Surgical
List of Services
Skin Cancer Surgeries
Do you know that skin cancers are often a result of UV exposure? Hence it is often found in sun exposed sites. The common skin cancers are the basal cell carcinoma, squamous cell carcinoma followed by melanomas.
After a clinical assessment by our dermatologist, the suspicious lesion may be biopsied to confirm the diagnosis. Following that, our dermatologist may discuss several options including Mohs Micrographic Surgery or wide local excisions. Depending on the biopsy results, site, size, some skin cancers or precancerous lesions like actinic keratosis may be treated with cryotherapy or topical treatment or superficial skin surgeries
Removal of skin lumps and bumps (including cysts, lipomas, skin tags)
There are multiple growths that can occur on skin. Usually these growths are not cancerous (benign) but sometimes require further investigations to confirm the diagnosis. Examples of benign growths include cysts, lipomas, seborrheic keratosis, sebaceous hyperplasia, pyogenic granuloma and skin tags. Have a check with our dermatologist to see what it is or if a biopsy or removal is needed.
Epidermal Cysts
These appear are dome shaped lumps with a central punctum. It can occur on any part of the skin such as face, neck, body, arms, and legs. An epidermal cyst may remain a similar size for many years without any issue, `but it can also suddenly increase in size with cheesy discharge or may get infected or rupture. Do discuss with our dermatologist on treatment options for this.
Lipomas
Lipomas are fat cell tumours under the skin. It appears as a smooth dome shaped lump under the skin. It is usually benign, slow growing and often harmless. Sometimes though, it may be painful. It can be removed surgically if needed.
Seborrheic Keratosis
These are common rough, tan-brown to dark pigmented growths that appear ‘stuck on’ the skin. Commonly occurring in sun-exposed areas and usually seen amongst the elderly. It may not have any symptoms but sometimes may be itchy and may bleed on scratching. Sometimes it is difficult to distinguish this from skin cancers.
After a check by our dermatologist, if it a seborrheic keratosis, it may be left alone. If patients are keen for removal, it may be removed with cryotherapy (liquid nitrogen), electrosurgery or an excision.
Sebaceous Hyperplasia
These are enlarged oil glands that occur on the face appearing as skin-coloured bumps.
Our dermatologist will make an assessment to confirm the diagnosis. It can be removed but often recurs.
Pyogenic Granuloma
This is a vascular (blood vessel) lump in origin usually after a result of trauma. Hence it often occurs on fingers, face and lips. It is friable, fragile and bleeds easily. If it occurs in older patients, a skin cancer should be ruled out. Treatment often includes electrosurgery, cryotherapy or surgical excision.
Skin Tags
Skin tags are extra skin that appear as small bumps, sometimes pedunculated. Usually found at fold areas such as the neck and underarm. It usually does not cause any problems and can be left alone. At times, the skin tag has been found to twist on its base and may result in pain and infection. The cause of skin tags is unknown. It can be removed with electrosurgery or snip excision under local anaesthesia. It can recur.
Skin Biopsies
During investigation of rashes or new growths, a skin biopsy may be required. There are various methods of biopsy depending on the type of growth, size and clinical diagnosis of the condition. This involves cutting some skin for laboratory testing after being numbed with local anaesthetic and may require closure with stitches.
Nail Avulsion and Nail Matrix Biopsy
Dark linear pigmentation noted on the nail known as longitudinal melanonychia may sometimes require further investigation to exclude any malignancy such as a nail melanoma.
In such situations a biopsy of the nail matrix (the part that makes new nails) may be required. The ABCDEF mnemonic has been helpful in assessing such nail pigmentation.
- Age (50-70 years old); Asian, African or Native American
- Brown-black pigmented Band with Breadth of >= 3 mm and Irregular Borders
- Change or lack of Change post treatment
- Digit – it is found usually on the thumb> big toe > index finger. Dominant hand, Usually, it involves one Digit as opposed to multiple digits
- Extension onto the skin next to the nail
- Family or personal history of melanoma or atypical moles (funny mole)
Electrocautery
This is a form of electrosurgery involving the use of an equipment to target small growths, commonly benign such as viral warts, seborrheic keratosis or sebaceous hyperplasia. Patients will receive medications to help numb the area first. Our dermatologist will discuss if this is a suitable option for you.
Cryotherapy (Liquid nitrogen)
This refers to application of liquid nitrogen onto skin lesions to freeze and remove them. It is used to treat many skin lesions, for example – viral warts, seborrheic keratosis, skin tags or actinic keratosis.
Intralesional Steroid
Local injection of steroids into the top layers of the skin may be used to treat certain conditions such as keloids (overactive scars) or alopecia areata (an autoimmune related form of hair loss).