REMOVAL OF SKIN LESIONS

Anything that is not normal skin and skin structure can be called a skin lesion. There is a huge variety of them in terms of color, shape, size, convexity, type of surface, but above all, the type of cells that constitute them determines the action taken, which can be assessed primarily by histological examination. Before starting treatment for skin moles, a medical consultation is necessary. The assessment is difficult, but more and more often it is possible to detect dangerous moles, at risk of cancerous transformation, the quick removal of which in many cases prevents the development of melanoma - one of the most malignant tumors.

Types of skin lesions:

• Pigment nevi - are congenital skin abnormalities that reveal themselves at different periods of life and undergo transformation under the influence of various factors, e.g. hormonal factors, UV radiation.

1. Epidermal pigmented moles
• Flat moles - at the level of the skin, separated from the surroundings, do not cause any discomfort. They increase as the child grows. In the case of chronic irritation, they may be the starting point of a malignant skin cancer - melanoma. However, this happens very rarely.
• Lengigines - small, light or dark brown spots, well demarcated from the surroundings. They are usually plural. They most often affect the trunk and appear in childhood. They resemble freckles, but are slightly larger. Solar and age lentigines appear under the influence of chronic exposure to sunlight or as a result of PUVA therapy, or in older people, usually with fair complexion, who find it difficult to tan.
2. Cellular pigmented nevi
• Blue moles - smooth, hairless moles, usually of small diameter, located quite deep in the skin, usually on the face and limbs. They range in color from light blue to black. They are safe.
• Congenital type of pigmented nevus - usually very large, sometimes with an uneven, warty surface, sometimes hairy. Although these features are considered safe, congenital moles often turn malignant.

• Keratinizations (senile and solar) - these are most often multiple yellow-brown lesions, having a dry, uneven surface, closely adhering to the skin. They lie at the level of the surrounding skin or are only slightly raised. They arise as a result of chronic sun damage or senile skin. They are located mainly on the face and other exposed areas (e.g. auricles, backs of hands, forearms, lower legs). They occur mainly in people over 40 years of age. Keratosis can become a starting point for skin cancer.
• Fibroids – benign tumors of connective tissue origin.
  
  
  • Soft fibromas – they are congenital, but may appear at any age. These are sac-like, hanging nodules, usually numerous, skin-colored or slightly darker, brownish. They are especially often located on the neck and back of the neck, especially in older women. Characteristic of Recklinghausen's disease.
  • Hard fibromas - they are essentially a fibrous reaction, they occur regardless of age. Usually single, smaller and more often located on the limbs. They appear in middle and older age.
• Lipomas – these are nodules of subcutaneous fat tissue of various sizes. They are movable in relation to the ground. They often occur in many places at the same time, most often in young or middle-aged women, and are the result of focal hypertrophies adipose tissue cells forming nodules or tumors, sometimes with a large surface area. Lesions occur mainly on the trunk, neck, buttocks, forearms and arms. They do not pose an oncological threat, but they can grow and cause pressure and discomfort.
• Atheromas – these are epidermoid cysts. They arise as a result of stagnation of secretions in the hair follicles of the sebaceous glands. It consists of a bag and a white, porridge-like content filling it with a characteristic unpleasant odor. Size semen may range from a few millimeters to several centimeters. The location is very diverse. Most often, they are located on the scalp, the back of the face, and the scrotum. The changes can be big. The skin is changed inflammation, sometimes there is a plug resembling a blackhead at the top.
• Seborrheic warts (senile) - classified as epidermal nevi, they are in fact benign flat, raised, verrucous epidermal tumors with a skin color of up to brown shades. Most often located on the trunk, face and back cancer. They appear in adulthood and older people. The spread of very numerous lesions on the trunk can sometimes be a predictor of cancer of internal organs, and in some cases, cancer of the gastrointestinal tract or other cancers.
• Common warts - these are epidermal lumps with an uneven surface and a size of 5-10 mm, most often located on the skin of the hands, on the fingers, on the nail folds, sometimes under the nail plate. They are associated with HPV-2 infection, as well as HPV-4 and HPV-7.
• Foot warts – are located on the sole of the feet, have a rough surface and skin color, and can reach 1-2 cm in size. They are of two types: diffuse, deep (mymercia) or more superficial, confluent into clusters, creating the so-called mosaic warts. Mymercia warts are often painful and may make walking difficult. The causative agent of mymercia is the HPV-1 virus, mosaic warts are caused by HPV-2.
• Flat warts (juvenile warts) - they are slightly raised, have a smooth surface and are several millimeters in size, sometimes they are linear at the scratch site. They appear on the face and the dorsal surface of the hands as multiple lumps with a smooth surface and gray color. The pathogenesis of flat warts is associated with HPV-3 viruses, less frequently HPV-10.
• Transitional warts – eruptions that have some features of common warts and flat warts. Occurs in immunocompromised patients.
• Granular granuloma – hemangioma associated with neoplasia of capillaries, caused by trauma and/or bacterial infection. The lump is usually single, bluish red, with a moist, easily bleeding surface and a pedunculated appearance. It shows rapid growth. They often appear in pregnant women or as a complication of oral isotretinoin therapy. It is most often located on the face and hands. Change is painful.
• Yellow tufts (xanthomas) - pale yellowish lumps located most often around the eyelids, most often seen in middle-aged or older people. Most often, they develop initially on the upper eyelids, usually slightly later the lower ones, are often asymmetrical - larger on one side. They are usually associated with the deposition of cholesterol in the skin

Treatment:

When removing birthmarks surgically, we are guided primarily by medical reasons. The surgical procedure to remove the skin lesion is performed under local anesthesia, completely eliminating pain. We always remove moles that may cause cancer transformation and those that are located in places exposed to frequent trauma or irritation, which may lead to their malignancy. We also remove birthmarks only for cosmetic purposes. Prophylactic removal of moles does not carry any risk of cancer transformation. If there is any suspicion about the type of mole, the safest method of treatment is surgical removal and a histological examination to assess the type of change (e.g. whether it is cancerous, what type and whether it is dangerous and requires further diagnosis and treatment). Removing birthmarks using a laser method makes it impossible to perform a histological examination, so the doctor must be 100% sure about the type of change. No samples should be taken from moles for examination due to the risk of malignancy. It is worth remembering that all moles should be subject to periodic medical evaluation. Removing suspicious lesions helps prevent disease and treat cancer.