
The center of the bump is dark and slightly indented, with a red ring around it, and there is some peeling of the skin.
I previously had a viral wart on my toe, and I'm wondering if this could be a wart as well.
Here is a close-up of the affected area: http://picsurge.com/g/zKY8oM.
The center part is not very clear, but it is indeed dark and the dark area feels firmer.
Thank you.

Niming, 30~39 year old female. Ask Date: 2016/10/20

Dr. Wu Yuxin reply Dermatology

Medical regulations state that "physicians must personally examine patients before providing treatment or prescribing medication," and therefore, online diagnosis is not permissible.
If you are experiencing significant distress, it is advisable to seek medical attention promptly.

Reply Date: 2016/10/20

More Info

When it comes to skin lesions, particularly those that present as black and red, it is essential to consider a variety of potential causes and treatments. Based on your description of a raised lesion on the lower edge of your right breast, which appears black in the center, surrounded by redness and some peeling, there are several possibilities to consider.

Possible Causes
1. Seborrheic Keratosis: This is a common benign skin growth that can appear as a raised, rough, and sometimes pigmented lesion. They can vary in color from light tan to black and may have a scaly surface. They are generally harmless but can be mistaken for other skin conditions.

2. Skin Tags: These are small, benign growths that can sometimes become pigmented. They are usually flesh-colored but can darken over time.

3. Viral Warts (Verrucae): Given your history of viral warts on your toes, it is possible that this lesion could be a wart. Warts are caused by the human papillomavirus (HPV) and can appear as raised, rough lesions. They may have a black center due to thrombosed capillaries.

4. Melanoma: Although less common, any new or changing pigmented lesion should be evaluated for the possibility of melanoma, a type of skin cancer. Characteristics to watch for include asymmetry, irregular borders, multiple colors, and a diameter larger than a pencil eraser.

5. Fungal Infections: Sometimes, fungal infections can cause lesions that appear red and scaly, and they may have darker centers.

Recommended Treatments
1. Consult a Dermatologist: The first and most crucial step is to have the lesion evaluated by a dermatologist. They can perform a thorough examination and may recommend a biopsy if there is any suspicion of malignancy.

2. Topical Treatments: If the lesion is determined to be benign, treatments may include topical therapies. For example, if it is a wart, topical treatments containing salicylic acid can be effective. For seborrheic keratosis, cryotherapy or topical treatments may be recommended.

3. Surgical Removal: If the lesion is bothersome or if there is any concern regarding its nature, surgical removal may be advised. This is often a straightforward procedure performed in an outpatient setting.

4. Skin Care: Maintaining good skin care practices can help prevent further irritation. This includes using gentle cleansers, moisturizing regularly, and applying sunscreen to protect the area from UV damage.

5. Monitoring: If the lesion is benign, regular monitoring for any changes in size, color, or shape is essential. Any changes should prompt a re-evaluation by a healthcare professional.

Conclusion
In summary, while there are several potential causes for the black and red lesion you described, a definitive diagnosis can only be made through a clinical examination by a qualified dermatologist. Given your previous experience with skin lesions, it is advisable to seek professional advice promptly to ensure appropriate management and peace of mind. Remember, early detection and treatment are key in managing any skin condition effectively.

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