A Sebaceous cyst, also known as Epidermal cyst, is a benign skin lump. It arises from the follicular infundibulum layer of the skin. The cyst can be skin-coloured or may acquire a bluish-grey tinge. It is usually filled with a cheesy-like material and is usually painless and non-tender. A sebaceous cyst can be removed under local anaesthesia.
A Lipoma is a benign skin lump that is made up of Fat cells from the subcutaneous layer of the skin. The lipoma is usually skin-coloured and painless and non-tender. A painful or tender lipoma should raise concerns and warrants an early consult. A smaller lipoma can be removed under local anaesthesia while a larger one may be to be removed under general anaesthesia.
A mole is usually seen as a classical pigmented (dark-coloured) flat lump on the skin. Some moles can be skin-coloured without the dark pigmentation. Moles can range in size from 1-2mm to more than 5cm in diameter. A mole warrants an early consult if there is pain or tenderness, itchiness, bleeding, ulceration, rapid growth, irregular edges or the appearance of lymph nodes. A benign mole can be removed under local anaesthesia.
The commonest skin cancers are SCC (Squamous cell carcinoma), BCC (Basal cell carcinoma) and MM (Malignant melanoma). These skin cancers can occur on all areas of the skin, though most commonly on the sun-exposed areas. A skin cancer usually presents as a skin lump with pain or tenderness, itchiness, rapid growth, ulceration or appearance of lymph nodes. Removal of a skin cancer will require a wide margin of at least 1cm around the tumour and is best done under general anaesthesia. SCC and BCC tend to have a much better prognosis than MM.
Viral warts can appear as a mushroom-like lesion on skin. It can either have a stalk or be a broad-based lesion. Viral warts are often caused by the Human Papilloma virus. Smaller viral warts can be treated with cryotherapy (cold freezing with liquid nitrogen) while larger warts will require surgical removal.
Hypertrophic scars and keloids are exuberant over-growth of scar tissue at a prior trauma site. The trauma can take the form of a surgical incision, previous abrasion or laceration as a result of a fall, BCG injection site, chickenpox site, earring or body piercing or even an innocuous insect bite. These exuberant scars will need treatment with steroid injection or surgical removal with appropriate anti-scarring prevention.
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