What is a Skin Lesion Excision

A skin lesion is a superficial growth or a patch of the skin that does not bear any resemblance to the area surrounding it. There are two categories of skin lesions, the primary and the secondary. Primary skin lesions are usually present at birth such as moles or birthmarks or those that are obtained during a person’s lifetime associated with infectious diseases, such as warts, acne, or psoriasis, allergic reactions such as hives or contact dermatitis, or environmental agents, such as sunburn, pressure or temperature extremes. On the other hand, secondary skin lesions are changes in the skin that result from the primary skin lesions. These may occur either as a natural progression of the primary lesion or through manipulation of the lesion by the person, such as scratching or picking at it.

Moles, cysts, warts, or skin tags are known as skin lesions. Most of the skin lesions are benign. But these are usually removed when they are painful, unsightly or restrict movement. The most common treatment for most skin lesions is surgical removal. Warts, another form of skin lesion, are removed by freezing them with the use of a liquid gas or treating them with a chemical paint. Some warts may be treated by burning them off. If a skin lesion is suspected to be malignant, a biopsy is done and is taken to the laboratory to be processed and checked for any signs of cancerous cells.

A wide variety of conditions and diseases can cause the development of skin lesions. The development of moles, freckles or birthmarks may be hereditary. The most common cause of skin lesions is infection of the skin itself by bacteria, viruses, fungi, or parasites. Some examples of skin infections that result in skin lesions are acne, athlete’s foot or tinea pedis, warts, and scabies. The formation of skin lesions may also be caused by some allergic reactions which often subside soon after the offending agent is removed. Sensitivity to outside environmental factors can also lead to the formation of lesions. For instance, the decreased sensitivity and poor circulation in a diabetic can add to the formation of extensive ulcers on the patient’s extremities. A sudden onset of skin lesions may be triggered by infections of the body’s entire system. Examples are diseases such as chicken pox, herpes, and small pox. Some cancers of the skin such as basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and Kaposi’s sarcoma are recognized by their lesions.

Lesions caused by infections or disorders heal depending on the type of infection or disorder and the overall health of the individual. Whether a lesion is localized or whether or not it has spread to other areas of the body (such as the lymph nodes) is the basis for the prognosis of skin cancer. The cure rate is 95-100% in cases where the lesion is localized and has not spread to other parts of the body.

Moles and freckles are lesion that cannot be prevented. They are benign growths that are common and unavoidable. On the other hand, others can be avoided or at least minimized by taking certain precautions. When a skin lesion is caused by an allergic reaction, knowing the offending agent and removing it from the home or workplace can aid in the prevention of this. If this cannot be done, developing ways for safely handling these agents with the use of gloves or protective clothing may work. In order to prevent the occurrence of infectious skin diseases, it is important that you keep the skin, nails and scalp clean and moisturized and avoid sharing personal care items such as combs, and cosmetics with others. To prevent skin lesions connected with sexually transmitted diseases, use of condoms is recommended. One should avoid scratching and picking at skin lesions in order to prevent spreading the infection which may end up in scarring. Those who have systemic conditions, such as diabetes mellitus or those with poor circulation should always make sure that they have regular inspection of their bodies for any changes in the condition of their skin as they may lead to a serious skin lesion. The key to preventing or minimizing the incidence of skin cancer is to have a regular visual inspection of the skin and a regular use of sun screen with an SPF of 15 or more.

Nevi, a medical term for moles, are pigmented cells that are clustered together and appear as small, dark brown spots located on your face, torso, arms and legs. However, moles can come in different colors and can grow virtually anywhere including your armpits, scalp, under your nails, and even between your fingers and toes. They also come in a wide variety of shapes and sizes, from oval to round and can be as tiny as a pinhead or large enough to cover an entire limb. Those moles that are greater than 8 inches in diameter and are seen at birth may need to be removed in order to prevent the possibility of malignant melanoma, which is the deadliest form of skin cancer.

Most of moles are harmless. On the other hand, there are rare cases wherein moles may become cancerous. It is important to monitor moles and other pigmented patches as this would help in the diagnosis of skin cancer especially malignant melanoma. Even if not all melanomas develop from pre-existing moles, they may still begin in or near a mole or other dark spot on the skin.

Moles, freckles, and birthmarks are a normal part of the skin. They will not disappear unless they are removed deliberately through a surgical procedure. Skin lesions, in general, do not really cause serious problems; however, for practical or cosmetic reasons, many would want to have them removed. A lot of factors actually determine the technique used for removing the lesion. Some of the factors are its size and location. The surgeon will be the one to advise you on the most appropriate method for your situation.

Effects of Excision Pre-auricular Cyst

The objective of skin lesion excision is sometimes to remove an unsightly mole or other cosmetically unattractive skin growth. Other times, a skin lesion will be removed to make sure it is not cancerous, and, if it happens to be cancerous, to stop its spread to other parts of the body.

Candidates for Excision Pre-auricular Cyst

Candidates for this procedure are those who have lesions that are too big, bothersome or unsightly; have precancerous or cancerous lesions; or those who are irritated or uncomfortable with the lesions that rub against their clothing.

