Surgical removal of benign and malignant skin lesions including

There are many malignant and benign skin lesions that are treated predominantly with surgical excision. Malignant tumours are commonest in in the white population group largely due to many years of sun exposure. Sometime a biopsy is essential to make a diagnosis. This can be done by means of a punch biopsy, shave biopsy, incisional biopsy or excisional biopsy. A scarless removal is desirable for very superficial benign lesions of the skin. The removal of these lesions especially when small and in hidden areas of the body a simple excision is all that is required. When large or in aesthetically sensitive area it is most suitable for the patient to have the procedure performed by a plastic surgeon for the best possible cosmetic result. Skin cancers on the other hand are treated with a view to effecting a cure therefore some form of scarring is the norm however a plastic surgeons expertise is invaluable in minimizing scarring especially in aesthetically sensitive areas.


It would appear that the incidence of malignant melanoma is increasing. Once again it occurs mainly in the white population almost anywhere on the body surface. In non white population the malignant melanoma occurs mainly in the nailbed and the sole of the foot. These tumours are black and may even originate although uncommonly on the mucosa of the mouth, conjunctiva, vagina etc. Thickness of the tumour is the single most important variable that determines the prognosis and survival rate.

The key issue is to pick up the cancer at an early stage to give you the best chance of the cure. Unfortunately this cancer on the skin appears benign and not very different from freckles and moles that are so common on our skin surface. It is also important to identify premalignant lesions, which we call dysplastic nevi. The rules for identifying potential malignancies are simple as ABCD:

  • Assymetry- shape is not uniformly round
  • Border- outline is irregular
  • Colour or Change- the colour is not uniform or otherwise a mole that has undergone a sudden change in characteristic.
  • Diameter- the size is greater than 6mm.

There are set guidelines for the management of the cutaneous melanoma, which is based on the thickness of the lesion. The thickness directs the size of the surrounding normal skin that needs to be taken with the lesion and also the need to be performing a sentinel lymph node biopsy. A proper examination, treatment and surveillance are vital to the management of malignant melanoma.