Excision of Benign & Malignant Skin Lesions

Surgical excision is recommended for malignant (cancerous) and certain benign (non-cancerous) skin lesions. In most cases, excision is performed after the lesion is anesthetized via local anesthesia. A small amount of surrounding tissue is removed as well to ensure that all malignant cells are excised. Benign lesions usually do not require the removal of any overlying skin and closed with absorbable sutures.

What is melanoma?

Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Almost half of the incidences of melanoma occur in new (dysplastic) moles or moles already present (congenital) on the skin surface.

Is melanoma fatal?

Melanoma can be life-threatening and has a fatality rate higher than those for basal cell and squamous cell cancers – it accounts for more than 80 percent of all deaths from skin cancer. Of the estimated 50,000 new cases of melanoma diagnosed each year, about 8,000 result in death.

Can early detection lower my risk of serious harm?

Yes. Surgery usually removes all traces of cancer when melanoma is detected early in its development. Survival rate drops once cancer has spread to the lymph nodes (30-40% after five years) and again when it begins to impair the major organs (12% after five years).

Am I at risk for developing melanoma?

The causes of melanoma are not yet known, although there are many suspected risk factors, including:

• Familial tendency to develop freckles or prominent or atypical (unusual-looking) moles.
• Presence of many freckles, moles, large moles or atypical moles
• Family member with melanoma
• Overexposure to ultraviolet radiation, especially sunbathing
• Overexposure to sunlight before age 18
• Caucasian ancestry, with fair skin (although all races/skin tones are susceptible)
• Sun sensitivity / Poor tanning ability
• Immune system deficiency due to disease or organ transplantation
• Previous presence of melanoma

How can I tell if I have melanoma?

Self-examination is the best way to find melanoma in its early, curable stages. Simply stand in front of a mirror and examine your body with arms lowered and then raised, making sure to pay particularly close attention to the forearms, upper underarms, palms, backs of the legs, tops and soles of the feet, and between the toes. Hand mirrors are useful for searching the back of the neck, scalp (parting the hair), back and buttocks.

I think I have melanoma. What do I do?

You should see your physician. The presence of cancer can only be confirmed with a biopsy, and early detection greatly increases the likelihood of cure.

What are my treatment options?

Treatment for melanoma depends on the tumor’s location, thickness and progression as well as the patient’s age, health, medical history and preferences. A biopsy is often performed to determine the extent of the cancer. Most often, the appropriate treatment is surgery, followed by adjuvant therapy (interferon, vaccines) for patients at great risk of metastasis (spreading of cancer throughout the body). Other common options are chemotherapy, radiation therapy (x-rays, gamma rays, radioisotopes) and biologic therapy (interferon, cytokines, monoclonal antibodies, vaccines) to improve the body’s self-defense abilities.

After weight loss, many people are left with a pouch of loose, hanging skin in the lower abdomen, known as a pannus. The pannus can be a small stubborn area as fat or a large pouch that extends to the legs and weighs over 100 pounds. It can cause back pain as well as skin rashes, infections, odors and ulcers because of the trapped perspiration under the folds of skin. This troublesome condition can be treated through a reconstructive procedure called a panniculectomy.

A panniculectomy is typically performed after patients have maintained a stable weight for at least 6 months, or at least a year after weight loss surgery. During this procedure, the doctor makes a horizontal incision across the abdomen and removes the excess skin and closes any existing hernias before closing the incision.

After surgery, patients may experience swelling and bruising and will need to wear a support garment to help the area heal. Within a few weeks, you will be able to return to work and other regular activities.

The best candidates for a panniculectomy include those who:

• Have lost at least 50 pounds
• Have maintained a stable weight
• Have excess skin folds in the abdomen
• Are in good overall health
• Have realistic expectations

The results of a panniculectomy are visible shortly after surgery, with full results usually developing after several months. Results are long-lasting as long as patients maintain their weight. If you lose more weight, you may wish to undergo more treatment to further enhance your appearance.