Lipoma

A lipoma is a benign tumor of fatty tissue. It typically grows slowly in the subcutaneous layer, which is the fat layer located directly beneath the skin. Lipomas can appear on any part of the body, but they are most commonly found on the neck, shoulders, back and extremities. Lipomas present as soft, mobile lumps under the skin. They usually do not cause symptoms; however, depending on their size and anatomical location, they may cause local discomfort, pain or restriction of movement. The diagnosis of a lipoma is generally established through a clinical examination. The diagnosis of a lipoma is usually made through clinical examination. In uncertain cases, an ultrasound scan may help confirm the diagnosis, while magnetic resonance imaging (MRI) may be required for large or atypical lesions to confirm the diagnosis and exclude other conditions. Lipomas often do not require any treatment. Surgical removal (excision) is recommended when:

• They increase rapidly in size
• They cause pain, discomfort or limitation of movement
• They cause aesthetic or functional issues
• There is uncertainty about the diagnosis and histological confirmation is required

Removal is usually performed in the clinic under local anaesthesia. For larger or deeper lesions, general anaesthesia may occasionally be required.

Skin cysts

Skin cysts are benign, sac-like structures that develop beneath the skin surface, typically containing keratin or sebum. There are various types, with epidermal and pilar cysts being the most frequently encountered in clinical practice. Epidermal (epidermoid) cysts account for 80% to 90% of all surgically excised skin cysts and primarily appear on the face, neck, back and chest. They originate from epidermal cells that become trapped beneath the skin. They often feature a characteristic small black spot (punctum or pore) at their center. Pilar cysts (trichilemmal cysts) account for approximately 10% to 15% of cases and occur almost exclusively on the scalp. They originate from the outer root sheath of the hair follicle. A typical skin cyst appears as a round, smooth, well-defined lump beneath the skin, that moves slightly upon pressure. Skin cysts are usually painless. However, they can become infected, leading to acute pain, swelling, redness, localized tenderness and, in some cases, the discharge of foul-smelling material or pus. The diagnosis of skin cysts is made via clinical examination. The definitive treatment is surgical excision of the cyst along with its entire wall (capsule) - complete removal is essential to prevent recurrence. The procedure is typically performed under local anesthesia.

Naevi - Moles

Naevi, commonly known as "moles," are common, benign skin lesions formed by clusters of melanocytes (the cells responsible for producing skin pigment). Most people have several moles on their body. They may be flat or raised, with colour ranging from light brown to black. Although the vast majority of moles are completely harmless, some may exhibit atypical behavior or evolve into a form of skin cancer known as melanoma. The international ABCDE rule is widely used to evaluate moles and identify suspicious characteristics:

• A – Asymmetry: Asymmetrical shape
• B – Border: Irregular borders
• C – Colour: Uneven or varied color within the same mole
• D – Diameter: Greater than 6mm
• E – Evolution: Any change in size, shape, color or sensation (such as itching or bleeding) over a short period of time

If you notice any concerning changes or feel uncertain about a mole, it is highly advisable to visit a surgeon or dermatologist. They can thoroughly evaluate the nevus through clinical examination and dermoscopy. Naevi without suspicious features do not require treatment. Surgical excision of a mole is necessary when malignancy is suspected, though it can also be performed for aesthetic or functional reasons. The procedure is carried out in the clinic under local anesthesia. The nevus is excised with clear margins and sent for histological examination (biopsy) to secure the final, definitive diagnosis.

Pilonidal cyst

A pilonidal cyst (also referred to as a pilonidal sinus or pilonidal disease) is a chronic inflammatory condition occurring in the coccygeal region at the base of the spine (tailbone). It typically develops when loose hairs penetrate into the skin, triggering an inflammatory response and leading to the formation of a cyst or small tracts (sinuses). The condition is more prevalent in men and predominantly manifests between adolescence and the age of 40. Factors that increase the risk of developing a pilonidal cyst include obesity, thick or coarse body hair and a sedentary lifestyle. Symptoms can vary depending on the stage of the disease. In early, uncomplicated stages or chronic cases, there may be no significant symptoms other than occasional fluid discharge from a small opening in the skin. In the event of acute infection, a painful swelling develops in the area, accompanied by redness, warmth, tenderness and potential pus discharge. The diagnosis is made through clinical examination and the primary treatment is surgical. During the acute inflammatory/abscess phase, immediate incision and drainage of the abscess are performed under local anesthesia. Definitive surgical treatment is scheduled after the acute inflammation subsides. This involves the complete removal of the cyst and its associated sinus tracts, to minimize the risk of recurrence.

Skin abscess

A skin abscess is a localized collection of pus beneath the skin. It typically forms due to bacterial invasion through the skin barrier and can occur anywhere on the body. It presents as a painful subcutaneous swelling accompanied by localized redness, warmth and tenderness. The diagnosis is made through a clinical examination. Treatment is always surgical and consists of immediate incision and drainage to evacuate the pus and allow the tissue to heal.