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Suspicious Skin Lesions

Although most skin lesions are benign and do not require any special treatment, they may become candidates for removal if they develop suspicious features. Changes in a lesion such as bleeding, pain, crusting, irregular pigmentation, or jagged borders may indicate the lesion could be cancerous and should be evaluated by a dermatologist for potential biopsy.

What are the types of suspicious skin lesions?

Lesions suspicious for basal cell carcinoma (BCC) will often ulcerate or bleed. Patients frequently describe lesions of BCC as a “pimple that won’t heal.” Basal cell carcinoma rarely spreads to other part of the body, but should be removed for safety.

Suspected squamous cell carcinomas occur mainly on the areas that are chronically exposed to the sun including the head and the back of the hands. These lesions have the potential to spread to other parts of the body, so proper diagnosis and treatment is needed.

Suspected melanoma occurs in persons that have had excessive sun exposure, have a large number of moles, or have a family history of melanoma.

How are suspicious skin lesions detected?

If a suspicious skin lesion is detected, it would be helpful to know the ABCDEs of checking for precancerous lesions.
A – Asymmetry – Does half of the lesion look different from the other half?
B – Border Irregularity – Are the edges of the lesion uneven, ragged, or blurred?
C – Color – Does the lesion have a variety of colors?
D – Diameter – What is the size of the lesion?
E – Evolving – Is the lesion changing or growing over time?

What should be done if suspicious skin lesions are detected?

If you have a lesion that appears to be suspicious, call us to make an appointment to have it evaluated. If we feel it’s concerning, the lesion will be removed and sent to the skin pathologist for evaluation.

What methods are used for the removal of suspicious skin lesions?

If a lesion is suspicious for cancer, it will be removed by one of several methods, depending on which is most appropriate for the situation. Some lesions will be removed by shave technique, where a blade is used to scrape the lesion from the skin after its been anesthetized. Others will be removed by punch technique where, after anesthesia, a small metal tool (like a tiny cookie cutter) is used to score the skin’s surface and the lesion is removed by snipping it free at its base. The resulting small hole is then closed with a stitch or two. Some lesions are removed by excision in an elliptical (football) shape with a scalpel and then closed with sutures.