Dr Jill Tomlinson performs minor surgical procedures including cryotherapy, shave biopsy, punch biopsy and excision of skin lesions under local anaesthetic in her Richmond rooms. These procedures are generally scheduled on a Monday, Thursday or Friday morning. A registered nurse is present for all procedures.
We offer a convenient "See & Treat" service that allows you to schedule your initial appointment and procedure in the same visit. If you wish to take advantage of this service please send us a copy of your referral, completed registration forms and a photograph of the mole or skin lesion that you wish to have removed. Dr Tomlinson will review your forms and photo promptly and we will email or call you with an estimate of how long you can expect the consultation and procedure to take, a financial estimate for the procedure and a list of potential dates for your treatment.
Benign skin lesions
There are many different moles and benign skin lesions that people wish to have removed because they don’t like the look of them, or because they find them troublesome and irritating. Benign skin lesions (“tumours”) are not dangerous and are not cancer, so most people aren't too concerned about what the exact diagnosis of the lump is - what matters is that
- any scarring from the procedure is minimal,
- the procedure isn't painful or complicated,
- we confirm that the mole or lump was nothing to worry about,
- your recovery is straightforward, and
- you have the opportunity to ask questions before, during and after the procedure about any queries or concerns you have.
Types of benign skin lesions
Whenever we excise skin or other tissue from your body we send it to a pathologist for testing, so that we can confirm what it is. Benign tumours of the skin or subcutaneous tissues that we can treat for you and which may be mentioned on the pathologist's report include:
- Cherry angioma. A cherry angioma is made up of dilated capillaries (blood vessels) and is removed for cosmetic purposes.
- Sebaceous hyperplasia, which is common in patients over 40 years of age, shows up as a soft yellow spot and commonly occurs on the forehead, cheeks, and nose. These can look like a basal cell carcinoma to the naked eye, but a biopsy will confirm the diagnosis.
- Lipoma. This is the most common soft-tissue tumour, and it is an abnormal growth of fat cells, not a true skin condition. Lipomas can be removed if they are a cosmetic problem or if there is uncertainty as to whether it is truly a lipoma. Dr Tomlinson specialises in removing lipomas through a small incision to minimise the subsequent surgical scar.
- Seborrhoeic keratosis. These are commonly located on the body (trunk) and face, but can also be on the limbs and scalp. Often they start as a pigmented flat area that can look very like a melanoma, then progress to be a browny-black raised area that may appear to be “stuck on” to the skin.
- Dermatofibroma. This is a flat spot or raised bump that can be found anywhere on the body and is made up of abnormal cells from the dermal layer of the skin. Dermatofibromas may be pink, brown, purple, red or yellow in colour.
- Acrochordon. This is a medical term for a “skin tag”, which affect around a quarter of the population and are easily removed. The most common sites for skin tags these are the armpits, neck and groin areas. They can be flat or have a thin stalk.
- Keratoacanthoma. This lump can’t be distinguished from a squamous carcinoma (skin cancer) by looking at it and it is recommended that a keratoacanthoma be excised so that the diagnosis can be confirmed on pathology. A keratoacanthoma can grow rapidly but reassuringly once it is removed you do not have to worry about that keratoacanthoma recurring – although it is possible for you to develop a new one.
- Pyogenic granuloma. This lump looks like overgrown flesh and often it bleeds, which is troublesome. We don’t know exactly what causes a pyogenic granuloma but it commonly occurs on the head, neck, fingers and limbs, and may follow a minor injury or cut to the skin in that area. Surgical removal is quite successful in fixing the problem.
- Epidermoid cyst. This is also known as an “inclusion cyst” or a “sebaceous cyst” – although it’s doesn’t have anything to do with sebaceous glands. Epidermoid cysts can grow slowly without causing problems, but sometimes they get inflamed and painful because the cyst wall ruptures internally. This is commonly diagnosed as an infection, but there is not necessarily any bacterial infection, just an impressive inflammatory response. Common reasons to have an epidermoid cyst removed are because you don’t like the look or feel of it, or because it causes pain or inflammation.
- Naevus. A naevus is the same thing as a mole. There are a variety of different types that may be listed on a pathology report (such as a junctional naevus, an intradermal naevus, a compound naevus or a blue naevus), but they are all benign skin tumours – that is, they are not a skin cancer and the naevus will not recur once it has been completely removed.
- Solar keratosis or actinic keratosis. This is a rough, scaly area of skin found on a sun-exposed region of the body. A solar keratosis does not require removal, but it can be difficult to tell the difference between a solar keratosis and an early skin cancer, so you may receive this diagnosis on a biopsy performed by your surgeon. Solar keratoses can be treated with a cream or laser – and, of course, sun protection is important to reduce the likelihood of developing more in the future.
- Trichilemmoma. This is a rare benign skin tumour.
- Naevus sebaceous of Jadassohn. This skin lesion is present at birth on the face or scalp and slowly gets larger. It is advisable to remove these as they have a significant risk of becoming a skin cancer.
- Trichoepithelioma. This uncommon lesion is usually pink and generally occurs on the face or scalp.
- Pilomatrixoma. This is an uncommon lump that is usually in children or younger adults, and mostly on the head, neck and arms.
- Pseudoepitheliomatous hyperplasia. This skin lesion can be difficult to distinguish from skin cancer, and when in doubt a biopsy is recommended to confirm the diagnosis.
Types of skin cancers
The most common types of skin cancers in Australia are squamous cell carcinoma, basal cell carcinoma and melanoma. Other types of skin cancers are relatively rare but include Merkel cell carcinoma, sebaceous carcinomas, dermatofibrosarcoma protruberans, microcystic adnexal carcinoma (MAC), cutaneous angiosarcoma, eccrine adenocarcinoma, atypical fibroxanthoma (AFX), digital papillary adenocarcinoma and Kaposi sarcoma. Making the correct diagnosis is important in determining the correct treatment for you, which is why we always send your biopsy to a specialist histopathologist. Whatever your diagnosis, you can rely on us to explain it to you and to provide you with a copy of your results for your own records.