Plastic surgeons are involved closely with the dermatologists in treating several surgical skin conditions. These may range from minor cysts to skin cancers.
Skin tumors and cysts:
Non-cancerous tumors and cysts of the skin are also treated by plastic surgeons especially if they are on the face. Skin cysts, sweat gland tumors, dermatofibroma and lipoma are some common ones. These cases may be referred by the dermatologist or GP to the PS.
Skin Cancer:
Skin cancers are malignant growths on the skin that have the potential to spread locally or even to other parts of the body/ they have the potential to be fatal. Fortunately they are on the skin surface and therefore picked up early. Most of them can be cured by simple surgery. There are three common types namely: Basal Cell Carcinoma, Squamous cell carcinoma and melanoma. Of these, melanoma may affect younger population as well and is the most dangerous.
When to Suspect?
Skin cancer should be suspected if a scaly or nodular or ulcer-like lesion on the skin refuses to go away or seems to heal and come back. A skin specialist or your GP may be the first resource person to go to, however not all general practitioners have experience with skin cancers. Skin cancer is more common in the Caucasian populations. Persons from Australia, New Zealand and South Africa seem to be particularly prone to them. Sun exposure and sun light induced damage is responsible for over 85% of these. Sun light damages the DNA of the skin cells. After cumulative damage reached criticality, the cells go beserk and start dividing without control – the result is cancer. This usually takes 15-20 years.
Skin cancers can be cured by appropriate surgery in most cases. Some can be destroyed by laser, freezing or cautery. A minority are treated by local creams. Plastic surgeons are able to offer these treatments with the best possible cosmetic outcome. Skin grafting or flaps, if needed, can easily be done by a PS.
Dr. Mohan Rangaswamy is offering skin cancer treatments in his practice; including reconstruction if needed.
Prevention:
For skin cancer prevention, prudent sun precautions should start from childhood. This includes appropriate clothing, sun screen creams, avoidance of excessive and prolonged exposure, being aware of one’s skin type and avoiding sun-tanning if one’s skin burns easily. Remember every episode of sunburn is a radiation burn!
Early detection:
An important tool is screening. This is best done by a dermatologist. Mole mapping service is also available to further improve screening accuracy and tracking of multiple moles over a long time.
Hidradenitis Suppurativa:
This is a rare condition in which multiple ‘boils’ form in the under-arms leading to pus formation, discharges, and eventually multiple pits and scars. Smoking aggravates the condition. Many are also overweight. This condition is unfortunately chronic. Usually affects underarms (axilla), groin, genital area and even the area around the anus. Milder cases can be treated by dermatologists by use of antibiotics, local hygiene, cessation of smoking and weight loss. However there are many patients who have been suffering for several years with no hope of cure. Unfortunately it is not widely known even in medical circles that surgery is essential in such advanced cases where in fact it is curative. So it is a good idea to refer such cases to an experienced PS. Dr. Mohan Rangaswamy has helped many such patients by radical removal of all axillary skin followed by skin grafting. Most of them have reached him after suffering for many years [6-20 years].
Vitiligo:
Characterized by lack of color or pigment, the patient has multiple white patches. Most such cases are treated medically but if resistant, useful improvement can be obtained by melanocyte grafting or by using cell spray [Recell]. Such cases represent another area of cooperation between derma and plastic surgery.
Mole / Wart removal:
Non-cancerous moles may be requested for removal by the patient due to irritating or cosmetic reasons. These can be removed surgically or by laser with minimal or no scar. Skin tags and Warts can also be removed by laser or Radiofrequency device.