Skin Lesion Removal

Melanoma

Melanoma is a malignant neoplasm that arises from the pigment-producing cells of the epidermis, known as melanocytes. It is considered the most dangerous type of skin cancer, as it has the potential to metastasize to other organs if not diagnosed and treated in its early stages. Melanoma commonly appears on sun-exposed areas of the body, such as the arms, legs, chest, and face, but it can occur anywhere on the body.

The most common presentation of melanoma is a change in the size, shape, color, or texture of an existing mole. Other signs include the development of new moles or a persistent sore that does not heal. It is important to note that melanoma can also occur in areas of the skin that have no prior history of moles.

Risk factors for melanoma include fair skin, red or blond hair, blue or green eyes, a history of sunburns, particularly in childhood, a family history of melanoma, and a large number of moles or atypical moles. Individuals with a weakened immune system are also at an increased risk for melanoma.

To reduce the risk of developing melanoma, it is essential to practice sun safety measures such as using sunscreen, wearing protective clothing, and avoiding sun exposure during peak hours. Regular self-examinations and dermatologist screenings can aid in the early detection of melanoma.

Treatment options for melanoma include surgical excision, radiation therapy, and/or immunotherapy. The appropriate course of treatment will be determined based on the stage and location of the melanoma. Early detection and intervention are crucial for optimal outcomes in melanoma management.

Skin Cancers 

Types of Skin Cancers

The most common type of skin cancer is basal cell carcinoma. Fortunately, it’s also the least dangerous – it grows slowly and rarely spreads beyond its original site. It commonly occurs on the limbs and face, especially on the nose, eyelids and upper lip. Though basal cell carcinoma is seldom life-threatening, if left untreated for a long time, it can invade deep beneath the skin and erode the underlying tissue and bone, causing severe damage (mainly if it’s located near any vital structures such as the eye).

Squamous cell carcinoma is the most common type of skin cancer, frequently appearing on the lower lip, face, or ears. Squamous cell carcinoma on the lips and intraoral cavity can be related to cigarette or pipe smoking. These cancers can be of different ‘grades’, with some types exhibiting more aggressive growth with higher incidences of recurrence and spread. In addition, this skin cancer may spread to distant sites, including lymph nodes and internal organs such as the lung and liver. Squamous cell carcinoma can become life-threatening if it’s not treated.

A third form of skin cancer, malignant melanoma, is the least common, but its incidence is increasing rapidly. Australia has one of the highest incidences of Melanoma in the world. Malignant melanoma is also the most dangerous type of skin cancer. If discovered early enough, it can be cured entirely. However, if it’s not treated quickly, malignant melanoma may spread throughout the body and is often deadly. The prognosis of Malignant Melanoma is based on its depth of invasion, so early detection is the key. Changes in a mole’s colour, shape or border can be an early sign of melanoma, as well as itching, ulceration or bleeding. Your GP or a skin specialist should always check for new moles.

Diagnosis & Treatment

Skin cancer is definitively diagnosed by either a punch biopsy (removing part of the growth) or an excisional biopsy (removing all of the growth). The specimen is then sent to the laboratory, and the cells are examined under a microscope. It can be treated by several methods, depending on the type of cancer, its stage of growth, and its location in your body.

If the tumour is small, the procedure can be done quickly and easily in an outpatient facility or surgeon’s office. The procedure may be a simple excision and direct closure, leaving a scar. These scars are often prominent for the first six to eight weeks before fading.

All specimens excised are sent for histopathological examination by a pathologist. These are expert specialists who analyse microscopic features of the skin structures and cells. They can determine the type of skin cancer and whether adequate margins have been taken around it. Suppose any component of cancer has been left behind or the excision margins are close (also known as an ‘involved margin’ or ‘close margin’ respectively). In that case, a second procedure is required to take out more tissue to ensure no cancer cells have been left behind. Inadequate excisions, if left untreated, often lead to a high rate of cancer recurrence in the same area, usually within the first few months after the initial excision. On the other hand, complete excision of skin cancer often results in a cure.

Other possible treatments for skin cancer include cryotherapy (freezing the cancer cells with liquid nitrogen), radiation therapy (using ionising radiation), topical chemotherapy (anti-cancer creams applied to the skin), and Mohs surgery, a particular procedure in which the cancer is shaved off one layer at a time.

All of which have their place and are suitable for specific types of cancer at specific sites. For example, Cryotherapy and anti-cancer creams are only effective on superficial skin cancers, limited to the very top layer of the skin. Even though these are non-surgical treatments, they may still leave a scar. Please discuss your options with your surgeon to find out which treatments are most suitable for you.

Reconstructive Surgery

Reconstructive Surgery is often required for skin cancers which are too big to be excised and directly closed or skin cancers in areas of the body where there isn’t a lot of skin laxity. Most commonly, local flaps or skin grafts are used to reconstruct small to moderate-sized skin cancers on the limbs and face. A Local Flap repair is where a geometrically designed pattern is made adjacent to the defect (where cancer had been cut out), so the defect can be closed using general laxity in the nearby skin. This technique is very often used on the nose (e.g. a Bilobe Flap), on the face (e.g. a Rhomboid flap or V-Y advancement flap) or the forehead (e.g. an A-T flap or H-flap).

