Skin, Lumps and Bumps
Skin, Lumps and Bumps
Benign Skin lesions & Cysts
Moles, cysts and other skin lesions can usually be removed under local anaesthetic very easily, as a day case ambulatory procedure.
Lipomas
These fatty lumps are common and tend to grow slowly over time. These lumps do not have to be surgically removed but if painful, enlarging or unsightly, patients may choose to have this done. If small and superficial they can easily be removed under local anaesthetic. An ultrasound scan can sometimes be helpful in confirming the nature of the lump. If the lump is large or deep, then an MRI scan is also carried out to help differentiate a benign lipoma from a more serious liposarcoma.
Skin Cancer
Skin cancer most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of the skin not ordinarily exposed to sunlight.
There are three major types of skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma.
Treatment for skin cancer is generally surgical excision. More complex surgery can sometimes be required including the use of grafts or flaps.
Melanoma
Melanomas tends to be the most serious type of skin cancer. They tend to arise in an existing mole and have an irregular shape and more than one colour. They can also itch and bleed. Melanoma skin cancer is the 5th most common cancer in the UK. Around 16,000 new cases of melanoma are diagnosed each year. More than 1 in 4 skin cancer cases are diagnosed in people under 50.
Surgery is the main treatment option for most melanomas, and usually cures early-stage melanomas.
Wide local excision
When melanoma is diagnosed by skin biopsy, more surgery is often needed to help make sure the cancer has been removed with a good secure margin. The amount of skin and soft tissue that needs to be removed relates to the depth of the melanoma within the skin. Thicker tumors need larger margins (both at the edges and in the depth of the excision). Sometimes smaller margins are taken if the melanoma is in a sensitive area such as the face. In uncommon situations where the melanoma is on a finger or toe and has grown deeply, part or all of the digit may need to be amputated.
Sentinel Node Biopsy
A test to check if melanoma has spread to the lymph glands (nodes) is often carried out especially when over 1mm in depth and is known as a sentinel node biopsy.
A sentinel node biopsy is carried out by injecting a radioactive substance and blue dye into the site of the original melanoma and then 1-3 nodes are removed from whichever region (armpit/groin/neck) the melanoma cells would likely to travel to first.
Block Dissection of Lymph Nodes
All of the lymph nodes in the region near the melanoma are removed. For example, if the melanoma is on a leg, the nodes in the groin region on that side of the body are removed. Scans can be useful to see if there are abnormal nodes and this surgery is carried out when there is biopsy proven disease in the lymph nodes.
Potential Complications of Surgery
Unsightly scars, infection, bleeding and clots in the legs/lungs can arise with any type of surgery. Surgery in a lymph node basin can lead to seroma (fluid collection), numb patch of skin and lymphoedema (permanent limb swelling). The blue dye that is used in sentinel lymph node biopsy can stain all body fluids blue for up to 72 hours and there is a very small risk (1 in 200) of a serious allergic reaction to the dye.
Advanced Melanoma
If melanoma is not diagnosed until an advanced stage, treatment is mainly used to slow the spread of the cancer and reduce symptoms. This usually involves medicines that target specific genetic changes in the melanoma, such as BRAF inhibitors, or medicines that boost the body’s immune response.
Once a person has had a melanoma, there is always a chance of this recurring. This risk is increased if the cancer was more advanced or widespread. Regular monitoring/follow up can be helpful to detect early recurrence.
Get in touch
If you would like to get in touch to ask our team any questions or you would like to book an appointment please contact us via the details below.