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Skin Cancer Surgery in Hull, York, Lincoln, Grimsby & London


Skin cancers are a common condition in the western world. They are related to sun damage to the skin over several years, hence they are most frequent in exposed parts of the body like the head and neck and the lower limb regions. The history of the lesion and their appearance typically gives a clue as to the type of skin cancer. However appearances can be deceptive and it is quite common to have a diagnostic dilemma. In that situation, the final answer is provided through a histological biopsy sent for further analysis in the laboratory.

Basal Cell Carcinoma (BCC)

This is the commonest type of malignancy in humans and makes up over 85% of all skin cancers. BCCs are commonly called rodent ulcers, are benign in behaviour since they do not spread but they are locally invasive and cause damage to neighbouring structures if neglected over a long time. Typical appearances are of a skin nodule with a pearly edge and prominent blood vessels on the surface and majority occur in the head and neck region.

Many different and well accepted treatments are used in the management of BCCs including Cryotherapy (freezing), topical ointments or cauterization if they are superficial and small in size. They are more commonly treated by surgical excision with reconstruction of the defect using a skin graft or local flap if required in larger lesions or those in anatomically sensitive parts of the body like the eyelids and nose. Radiotherapy is sometimes used either as an alternative or an adjunct to surgery. Prognosis is usually very good with low recurrence rate.

Squamous Cell Carcinomas (SCC)

These make up about 10% of all skin cancers. They are locally invasive and have a small but significant potential to spread to other organs of the body particularly if neglected. SCC's may appear as raised fleshy or crusty growths with surrounding skin changes. Their occurrence is usually related to chronic ultraviolet light exposure or maybe related to other causal factors like: Albinism, Xeroderma pigmentosum, ionizing radiation or arsenic exposure, chronic wounds, impaired immune function or human papillomavirus infection.

SCCs can be treated with different modalities including Cryotherapy (freezing), topical ointments or cauterization particularly if they are multiple, superficial and small. They are most commonly treated by surgical excision biopsy with reconstruction of the defect using a skin graft or local flap if required. Radiotherapy is sometimes used either as an adjunct to surgery. Prognosis is usually good with low recurrence rate but is dependent on the presence of low or high risk factors.

Melanoma

Melanomas are malignant tumours of melanocytes, the pigment producing cells and the vast majority arise from the skin. Melanomas occur predominantly in adults, and more than 50% of these arise in apparently normal skin. They sometimes arise from pre-existing skin moles (naevus) which show certain changes suggestive of malignant transformation which include:

An excision biopsy, should be performed for any suspicious lesions, and the specimens should be examined by an experienced pathologist. Suspicious lesions should never be shaved off or cauterized. Distinguishing between benign pigmented lesions and early melanomas can be difficult, and even experienced pathologists can have differing opinions. Clinical staging is based on the thickness of the tumour and presence of spread to regional lymph nodes or distant sites.

Melanomas are treated surgically by wide local excision only if early. Lymph node biopsy and regional lymph nodes removal are additional procedures that maybe required depending on the stage of the disease at presentation. The risk of relapse decreases substantially over time, though late relapses are not uncommon.

Melanoma classification:

Superficial spreading
Nodular
Lentigo maligna melanoma.
Acral lentiginous (hands / feet)

Signs of malignancy in moles:

Darker or variable discoloration
Itching
Sudden change in size or shape
Development of satellites lesions
Ulceration or bleeding are late signs
Flat lesion becoming raised

Other Skin Cancers

These are less common and make up less than 2% of all skin cancers. They include Dermtofibrosarcoma Protuberance, Adnexial skin tumours like Porocarcinoma amongst others. They have a low metastatic rate but are often highly recurrent locally.

Complications / Risks
  • Scar contractures
  • Infection
  • Bleeding
  • Bruising
  • Incomplete excision
  • Contour deformity
  • Damage to specific structures
  • Limb swelling
  • Recurrence
  • Further surgery or radiotherapy
  • Need for prolonged follow up

Contact Us

If you require further information about any of our procedures, you can speak to a plastic surgeon:

Hull 01482 223 553
York 01904 820 449
Lincoln 01522 899 808
London 020 7205 4448