Excision of lumps
The two common superficial skin lumps are lipomas and sebaceous cysts. They can occur anywhere on the body’s surface.
Lipoma:
Lipoma is a soft fat growth situated in the fat layer under the skin. It is slow growing and benign. It is usually painless; however, when it increases in size, it can press on the surrounding nerve fibre and causes pain.
Sebaceous cyst:
A sebaceous cyst is a slow-growing skin lump that can occur anywhere on the skin and is benign. It forms from the sebaceous glands of hair follicles when the skin pores are blocked. It is usually round in shape with a black dot over the tip of the cyst (a punctum). It is also characterised by smelly cheesy material discharging from the tip of the cyst. Some of the sebaceous cysts will become infected, and the patient will present with swelling, pain, redness and pus discharge from the lump.
How to diagnose:
The lump can be diagnosed with physical examination. Big and diffuse lump will require MRI scan to confirm the depth and invasion. A needle biopsy will only be needed if the lump is big, diffuse in size and it is suspected to be a liposarcoma which is a malignant form of the lipoma.
When to see a surgeon:
- When you are not sure about the swelling/lumps.
- When the known lumps increase in size,
- When the lumps become painful,
- When there is discharge from the lumps and
- The lump is hard when you touch it.
Treatment:
Small lumps can be excised under local anaesthesia (LA). It is done by injection of local anaesthetics around the lumps. An incision will be made over the lump, and the entire lump will then be removed.
General anaesthesia (GA) will be offered when the surgery time is expected to be longer. GA is offered for excison of bigger and diffuse lumps or when a patient requires the excision of multiple lumps.
Excision of a sebaceous cyst involved complete removal of the cyst wall and it can be straightforward. However, when a sebaceous cyst is infected, the treatment can be prolonged. One of the effective approaches is antibiotics treatment to reduce the inflammation before the complete excision of the sebaceous cyst.
