Skin and Soft Tissue

This includes many relatively minor procedures in different anatomical locations. In general, surgery is indicated if:

    1.    There is any concern that the lump/mole etc could be a cancer or pre-cancerous lesion.

    2.    There is pain or the lesion is interfering with daily activities.

    3.    There is an obvious cosmetic problem with the lesion.


Painful lesions

There are many other skin lesions which are not cancerous but which are painful or get caught on combs or clothing and as such cause problems. There are too numerous diagnoses to list completely but here are some of the more commonly encountered:


Sebaceous cyst - these occur anywhere on the skin except the soles of the hands and feet. They represent a blocked sweat gland and commonly come to attention if they become infected.


Lipomas - these are collections of fat usually just under the skin. They may be multiple but are of little significance unless these are getting bigger or causing pain.


Papillomas - these are sometimes called skin tags and may be due to a viral infection (warts), arise in sun damaged skin (keratomas) or arise spontaneously in (seborrhoeic keratosis)


There are a large number of more unusual conditions, which may give rise to a lump in the skin. Some of these may be tender particularly if they press on a nerve or sensitive area. These include: dermatofibromas, epitheliomomas, capillary haemangiomas, angiolipomas, cylindromas, and piloatricomas. Many of these lumps cannot be differentiated clinically and it is only when they are removed that it is possible to put a name to these.


Ingrown toe nails - most commonly these occur on the big toe but this is not always the case. The edge of the nail cuts into the skin at the sides of the nail and allows for infections to develop which are often extremely painful.


Pilonidal Sinus - This is most common between the buttocks but can occur at other sites. In all cases it is because a shaft of hair has got under the skin and set up a reaction around this. Symptoms may simply be of a swelling but if it gets infected it will become very painful and may discharge.


Abscess - an abscess can occur anywhere in the body and it represents a localised area of infection with the formation of pus. When an abscess developes it is usually red and painful, it may also feel warm to the touch. If left untreated an abscess may burst and discharge pus. In the skin abscess usually represent infection in a pre-existing problem i.e sebaceous cysts or a pilonidal sinus.