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Examples of Therapeutic Interventions<\/strong><\/span><\/p>\n Freezing with liquid nitrogen<\/strong><\/span> is achieved by applying liquid nitrogen with a cotton swab. This cotton swab is held against the skin eruption until it freezes to depth of 1 mm into unaffected skin. Freezing too deeply or for too long results in scarring and depigmentation.<\/span><\/p>\n Excision<\/em> =<\/strong> Removal by cutting. e.g. sample excision (cutting out a piece of tissue for anatomical-pathological assessment<\/em>) and excision of the wound margins. The following rules apply to excision:<\/span><\/p>\n Excochleation<\/strong><\/span> involves scooping or scraping out tissue with a sharp spoon (curette<\/em>).<\/span><\/p>\n Extirpation<\/strong><\/span> is resection, eradication. Extirpation is usually considered when an entire organ or tumour must be removed (uterine extirpation or extirpation of a breast tumour<\/em>).<\/span><\/p>\n In discussions of the various therapeutic options for tumours and skin lesions, the treatment of choice is always mentioned first. The techniques involved with these interventions are discussed in the section “Skills<\/em><\/span>.<\/span>“<\/span><\/p>\n Intracutaneous Tumours<\/strong><\/span><\/p>\n Resected specimens must always be submitted for anatomical-pathological assessment.<\/span><\/p>\n Keratinous Cyst<\/strong><\/em><\/span><\/p>\n Intracutaneous retention cysts<\/strong><\/span>, surrounded by a connective tissue capsule and filled with sebum. Examination reveals that the skin is fixed to the tumour and the outlet to the sebaceous gland is often visible under the skin as a black dot. Frequent sites include the pilose scalp, behind the ears, earlobes, neck, back, and groin.<\/span><\/p>\n Complications<\/em>:<\/strong> Tendency towards infection, abscess, and fistula formation.<\/span> Naevus Pigmentosus<\/strong><\/em><\/span><\/p>\n A light<\/strong><\/span> or dark brown<\/strong><\/span>, flush<\/strong><\/span> or raised birthmark<\/strong><\/span>, composed of naevus cells<\/strong><\/span>. If malignancy is suspected, the patient must be referred to a dermatologist who, if necessary, will consult a (plastic<\/em>) surgeon. Usually, the dermatologist will excise the entire naevus. Diagnostic characteristics that are suspicious of malignancy include:<\/span><\/p>\n Reasons for treating:<\/em><\/strong> Cosmetic considerations or when the naevus is uncomfortable due to its location.<\/span> Subcutaneous Tumours<\/strong><\/span><\/p>\n Dermoid Cyst<\/strong><\/em><\/span><\/p>\n Subcutaneous cyst<\/strong><\/span>, surrounded by a thick<\/strong><\/span>, fibrous capsule<\/strong><\/span> and filled with sebum<\/strong><\/span>, hair<\/strong><\/span>, or keratin<\/strong><\/span>. These cysts arise during embryonic development when epithelial cells relocate to the subcutis due to invagination of the ectoderm.<\/span><\/p>\n Frequent sites:<\/em> <\/strong>Around the eye, base of the nose, and forehead.<\/span> Epithelial Cyst<\/strong><\/em><\/span><\/p>\n Subcutaneous cyst<\/strong><\/span> that occurs when cells from the epidermis are relocated to the subcutis due to trauma.<\/span><\/p>\n Frequent sites:<\/em><\/strong> Lines in the palm of the hand, soles of the feet, eyelid.<\/span> Lipoma<\/strong><\/em><\/span><\/p>\n Subcutaneous tumour<\/strong><\/span> composed of fatty tissue. During palpation, the skin moves easily over the tumour. Lipomas can occur multiply.<\/span><\/p>\n Frequent sites:<\/em><\/strong> Neck, back, and buttock.<\/span> <\/p>\n","protected":false},"excerpt":{"rendered":" Benign intracutaneous and subcutaneous tumours may be considered for excision. General practitioners should not attempt the following operations: excision of ganglions, excision of large lipomas, excision of lateral and medial cervical cysts, excision of breast tumours and operations involving a leg with insufficient circulation. These operations should be performed by a specialist to minimise the […]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[75],"tags":[146],"class_list":["post-774","post","type-post","status-publish","format-standard","hentry","category-theoretical-background","tag-minor-surgery"],"acf":[],"yoast_head":"\n\n
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\n ![](\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-7a.jpg\")
Figure 7a<\/span><\/span><\/strong><\/td>\n![](\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-7b.jpg\")
Figure 7b<\/span><\/strong><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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\nReasons for treating<\/em>:<\/strong> Cosmetic considerations; pain due to local pressure; prevention of infection.<\/span>
\nTherapy:<\/em><\/strong> Extirpation. If the keratinous cyst has abscessed, incision and drainage followed by extirpation in a more stable stage.<\/span><\/p>\n
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\nTherapy:<\/em><\/strong> Excision, whereby at least 2 mm of healthy skin must be co-excised. Always submit for anatomical-pathological assessment.<\/span><\/p>\n
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\nReasons for treatment:<\/em><\/strong> Cosmetic considerations and the risk of malignant degeneration.<\/span>
\nTherapy:<\/em><\/strong> Excision.<\/span><\/p>\n
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\nReason for treatment:<\/em><\/strong> Cosmetic considerations or pain due to local pressure.<\/span>
\nTherapy:<\/em><\/strong> Excision.<\/span><\/p>\n
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\nReason for treatment:<\/em><\/strong> Pain due to local pressure, cosmetic considerations.<\/span>
\nTherapy:<\/em><\/strong> Extirpation of a lipoma is best left to a surgeon. A tumour that is palpable on the surface is often the tip of the iceberg, extending to unexpected depths and widths. Lipomas that are already the size of a chestnut on palpation may extend far into deeper layers.<\/span><\/p>\n
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