Skin Tumours
Excision of Skin Tumours
What is it?
Skin tumours may be benign or malignant. Common benign tumours include naevi, usually called “moles”, and seborrhoeic keratoses. Although they are not malignant, they may be removed when they are unwanted, cause discomfort or are exposed to repeated trauma and bleeding in areas of contact.
Malignant skin tumours include basal cell carcinoma, squamous cell carcinoma and melanoma. Timely diagnosis and treatment are essential, particularly in melanoma.
The ABCDE rule helps identify suspicious changes: Asymmetry, irregular or poorly defined Borders, variation in Colour, Diameter and Evolution of the lesion.
Surgical excision is usually advised. Depending on the location and size of the defect, skin closure may require different techniques specific to Plastic Surgery. Each situation should be assessed and discussed during consultation.
Frequently asked questions
Answers to common questions about the assessment and excision of skin tumours.
What are skin tumours?
They are lesions that develop in the tissues of the skin. They may be benign, without cancerous behaviour, or malignant, when they represent a skin cancer.
Are all skin tumours malignant?
No. Many skin lesions are benign. Distinguishing a benign lesion from a malignant one depends on clinical assessment and, when needed, examination of a tissue sample.
Which benign lesions are commonly considered for excision?
Common examples include naevi, usually called moles, and seborrhoeic keratoses.
Why might a benign skin lesion be removed?
Removal may be considered when a lesion is unwanted, causes discomfort, is repeatedly traumatised or bleeds because it lies in an area of friction or contact.
Which malignant skin tumours are commonly considered?
The main examples are basal cell carcinoma, squamous cell carcinoma and melanoma. Timely diagnosis and treatment are particularly important in melanoma.
What does the ABCDE rule mean?
ABCDE stands for Asymmetry, irregular or poorly defined Borders, variation in Colour, Diameter and Evolution. A change in any of these features should prompt medical assessment.
Can a small lesion be a melanoma?
Yes. Although many melanomas are larger than 6 mm when diagnosed, they can also be smaller. Size alone cannot rule out melanoma.
Which changes in a skin lesion should be assessed?
A new spot, one that looks different from the others, or one that changes in size, shape or colour should be examined. Persistent itching, bleeding or growth also warrants assessment.
Can the diagnosis be confirmed from appearance alone?
Not always. Benign and malignant lesions can sometimes look similar. When there is uncertainty, a biopsy may be needed so that the tissue can be examined under a microscope.
What is an excisional biopsy?
It is the complete removal of a lesion for treatment and/or diagnosis. In other situations, only part of the lesion may be sampled, depending on its size, location and the clinical concern.
Is skin lesion excision usually performed under local anaesthesia?
Many small skin biopsies and excisions are performed under local anaesthesia, which numbs the area. The appropriate approach depends on the lesion, its location, the extent of surgery and the patient's circumstances.
Why may the removed tissue be sent for analysis?
Microscopic examination by a pathologist helps determine the nature of the lesion and, when cancer is present, provides information that can guide further treatment.
How is the skin closed after excision?
Closure depends on the size and location of the defect. It may be closed directly with stitches or, when needed, with Plastic Surgery techniques such as a local flap or skin graft; some wounds may be allowed to heal without immediate closure.
Will an excision leave a scar?
Any skin surgery can leave a scar. Its appearance varies with the site, the size of the excision, the closure technique, tension on the wound and the individual's healing response.
How can I monitor my skin and reduce my skin cancer risk?
Check your skin regularly, including areas that are difficult to see, and seek assessment for a new, different or changing lesion. Limit excessive ultraviolet exposure by using shade, protective clothing, a hat, sunglasses and broad-spectrum sunscreen, and avoid indoor tanning.
This information is general and does not replace an individual medical assessment.