There are two types of Skin Grafts: Split Thickness Skin Graft (or STSG) and Full Thickness Skin Graft (or FTSG). STSG is where skin shaving is taken from a ‘donor site’ (commonly from the thigh). This is then placed and secured into the defect with sutures or staples. The donor site often heals with simple dressings within 10-14 days. The wound on the donor site is similar to a gravel rash; it can ooze blood-stained fluid through the dressings and be ‘stingy’ in the first 3-5 days. This is the most common method of skin grafting for lower legs, as well as some scalp defects. The donor site is often left with a permanent but very faint patch of discolouration.

FTSG is where a full-thickness piece of skin is cut out from the body (donor sites are usually the upper inner arm, behind or in front of the ear, lower neck or the groin). This skin is sewn into the defect, sometimes with a pressure dressing (also known as a ‘tie-over’). The donor site is left with a straight line scar which is barely visible after two months.

With any skin graft, there is always the risk of graft failure, where all or part of the skin graft fails to ‘take’ on the raw surface. This could be due to various causes, such as infection in the wound, bleeding under the graft, swelling in the area, or too much movement under or around the graft. When grafts fail, they undergo a slow necrosis, where the graft will first turn yellow and sloughy, then black before falling off like a scab. Most of the time, the wound will continue to heal slowly over 4-6 weeks; it is only in infrequent instances that another graft is required to help the healing of the wound.

More commonly, grafts ‘take’ with minimal failure, usually around the rim where surrounding skin movement prevents graft edges from adhering. Grafts first appear blue to purple, then it becomes fragile and occurs pinkish red (due to the in-growth of underlying blood vessels into the graft). Grafts take up to 2 weeks to heal and eight weeks to ‘settle’, which should be a faintly discernible patch that can be easily camouflaged with a thin layer of foundation or tinted sunscreen.

If the cancer is very big or has spread to the lymph glands or elsewhere in the body, major surgery may be required. The different techniques used in treating extensive skin cancers can be life-saving, but they may leave a patient with less-than-pleasing cosmetic or functional results. Depending on the cancer’s location, size and severity, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip.

No matter who performs the initial treatment, the plastic surgeon can be an essential part of the treatment team. Plastic and reconstructive surgeons have a wide array of reconstructive techniques – ranging from re-arranging local tissue to a complex transfer of tissue flaps from elsewhere on the body. Reconstructive surgery can repair damaged tissue, fill in tissue defects, rebuild body parts, and restore most patients to acceptable appearance and function.

The Aim of any skin cancer surgery has two components:

1. To adequately remove the cancer
2. Then reconstructing the defect to achieve both good cosmetic and functional outcomes.

The critical point to note is that the earlier a skin cancer is detected and treated, the operation is usually a lot simpler.

Moles & Cysts

Moles, keratoses, and epidermal cysts are common types of skin growths that may need excision.

Moles

Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. Some moles are known as dysplastic naevus, with atypical cells. These cells can transform into malignant melanomas.

Changes in a mole should be viewed seriously. This include change in shape, colour and size. Other warning signs include moles which were flat then became raised, moles that have suddenly started to itch, moles which ulcerate and bleed, and finally, new moles that have only recently appeared. Moles can be removed due to concerns that they may harbour underlying malignant change.

Moles can also be removed for cosmetic reasons, or they can also be removed because they’re constantly irritated by clothing or jewellery (which can sometimes cause pre-cancerous changes).

Removing a mole means exchanging the mole for a scar. Superficial scraping and shaving of a mole often will result in inadequate removal and recurrence of the mole later. More importantly, it often changes the appearance of the mole, which could either make it look like a mole undergoing malignant change or make the mole itself challenging to monitor for malignant transformation. The best way to remove a mole is to cut it out and close the area with fine sutures. It leaves a small straight line scar which becomes very faint after 6- 8 weeks and hardly visible in the long term.

All moles excised from our practice are sent off for histopathological examination to ensure no untoward changes occur in these lesions.

Seborrheic Keratoses

Seborrheic Keratoses are brown raised lesions which can be small or large. These often don’t undergo any change over many years. Sometimes they can become irritated from constant picking or rubbing and may bleed when traumatised. These are not malignant and can be removed for:

1. Cosmetic Reasons
2. Constant Irritation
3. Colour change which may be due to malignant change

Solar or Actinic Keratosis

Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found in areas exposed to the sun. It is commonly regarded as an area of sun damage and is typically a marker of the sun’s effects on your skin. A tiny proportion can become skin cancers characterised by the thickening of the area.

