Many of the patients referred to Aspire Care Clinic are coming to have lesions assessed. These lesions include moles, cysts, skin tags, warts, seborrheic keratosis, and actinic keratosis. If your doctor has any concerns with these lesions after examining them, a biopsy will done and the sample will be sent to the lab for further analysis. With all lesion removals, the nursing staff will go over after care with you and provide you with a wound care handout.
Moles are also known as melanocytic nevus and are benign skin lesions. Individuals can be born with moles or they can develop over time. There is not an exact reason for development of moles, however genetic factors, repeated sun exposure and immune status are factors.
Moles can be flat in appearance or protrude outwards. They can range in colour from skin coloured to light brown or almost black. Moles often appear to be symmetrical in shape however they can have odd shapes as well.
Moles are often removed with a shave biopsy. You will be given a local anesthetic and then a very superficial shave is done to remove the mole. This procedure is quick and does not require the use of any suturing and after care to the site is very simple. If the mole appears to be suspicious, the biopsy will be sent to the lab for further analysis as well.
Cysts are also very commonly removed in the clinic. These occur under our skin’s surface and normally present as palpable, mobile spheres. Unless the cyst is infected, the skin above them is a healthy layer of unbroken tissue. For this procedure, you will be given local anesthetic and then a small excision is done to expose the cyst itself. Once the cyst is removed, a few sutures are put in place to close the site. Wound care instructions are given and you will be advised on when to return to have your sutures removed.
Skin tags are another common skin issue dealt with at Aspire. Skin tags are harmless lesions that tend to hang off of our skin. The procedures for the removal of skin tags can involve cauterization and the other involves cryotherapy. If skin tags need to be cauterized, you will be given local anesthetic and then the tag is cauterized off. If cryotherapy can be used, the affected area is sprayed with liquid nitrogen (essentially very cold air).
A wart is a very common benign skin lesion. They commonly occur in school-aged children and individuals with dermatitis. Warts are caused by some form of HPV (human papillomavirus) that infect the skin (there are more than 150 known types of this virus). The infection begins in the basal layer of the epidermis, and then causes proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles.
Warts can be spread by skin to skin contact and by picking or itching at the area and then touching another part of your skin. They can develop on the skin’s surface or under fingernails and toenails. They often look like rough cauliflower-like areas and may have tiny red or black dots visible.
Warts can be treated in the clinic with the following treatments: cryotherapy (liquid nitrogen), cantharone (topical agent) and skin shaves. Sometimes one of these methods may be used at once or a couple of them may be used in conjunction for treatments. Warts are generally stubborn and will require a few appointments for effective treatment of the lesion.
Seborrheic keratosis is a harmless wart like spot that often develops in older adults. It is estimated that 90% of adults over 60 years of age develop them. These are a very common sign of aging skin and some individuals can develop hundreds of them over the body’s surface. There is no definitive cause to these lesions. However, it is noted that they can develop after a sunburn, as a result of dermatitis or due to repeated skin friction.
The characteristics of seborrheic keratosis can include a smooth, waxy or wart like surface and they can exhibit different colours such as skin colour, yellow, grey, tones of brown and even black. They stick to the skin’s surface much like barnacles. Treatment and removal of these lesions include cryotherapy (liquid nitrogen) and skin shaves. Often the diagnosis of seborrheic keratosis is easily done by a visual skin check but sometimes it can resemble skin cancers-if this is the case, a sample will be obtained and sent to the lab for further analysis.
Actinic keratosis is a precancerous scale-like lesion found on sun damaged-skin; it is also known as solar keratosis. Actinic keratosis can appear flat or like thickened plaques and can look scaly or wart like. They can appear white to yellow in colour, and may be tender to touch. These are most commonly found in sites that are repeatedly exposed to the sun such as the face, scalp, and the backs of hands.
Actinic keratosis is normally diagnosed visually but occasionally a small skin biopsy is necessary. These lesions are treated with cryotherapy (liquid nitrogen), skin shaves or excisions.