Our skin is subjected to considerable wear and tear from an early age. Sun exposure is a major skin irritant. However it takes years for such irritants to manifest in the form of a skin lesion. Therefore the resulting skin lesions tend to occur in adults and in middle age or elderly. Skin lesions are very common. Virtually every one of us will have had or will develop at least one skin lesion during the course of our lives and most of us will develop more than one. Fortunately the vast majority are and will remain entirely benign.
A cyst is a swelling that appears under the skin. The overlying skin is usually normal, occasionally discolored due to thinning of the skin. The size of the swelling may range from that of a pea to a small marble but occasionally it can be larger. Cysts are invariably benign. Excision is advised.
These occur commonly in the armpits and in the neck. They are often multiple. They tend to grow where the skin is moist due to perspiration. They are usually excised for cosmetic reasons.
There are fatty swellings that appear under the skin (Lipoma). They are benign and relatively common. They are often soft to the touch and the overlying skin is always normal. Sometimes they are multiple. Excision or biopsy is usually advised.
These appear as small bright red spots. They are benign. Larger vascular lesions appear in childhood and young adults, these are often congenital. The latter may require special investigation and treatment. Small vascular lesions are relatively easy to remove.
Moles and Pigmentation
Moles may be flat or elevated. Sometimes they grow hairs. The most important feature however is pigmentation.
When should you be suspicious of a mole? Know your ABCDE.
A. Asymmetry: If you were to draw a line down the middle of the mole, the two sides should match, meaning it is symmetrical.
B. Border: A benign mole has smooth, even borders.
C. Color: Most benign moles are all one color, often a single shade of brown.
D. Diameter: Benign moles usually have a small diameter that malignant ones.
E. Evolving: Benign moles stay the same over time. Be alert when a mole start to evolve or change in any way.
Most skin lesion excisions are performed under local anaesthetic in a side room at the hospital, and you can be completely finished within an hour. If a lesion has raised suspicion, a skin biopsy will be sent to the laboratory to rule out any cancers. You will then come back to see the consultant within 7 days post surgery. It is at this stage that sutures are removed and the wound is assessed.