Dermatokirurgi - Hudkirurgi

Removing skin changes
Removing a skin change within healthy tissues with a scalpel, CO2 laser or cryotherapy.

You should have this treatment:
The treatment of removing skin changes is recommended for cancer prophylactics and therapy, mainly if this is carcinoma basocellulare, carcinoma spinocellulare or malignant melanoma. If a change is not removed, it can grow, leak and destroy side tissues or transfer to other body organs.

We also remove skin changes for cosmetic reasons, returning infections, inreasing up purses or cysts.

Main sources of skin cancer are long lasting expositions to sun and also solar light. Genetic and ethnical factors are also significant in that process. People with pale skin or light carnation do not get tan and more often than other people suffer from cancer. There are also other factors generating cancer problems: radiation, injuries, chemical substances, etc.

Most skin cancers grow up slowly and it usually takes a long time since their generating to diagnosis and treatment. Skin cancer can be more aggressive when the patient's immunology system does not work properly, or when a cancer changes places at ears, lips, nose or around the eyes. There is a chance for 100% cure, or for reducing the possibility to geting ill to minimum if a patient has regular skin examination done by a doctor, and has video-dermatoscopy. You should have medical examinations if you belong to the risk group (have pale skin, get tan intensively, have many color changes, have relatives with cancer.) It is not true that removing skin changes with scalpel is dangerous. Here in Poland that superstition has been repeated all over in our society and has caused many tragedies - of not examined and not treated skin cancer.

What is the treatment?
Despite the treatment's method, the patient should be carefully examined, and their skin change ought to be carefully studied. In our clinic not only a doctor examines skin changes, we also use video-dermatoscopy to obtain more objective picture. Before the treatment the doctor explains to the patient what is the treatment about and how it will be done, tell then whether they should change the bandage, remove sutures, come for control visits, have a painkiller treatment.
The removed tissues are then examined histopathologically.

Most treatments are done with local anesthesia. After surgery we usually apply sutures and bandages. After 7 to 14 days we remove the sutures. The treatment is painless, save the moment of local anesthesia injection, but it feels like regular inoculation. During the after-treatment therapy patients usually need small doses of painkillers. Laser treatment and cryosurgery leave a patient with bandages for only a few days

After treatment injured places can be painful for an hour or two. The pain is so insignificant and diminish that even Paracetamol can overcome it. For a few days after the treatment we advice our patients not to stretch skin at treated place, nor to make any sudden movements, nor remove the bandage. A scar will be visible at the beginning, but with time it will get paler and smaller. It is important not to tan the scar for at least 6 months.

Scar
It is impossible to remove skin changes and leave no mark. In many cases a mark is hardly visible. But in some cases there are "not very attractive" scars left. You should discuss it with the doctor before the treatment.

DICTIONARY

Carcinoma Basocellulare
It is local and malignant change, which usually does not transfer. It is a cancer rooted in skin cells or hair bags. Surgery treatment is necessary; it should be done with a healthy tissues margin.

Seborrheic Keratosis
It is a benign epidermis cancer, morphologically variousial. It can look flat and haughty, with clear margin and color similar to healthy skin or it can be high, papilla-look, horny and dark brown change. It allocates usually at neck, face, and hands' tops. It is usually a problem of adult and elderly people. We can remove it with curette, laser or cryosurgery treatment.

Birthmarks:
Colored spots are areas of condensed melanin places located in epidermis, they can show up during childhood and all lifetime, but most of them generate up to beginning of thirties. They are:

	"café au lait" changes
	Hutchinson spots - tiny, clearly separated light or dark-brown spots, multiplied usually, placed on torso, generally they are effects of intensive and long lasting sun exposure of elderly people who get tan with trouble
	Becker marks
	Flat marks, which are colored changes of different shape and size, growing up progressively, proportionally to a child's tallness
	Blue marks, which are kind of melanocyt mark with grey-blue color

Cell spots are built with birthmark cells, they are of various colors, flat or rough surface, and sometimes hairy. Almost everybody can have over ten marks of that kind. They may generate the cancer changes

Skin cancer (melanoma)
It is a malignant change of cells producing melanin, which may appear all over the skin and on practically every body organ. At the beginning it grows in dermis and epidermis area. Then the skin cells grow in other places and transfer to various body organs. Surgery treatments must be done with one - two centimeters healthy skin margin. Nowadays, surgery treatment is accompanied by immunostimulating therapy.

Carcinoma Spinocellulare
It is a local malignant cancer, which transfers itself more frequently than carcinoma basocellulare. It generates in spinocellulare epidermis cells. Surgery treatment must be done with a healthy skin margin.