12Jan

Lumps and Bumps

Skin Lesions

In our practice we often remove skin lesions (such as moles, or nevi), subcutaneous masses such as lipomas, or even chronic areas of repeated infection such as sebaceous cysts that tend to recur intermittently. Most of the small areas can be excised in the office, under local anesthetic, with decreased cost to the patient.

Larger masses need to go to the operating room for excision where we have better lighting, suction available, anesthetic options, and more tools at our disposal.

Moles & Melanoma

Pigmented (dark) moles and even non pigmented moles can harbor cancerous changes. Melanoma is a particularly worrisome cancer as it can metastasize and kills too many Americans every year. At this point, surgery remains the only cure for melanoma. Although some treatments have become more effective at slowing the progression of metastatic disease, early surgery and removal remains the best option to actually cure melanoma.

If you have a mole that you have noticed a change in size, color, or shape, or if it has started to become irritated or starts to itch (especially if it has bled), please have us or another provider take a look. Melanoma has become increasingly common and sometimes we are surprised by how nondescript a small melanoma can appear.

We perform wide local excision of melanoma and also perform lymph node sampling such as Sentinel Lymph Node Biopsy, and complete lymph node excisions for advanced, local cancer.

Lipomas

Lipomas are another common "lump" that we are asked to evaluate. These are almost always benign, fatty tumors that are usually straight forward to treat by excision. However, cancers that have a similar appearance such as liposarcoma or a different type of soft tissue cancer can be present. If you have experienced a subcutaneous lump for years and it has remained unchanged, it is most likely benign.

But, if you do notice growth and/or increasing discomfort due to pressure the growth is exerting on the surrounding tissue, consider excision soon. These masses are easier to excise when they are small. Some people experience recurrent skin infections in the same area. This often presents as a "boil" that comes to a head, drains, and then receedes again. Patients then forget about it until they have to go through the painful process again.

If this process occurs in the same spot, it is likely a chronic, cystic mass such as a sebaceous cyst or an epidermal inclusion cyst. These occur most often (in decreasing order) on the back, neck, trunk, or limbs. The entire cyst has to be surgically removed or it will continue to recur.

Don't Live In Pain

It seems that sometimes people resign themselves to live with something that bothers them, but that they feel is too small to bring up to their surgeon. Often, our patients tell us that they have been waiting for an appointment time to see a dermatologist. They are often surprised to learn that we actually enjoy doing small cases.

Many of our operative procedures in the O.R. last 2 or 3 hours at a time and every month we will have a few procedures that last more than 3 hours and sometimes 5 hours. As you can imagine, it's a nice break for us to help people out by removing a small bothersome problem that's less stressful (for us and the patient!) than a life threatening surgical problem or cancer.