Skin Surgery (Mole and Cancer Removal)

Most of the population has moles, warts, pigmented spots and other lesions on their head, face and neck. Moles can be present at birth or appear later in life as a result of sun exposure or hereditary factors. Most of these growths are benign; however, some lesions may be pre malignant or malignant. Most types of skin cancers can look like common moles. Basal cell carcinoma is a cancerous mole that classically does not spread to distant parts of the body, but in some areas of the face can spread to deeper structures and require extremely disfiguring surgeries to be removed. Moles that are basal cell carcinoma can have a pearly appearance and can also have spider veins associated with the mole. Squamos cell carcinoma is a more aggressive lesion that usually presents as an ulcer with ability to spread to distant organs. One of the most dangerous cancer in humans is melanoma, this pigmented lesion needs only couple of millimeters (depth of invasion) to develop metastasis; if is not diagnosed early, its effects can be catastrophic.

What are signs of alarm of a skin lesion?

Asymmetry, irregular borders, irregular distribution of the pigment and diameter larger than a size of a pencil eraser (6mm).

How skin lesions can be treated?

Small lesions can be treated with liquid nitrogen, laser, radio-wave, cauterization and conventional surgery.

Large lesions oftentimes have to be biopsied to know the diagnosis before definitive excision. A skin biopsy is the removal of a piece of skin for the purpose of further examination in the laboratory using a microscope. There are several ways to biopsy the skin. A shave biopsy is a procedure in which the doctor takes a thin slave off the top of the skin, punch biopsy takes a small fragment of tissue from the area of interest, incisional biopsy takes a piece of the lesion using the scalpel blade and lastly there is the excisional biopsy which is used to completely remove the abnormal area of skin.

In the oral cavity the most common types are: punch, incisional and excisional biopsies. The inside of the mouth is lined with a special type of skin called mucosa that is smooth and pink in color. Any other color or alteration in this appearance should be a slight warning for pathological process. There are several ways to detect suspicious lesions: reddish or whitish patches in the mouth, a sore that does not heal and bleeds easily, a lump or thickening. These changes can be seen on the lips, gum, and tongue, floor of the mouth, cheeks and palate.

Local anesthesia and intravenous sedation are used in most cases, large cancer surgeries have to be done under general anesthesia.