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ABC of General Surgery

Skin Lumps

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 1. What are Skin Lumps?
Lumps that are palpable or even visible just under the skin are very common.  There are a wide range of causes of skin lumps, most of which are harmless or benign, but a few are a pointer to a more serious condition.

2. What do I do if I have a Skin Lump?
The best advice is to consult your GP.  If your GP feels that the lump requires removal then an appointment with a hospital specialist can be arranged.

3. What will happen if I have a Skin Lump and I do nothing about it?
Usually nothing, but if a lump is appeared recently, or is growing in size, or is painful, or changes colour or produces blood or a discharge then it should be treated seriously.

4. What treatment is required for a Skin Lump?
The treatment depends on what the lump is. Usually a specialist can tell what the lump is with a good degree of confidence just by examining the lump, but to be 100% sure a biopsy is required.  A biopsy is a procedure where part (or all) of the lump is removed and sent for microscopic examination.  Usually, complete removal of the lump is both the diagnosis and the cure and nothing else needs to be done.  Occasionally the lump shows evidence of a more serious condition and further treatment can only be decided once the biopsy result is available.

5. What will happen if I need an operation on my Skin Lump?
Most skin lumps are small (<2 cm) and are in, or just underneath, the skin.  These lumps can usually be removed using just a local anaesthetic either by your GP or in your local hospital day surgery unit.  Larger or deeper lumps may require a general anaesthetic, but again most can be treated in your local day surgery unit.

6. What does the operation involve?
The operation involves making an incision in the skin, removing the lump (usually with a small amount of the normal surrounding tissue), then closing the incision with stitches.  Some surgeons use stitches that will dissolve in the body and do not need to be removed, others used stitches that are removed after the wound has healed (usually 1 to 3 weeks).  Your surgeon will discuss which method is appropriate before the operation..

7. What are the possible complications of a Skin Lump operation?
This sort of minor surgery is very low risk and any complications are usually related to wound itself.  Sometimes a small amount of bleeding occurs but it is usually minor and settles just with simple pressure or a new dressing.  Infection can occur in any operation and is more likely if lumps are already infected or removed from "dirty" areas.  Such infections usually settle quickly by themselves but may require antibiotics and/or drainage.  Other possible complications relate to damage to other structures during the operation.  The most likely is damage to small nerves which lie under the skin and which are invisible to the surgeon.  Damage to such a nerve may cause a small area of numbness which of recovers and rarely causes a significant problem.

8. How long does it take to recover?
Most patients find that about one week is required to recover fully after minor surgery but this depends on the site and size of the operation.  How long you stay off work is dependent on the type of work you do.  Common sense says “if it hurts don’t do it”.

9. Where can I go for help if I think there is a problem after the operation? 
If you are concerned then first read the printed information that you should have been given.  Most problems that occur are minor and can be easily remedied using this advice.  The information should give a telephone number at the hospital that you can call to ask for advice if you are still worried.  Only consider calling your GP if you are advised by the hospital or you cannot contact the hospital help line.

10. Will I need to come back to hospital after the operation?
Most patients do not need to be seen again in the outpatient clinic after their skin lump operation.  When the biopsy result is available your specialist or GP should write to you with the result.  If your specialist feels that you should be seen then an appointment will be made for you.

11. Will the operation cure all the symptoms?
Most patients are reassured by having the lump removed and have complete relief of their symptoms.  It is normal for a scar to remain at the site of the operation and this scar should fade progressively with time.

12. Will the Skin Lump come back?
In most patients the lumps are removed completely and do not come back.  The risk of a lump coming back depends mainly on the nature of the lump and you specialist can only advise you once the biopsy result is available.

© S.R.Dodds 2006

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