Diagnosis of skin induration is made by palpation (feeling the area) and assessing whether the raised area has a hard, resistant feeling. Because there are many different underlying causes of induration of skin, the treatment varies widely.
Signs of Induration
Indurated skin generally has the following signs:
Feels firmer to the touch than surrounding skinAppears thickLooks smooth and shiny
The indurated areas commonly appear on the hands and face, but can also be found on the chest, back, abdomen, breasts, or buttocks.
Causes of Induration
The primary underlying causes of skin induration include:
Specific types of skin infectionCutaneous metastatic cancersPanniculitis
Skin Infections
Several types of skin infections can manifest with symptoms of skin induration. Examples include:
An abscessAn inflamed cystInsect bites that become infected
Not only is there an underlying skin condition that can cause infections that exhibit skin induration, but there is also a causative microorganism. According to a Baylor University Medical Center study, staphylococcus aureus is responsible for the majority of skin and soft tissue infections.
Cutaneous Metastatic Cancers
Cutaneous metastasis occurs when cells from a cancer in the body spread to the skin. Metastatic skin lesions may originate from various other types of cancer.
Another source of cutaneous metastasis is skin cancer. In this instance, the primary melanoma spreads/infiltrates to distant areas of the skin, where secondary growths begin to surround the primary melanoma site.
Scleroderma
Scleroderma (systemic sclerosis) is a rare condition involving inflammation and fibrosis of the skin and internal organs. The disease has three phases, and the second phase involves skin induration. The condition is linked with significant illness and mortality rates.
Diabetes
Diabetes can cause a condition called recurrent plantar ulcers, which are ulcers or sores on the bottom of the feet (due to poor circulation to the lower extremities).
Studies have shown that induration on the soft tissue of the feet may cause an increased risk of recurrent foot ulcers in people with diabetes because it results in a decrease in the foot’s ability to absorb shock when a person is bearing weight.
Panniculitis
Panniculitis is an inflammation within the fat tissue of the body. It has many underlying causes, including:
InfectionsInflammatory disorders (such as lipodermatosclerosis)Trauma or exposure to the coldConnective tissue disordersPancreatic disorders
Symptoms of panniculitis may include reddened, tender nodules (indurated areas of the skin) over the chest, abdomen, breasts, face, and buttocks.
Diagnosis of panniculitis is most often made by visual examination, in combination with a biopsy for confirmation.
Treatment
Treatment of induration of skin varies greatly depending on the underlying cause.
Example treatment options may include:
For an abscess, the treatment of choice may be antibiotics, incision, or drainage. For inflammatory disorders, like scleroderma or lichen sclerosus, immunosuppressants or steroid creams can be used.
Supportive Care
Supportive care for conditions involving skin induration can vary greatly, depending on the underlying cause. Examples of supportive care for skin conditions may include:
Warm compressesAnalgesiaElevation of the affected extremity (to help reduce any swelling)
A Word From Verywell
Many skin conditions require close follow-up care, particularly if symptoms begin to worsen and/or if treatment (such as antibiotics) is ineffective.
Skin infections are commonly resistant to certain types of antibiotics; therefore, if a fever develops, the induration gets larger, or the area becomes reddened and hot to the touch, it is vital to consult with your healthcare provider as soon as possible. Your antibiotic may need to be changed to a different type of medication.
