MInor Surgery:
Aberdeen Surgical offer a variety of minor surgical procedures:
Excision of skin or subcutaneous lesions
Drainage of subcutaneous abscess
Other operations for abscesses
Skin and Soft Tissue
This includes many relatively minor procedures in different anatomical locations. In general, surgery is indicated if:
1. There is any concern that the lump/mole etc could be a cancer or pre-cancerous lesion.
2. There is pain or the lesion is interfering with daily activities.
3. There is an obvious cosmetic problem with the lesion.
1. Skin cancers and pre-cancerous conditions.
There are a number of types of cancer that involve the skin. In all cases the earlier that these are treated the better the outlook – indeed most are cured if found and treated promptly.
What factors should I be aware of as indicators of a possible skin cancer?
One of the common types of skin cancer is a melanoma- this usually develops in a pre-existing mole so that any mole which:
- Changes colour – in particular becomes darker
- Itches
- Gets bigger – this includes becoming raised
- Bleeds
Should be considered for removal. In most cases there will not be any underlying problem but, as above, it is better to be safe. Rodent ulcers or basal cell carcinomas develop in areas of skin which have been exposed to the sun. These are unusual tumours as they tend to grow slowly but not to spread.
The classic basal cell carcinoma is a hard nodule in which the centre is ulcerated, hence the name rodent ulcer. They may however have many different appearances and any lump or nodule of skin that is not healing after 4 weeks should be considered for removal particularly if on the face, back of the hand or neck/ shoulder which may have been exposed to the sun.
The other common skin cancers are called squamous cell cancers. As for rodent ulcers these often occur in areas of skin which have been damaged by the sun but they may also occur in ulcerated areas of skin and in old burn etc. As for a basal cell cancer you should seek advise for any nodule or non-healing wound after a period of approx 4 weeks.
2. Painful lesions
There are many other skin lesions which are not cancerous but which are painful or get caught on combs or clothing and as such cause problems. There are too numerous diagnoses to list completely but here are some of the more commonly encountered:
Sebaceous cyst - these occur anywhere on the skin except the soles of the hands and feet. They represent a blocked sweat gland and commonly come to attention if they become infected.
Lipomas - these are collections of fat usually just under the skin. They may be multiple but are of little significance unless these are getting bigger or causing pain.
Papillomas - these are sometimes called skin tags and may be due to a viral infection (warts), arise in sun damaged skin (keratomas) or arise spontaneously in (seborrhoeic keratosis)
Ingrown toe nails - most commonly these occur on the big toe but this is not always the case. The edge of the nail cuts into the skin at the sides of the nail and allows for infections to develop which are often extremely painful.
Pilonidal Sinus - This is most common between the buttocks but can occur at the umbilicus or between the fingers (usually in hairdressers) in all cases it is because a shaft of hair has got under the skin and set up a reaction around this. Syptoms may simply be of a swelling but if it gets infected it will become very painful and may discharge.
Abscess - an abscess can occur anywhere in the body and it represents a localised area of infection with the formation of pus. When an abscess developes it is usually red and painful, it may also feel warm to the touch. If left untreated an abscess may burst and discharge pus. In the skin abscess usually represent infection in a pre-existing problem i.e sebaceous cysts or a pilonidal sinus.
3. Miscellaneous skin lesions.
There are a large number of more unusual conditions, most with complicated names, which may give rise to a lump in the skin. Some of these may be tender particularly if they press on a nerve or sensitive area. These include: dermatofibromas, epitheliomomas, capillary haemangiomas, angiolipomas, cylindromas, and piloatricomas. Many of these lumps cannot be differentiated clinically and it is only when they are removed that it is possible to put a name to these. In general these are:
- benign lesions
- May be solitary or multiple
- Some are markers of other internal diseases