Your Consultation

Before the operation, the area to be treated is cleansed with alcohol or another antibacterial preparation. The procedure is done on an outpatient basis, with the use of a local anesthetic. This is not a highly invasive procedure and can often be well-tolerated by young and old patients, as well as those with other medical conditions.

The Skin Lesion Excision Procedure

An elliptical excision is the most common type of excision. The ellipse is designed so that the resulting scar runs parallel with present skin creases. This makes sure that the scar is as narrow and short as possible.

The area to be excised is underlined with a colored pen. Next, the dermatologist will cut around and under the lesion with a scalpel and sharp scissors so that it is entirely removed. The lesion is placed in formalin ready to be sent to the pathology laboratory.

Some bleeding in the area from where the lesion has been removed may be possible. The doctor may coagulate the blood vessels with a diathermy and this can make a hissing sound and a burning smell.

After which, the edges of the ellipse will be sewn together to make a thin suture line. There may be two layers of sutures -¬ a layer underneath that is absorbable and a layer of sutures on the surface that will need to be removed in 4 to 14 days. A special kind of skin glue is often used to join the edges together, instead of sutures. A dressing may be administered and instructions should be provided on how to nurse your wound and when to get the stitches out.

Recovery

Your wound may be tender for about 1 to 2 hours when the local anesthetic wears off. Leave the dressing in place for 24 hours or as advised by your dermatologist. Keep the wound dry for 48 hours. After which, you can gently wash and dry the wound. If the wound becomes red or very painful, consult your dermatologist – it could be infected.

Abstain from strenuous exertion and stretching of the area until the stitches are taken out and for some time afterwards. If there is any bleeding, put pressure on the wound with a folded towel without looking at it for 20 minutes. If it is still bleeding after this time, seek medical attention. The scar will be red and appear raised at first but usually diminishes in color and size over several months.

Risks

Some risks connected with this procedure are:

  • The local anesthetic may not numb the area enough and you may experience some minor discomfort. In rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.
  • Infection or bleeding.
  • The lesion may grow back if it was a cancerous or precancerous growth.
  • A lumpy scar may grow where the lesion once was.

FAQs

How can skin lesions be removed?

For minor lesions such as warts, freezing with a liquid gas or treatment with chemicals that are painted on such as salicylic acid may be done. However, for a more accurate removal or for removal larger lesions, the choice of treatment is a surgical procedure.

What is to be expected after the removal of skin lesions?

usually, patients who undergo removal of skin lesions may go home within one to two hours after the procedure. In the event that a general anesthetic is used, arrangements should be made for someone to drive you home and stay with your for the next 24 hours.

Are skin lesions cancerous?

Most of skin lesions are actually non-cancerous. Still, doctors might want to observe and perform an excisional or punch biopsy (tissue sample to undergo microanalysis) to know whether or not a particular lesion is cancerous. One should examine their skin regularly, that is, on a monthly basis since the key to a successful treatment is early detection. One should observe for changes in existing moles, presence of new moles, or a change in a certain area of the skin. As you observe moles, make sure that you look for asymmetry as an irregularly shaped mole may be suspected for cancer, border as a suspect mole may have irregular borders, color as cancerous moles may appear as mixtures of red, white, blue, brown, purple, or, black, and the diameter as skin lesions greater than 5mm may be suspected as cancerous.

When should I seek medical advice regarding my moles?

If at past age 20 a new mole appears, it is wise to consult your doctor. Pain, itching or burning, oozing or bleeding, inflammation, presence of scales or crusting, and sudden change in size, shape, color or elevation of the mole are some of the signs and symptoms which may indicate a medical concern. If you have any concerns about a mole in your body, it is advisable that you see your doctor or ask for a referral to a dermatologist.

Are there some medications that can cause skin lesions?

Some medications or substances may actually skin lesions. Some of these medications, substances, or toxins are Procainamide, Procan-SR, Procanbid, Promine, Pronestyl, and Pronestyl-SR. These are not the only medications that may cause skin lesions. There are many other drugs or substances that are not listed here that may cause your symptoms. Make sure that you let your doctor know of any medications or treatments that you are currently using. Indicate the prescription or whether it is over-the-counter, supplements, herbal or alternative treatments.

What is the purpose of a skin lesion excision?

The main purpose of this procedure is to fully remove the skin cancers such as basal cell carcinoma, squamous cell carcinoma or melanoma. If the cancer is not cut out, it may spread to the surrounding skin and to other parts of the body (metastasize). Other reasons that skin lesions are excised include cosmetic appearance, to remove an inflamed cyst, or recurrent infection.

What happens during the procedure?

The doctor disinfects the area and then numbs the skin around the lesion using a spray or shot of a local anesthetic. The anesthetic should prevent any feeling of pain during the operation. The doctor will then cut a football-shaped patch around the lesion, remove the lesion and stitch the skin back together.

Will I have a scar?

You will always have some sort of scar since it is impossible to cut the skin without scarring in some way. Your dermatologist will attempt to excise the lesion in a way that will keep scarring to a minimum. Some people have an abnormal response to skin healing and these people may get larger scars than usual (keloid or hypertrophic scarring).