A skin lesion is an abnormal lump, ulcer or discoloration of the skin. A lesion is benign when it is harmless. Benign skin lesions may be unsightly or may be traumatized repeatedly especially during shaving. For these reasons, benign lesions are often surgically removed.
Naevi is a medical term for skin mole. It is often darker than the surrounding skin (eg brown or brown-black) because it contains more pigment (colour). Rarely, some moles can develop into malignant melanoma especially when they are exposed to a lot of sun.
Capillary haemangiomas (also called strawberry birthmark) occur in children and grow larger or smaller as the baby/child develops. They are pink or red-purple in colour because they consist of enlarged blood vessels.
Papillomas are wart-like benign swellings on the skin or on a mocous membrane.
Seborrhoeic keratosis is also known as senile keratosis because it usually occurs in older people. They appear as yellowish or brown raised lumps.
Fibromas are raised swellings that are seen in association with chronic trauma.
A skin lesion is described as malignant when it is a cancer. Skin cancer can occur anywhere on the body, but it is most common in skin that is often exposed to sunlight, such as the face, neck, hands, and arms. You should seek medical advice if you notice changes in a facial skin lesion, for example: increase in size; ulceration; bleeding; change in colour.
Basal cell carcinoma (often called rodent ulcer) is a non-melanoma skin cancer and is the most common cancer worldwide and the most common skin cancer, typically occurring in sun-exposed skin. Therefore, the majority occur in the skin of the head and neck on the ears, neck, or face. These lesions grow slowly and although they rarely spread to other parts of the body, they cause local tissue destruction. Basal cell carcinomas can appear as pearly white or waxy bump, often with visible blood vessels.
Actinic keratosis is potential precursors of squamous cell carcinoma (premalignant) with approximately 1 in 20 becoming cancerous. These lesions are small, scaly red, brown, or skin coloured patches caued by sun exposure. People with fair skin, blond or red hair, and blue or green eyes are at most risk. Early treatment is advised to stop possible progression to squamous cell carcinoma.
Actinic cheilitis is a precancerous condition that usually appears on the lower lips. Scaly patches or persistent dryness and cracking of the lips may be present. Less common symptoms include swelling of the lip, loss of the sharp border between the lip and skin, and prominent lip lines. Actinic cheilitis may eventually evolve into invasive squamous cell carcinoma if not treated.
Squamous cell carcinoma is a non-melanoma skin cancer that can appear as a firm red nodule, a scaly growth that bleeds or develops a crust, or a sore (ulcer) that doesn’t heal. It most often occurs on the nose, forehead, ears, lower lip, hands, and other sun-exposed areas of the body. Squamous cell carcinoma is curable if identified and treated early. If the skin cancer becomes more advanced (spreads to local lymph nodes), treatment will depend on the stage of cancer.
Malignant melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more serious and potentially deadly. Melanoma is usually brown or black cancer that begins in a pigmented cell in the skin. Beware of a change in the appearance of a mole or pigmented area. Consult a doctor if a mole changes in size, shape, or color, has irregular edges, is more than one color, is asymmetrical, or itches, oozes, or bleeds. These cancers have a tendency to spread to other parts of the body. It can be cured if it’s found and treated early.
If your surgeon is concerned that your skin lesion is a skin cancer, he will perform a biopsy under local anaesthesia and the tissue biopsy result will be available after approximately 1 week. If the biopsy confirms a skin cancer, your surgeon will arrange treatment for you depending on the type of skin cancer. Alternatively, your surgeon may recommend CCPDMA (complete circumferential peripheral and deep margin assessment). See “CCPDMA” page.
The exact treatment will depend on the diagnosis, place and size of the lesion, the age of the patient, cosmetic considerations, the doctor’s recommendations and your preferences. Several treatment options exist. The commonest methods are described below: