BY DR ROGER DOWN, MBBS, FRCS, FRACS, MD (LOND)
Last month, we considered the most common lumps people experience. Some people get multiple lesions, and the most typical are outlined here:
Lipomas: These are quite common, can occur anywhere, and are lumps under the skin in the subcutaneous fat. Ninety-eight per cent are noncancerous benign tumours. Some people develop these all over the body. This is called Dercum’s disease and is a genetic defect. Small solitary lipomas can be easily removed through a very small nick in the skin, but larger ones are often tied down to the tissues beneath and require an experienced surgeon to remove without deformity or complications.
Neurofibromas: Usually benign tumours of the nerve, just below or within the skin. They can be sensitive to pressure, single or multiple. Some people have a genetic defect/aberration and produce hundreds of these benign tumours all over their body – Neurofibromatosis, another genetic defect. It is recommended only those tumours causing discomfort or those that affect movement due to size or position need to be removed.
Common lesions that should not be removed include:
Strawberry angioma: This is a bright red, often raised lesion that can occur anywhere. It is a common cause of parental concern on the face of their baby. If left, it will resolve without trace, scarring or deformity within three to four years. Surgery is inappropriate. In adults, they are usually multiple, small, and occur with increasing age.
Port wine stain: These can be small or extensive on any part of the body and can be associated with deeper organ lesions/extensions. If on the face or scalp, they require referral to a specialist surgeon to look for any other associated lesion.
Seborrheic Keratoses: These pigmented/white variegated crusty lesions appear on any area of the body with increasing age. They are never malignant and should not be removed unless they are causing anxiety or are big and cosmetically unsightly. They are simply removed without an incision by a partial thickness skin shave and heal rapidly without a scar.
More next time. Have fun, take care, God bless and have a great year.