These lesions can spontaneously resolve, especially with good skincare and avoidance of sun exposure. Persistent lesions can be treated with cryotherapy or salicylic acid creams, which can be prescribed and performed by your family doctor. They do not require excision unless a malignant change is suspected or proven on a biopsy.

Epidermal Cysts

These are ingrown cysts of the skin, where skin cells cluster beneath the skin and produce oils. They can enlarge very slowly. Some do not cause any symptoms or problems, others can become troublesome. Characteristically, they undergo enlargement and then discharge of offensive thick white/yellow paste periodically, which results in the ‘disappearance’ or deflation of the cyst. The cyst then recurs and enlarges until the next time it discharges.

Other times, the cyst can become infected repeatedly and continually discharge offensive material associated with redness, swelling, and pain in the area. As a result, multiple courses of oral antibiotics are often required to alleviate an infective episode.

Some cysts spontaneously resolve without surgery, while others may require surgical removal. Cutting out a cyst involves the removal of the cyst and its capsule; otherwise, the recurrence rate is very high. An adequate excision can often be done in the office. A straight-line scar is often the result of cyst excisions. The best time to excise a cyst is when it is inflated and palpable but not infected. Cutting out a cyst while it is infected can lead to wound complications, such as the breakdown of the wound and infection. It also makes removal very difficult due to surrounding inflammation. Thus the likelihood of complete removal is lower.

Reclaiming Radiant Skin: Expert Skin Lesion Removal by Dr. Foti Sofiadellis

Unveil your skin’s natural beauty and confidence with precision skin lesion removal performed by the esteemed Dr. Foti Sofiadellis. As a trusted dermatologist, his skillful techniques and compassionate care ensure safe and effective removal of various skin lesions. From moles to growths, Dr. Sofiadellis specializes in restoring your skin’s flawless canvas.

Understanding Skin Lesion Removal: Your Path to Clarity

The Importance of Professional Skin Lesion Removal

Skin lesions, whether benign or concerning, can affect your appearance and self-assurance. Dr. Foti Sofiadellis recognizes the significance of expert removal, not only for aesthetic reasons but also for accurate diagnosis and peace of mind. His in-depth knowledge and meticulous approach ensure each procedure is tailored to your specific needs, guaranteeing optimal results and minimal scarring.

Moles, Tags, and More: Comprehensive Lesion Removal

From common moles to skin tags and cysts, Dr. Sofiadellis offers a comprehensive range of lesion removal solutions. He evaluates each lesion’s characteristics, considering its location, size, and type before recommending the most suitable removal technique. With an emphasis on precision and aesthetics, he aims to restore your skin’s natural radiance seamlessly.

Skin Cancer Concerns: Timely Removal for Peace of Mind

In cases where a skin lesion raises suspicion of malignancy, early removal is crucial. Dr. Foti Sofiadellis’s expertise extends to skin cancer screenings and removals, prioritizing your well-being. With a focus on early detection and swift action, he ensures that any potential cancerous growth is addressed promptly, promoting both physical and emotional healing.

Your Journey with Dr. Foti Sofiadellis: Expertise and Compassion

Initial Consultation: Your Concerns, Our Expertise

Your skin lesion removal journey begins with a thorough consultation. Dr. Sofiadellis takes the time to understand your concerns and answer any questions you may have. His patient-centered approach fosters open communication, enabling you to make informed decisions about your treatment plan.

Surgical Precision: Removing Lesions Safely and Seamlessly

With years of experience, Dr. Foti Sofiadellis employs advanced surgical techniques to remove skin lesions with utmost precision. Whether utilizing excision, cryotherapy, or laser therapy, he tailors the approach to suit your specific needs. His meticulous attention to detail ensures the best aesthetic outcome, minimizing scarring and maximizing your comfort.

Recovery and Beyond: Supporting Your Healing

Following your skin lesion removal, Dr. Sofiadellis provides personalized aftercare instructions to promote smooth healing and minimize any discomfort. His compassionate team is available to address any concerns you may have during your recovery journey. As your skin rejuvenates, you’ll appreciate the seamless results and renewed confidence.

Why Choose Dr. Foti Sofiadellis for Skin Lesion Removal

• Dermatological Excellence: With extensive dermatology experience, Dr. Sofiadellis’s expertise guarantees safe and effective lesion removal.
• Personalized Approach: He customizes each removal procedure to your unique skin type, lesion characteristics, and desired outcome.
• Compassionate Care: Dr. Sofiadellis and his team prioritize your well-being, providing a supportive and reassuring environment throughout your journey.
• Optimal Aesthetic Outcomes: His commitment to surgical precision and aesthetic harmony ensures minimal scarring and natural-looking results.

Taking the First Step Towards Flawless Skin

If you’re ready to bid farewell to skin lesions and unveil your skin’s true radiance, Dr. Foti Sofiadellis is your dedicated partner. Contact our practice today to schedule a consultation and embark on your journey to clearer, healthier, and more confident skin. Experience the transformation that professional skin lesion removal can bring – your skin’s rejuvenation is just a step away.