Removal of fibromas, lipomas, sebaceous cysts and other skin lesions

Fibroma - is a benign tumour arising from elements of connective tissue.

Soft fibroma (fibroma molle)

It occurs as a single, pedunculated, flesh-coloured papule, mostly appearing on the abdominal wall and in large skin folds (groins, armpits), or as numerous nodules or tumours in von Recklinghausen's disease in combination with neurofibromas and neuromata. Also acrochorda (fibromate filiformes), known as cutaneous skin tags, are popular, especially in middle-aged and older patients, more commonly in women than men, in areas where the skin forms creases, such as the neck, the nape of the neck and armpits. They are typically from 2 mm to 1 cm big. Acrochorda are flesh-coloured, harmless and typically painless.

Hard fibroma (fibroma durum, dermatofibroma, histiocytoma)

It is considered to be a result of a reactive response with hypertrophy of fibrous tissue, rather than a real cancer. It usually occurs as an effect of minor injuries, stinging of the skin by insects or scratches. It appears mainly on the skin of limbs, on their extensor surface, usually in the form of a single nodule of a 2 mm - 1 cm diameter. It can range in colour from flesh-coloured to red-purple, it is smooth or rough to the touch and moveable.

Diagnosis:
Usually made on the basis of characteristic clinical picture.

Treatment

Treatment of fibromas is usually unnecessary, unless they become the reason of patient's discomfort or if there appear symptoms of irritation, erosion and other untypical changes. Then, they might be removed with CO₂ laser or surgically, with local anaesthesia.

Steatoma (sabaceous cyst)

A benign tumour, in a form of epidermal cyst, growing slowly within the skin, containing keratinous substance, sebaceous glands and the elements of hair follicles.
There are two main types of cysts, which differ mainly in their cellular structure:

- epidermal cyst - usually occurs on the face, nape of the neck and chest,
- trichilemmal cyst - forms from a hair follicle, it is most often found on the scalp.

Frequently, there might occur small superficial epidermal cysts, so called milia, usually found on the face or on the genitalia.

Symptoms:
They are spherically shaped, moveable and painless nodules. Quite often they might grow and turn pearly-white or yellowish and stay asymptomatic. In case of secondary infection, the cyst becomes red, painful, which is often accompanied by the cyst puncture and release of its content.
Diagnosis:
Usually made on the basis of characteristic clinical picture.

Treatment

Milia are removed using a fine needle and then squeezing out the contents. Bigger cysts are cleaned during a surgical procedure, after opening the lesion with a scalpel, or removed in one piece, which prevents recurrence if the entire cyst wall has not been removed during the procedure. In case of infection of the cyst, a seton - a gauze strip is inserted into a wound and antibiotic therapy is applied for 7-10 days.

Lipoma

It is a benign tumour composed of adipose tissue. Lipomas are most commonly found in young and middle-aged women and result from local hypertrophy of fat cells with formation of lumps or tumours, sometimes achieving large sizes. They are rarely malignant.
Symptoms:
Typical lipomas are soft, single or multiple, subcutaneous, moveable lumps located just beneath the skin. The lesions mostly occur on trunk, nape, buttocks, forearms and arms. They are usually symptomless, however sometimes may become painful.
Diagnosis:
Diagnosis is usually made on the basis of characteristic clinical picture, however, when the lesion grows rapidly, it might be necessary for a patient to have a biopsy performed.

Treatment

Treatment of lipomas is usually unnecessary. However, if they cause patient's discomfort or concern, they may be removed surgically.