September 14 — The largest organ of the body is the skin, so taking care of it is really important.
Nikki Sommer, nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5FM this morning to talk Medical Matters.
Today it’s time for skin talk, including lumps, bumps, lesions and cysts.
The two most common types of skin lesions are fatty tumors called a lipomas or a sebaceous cyst, which is a fluid-filled sack.
Sommer said, “It (sebaceous cyst) can start out small like a pimple and that’s what (patients) think it is and they try and pop it and then it grown on to be a little bit more of a nuisance.”
Those lesions can be removed in the office.
It’s a good idea not to try to treat them on your own — get help.
Sommer said, “Lipomas are really not painful. It’s usually genetic, so they’re bumpy and lumpy and doughy as they call it. They can become really, really big, so a lot of times people have them removed as they start to get larger.”
The removal process is relatively simple as long as the cyst isn’t really big.
Sommer said, “They mark the area. We numb it with some lidocaine. So you don’t feel anything. There’s no big anesthesia and once you’re numb, they take the magical scalpel and they cut it out. With the sebaceous cysts, they’re really interesting. They have like a cheese-like substance and it actually comes out in like a ball.”
Mike Stapleford of KeysTalk 96.9/102.5FM noted, “Oh now we’re starting to get into the pimple kind of talk aren’t we?”
Sommer laughed, “It comes out kind of like a formed little ball. So that’s why it’s really important you don’t try and squeeze the cheese. Let your doctor do it for you. Once the sack is removed, it’s separated from the tissue within. They make sure that there’s no remnants of the cyst and they sew you up with some sutures. It could be dissolvable or removable that would be taken out within a week.”
How do abscesses form?
Sommer said, “It could be from an infected sebaceous cyst if somebody has been squeezing, poking and trying to do it at home. But abscesses, they can form from, say you get a cut on your hand and you don’t realize it and you don’t wash it, you can get an infection under the skin. That’s where an abscess can form.”
If that’s left untreated, it can become a really big problem.
Sommer said, “A lot of times, you’ll cut yourself and you’ll see it’s red, it’s raised, it’s hot. People will try and put topical antibiotic ointment on it and it doesn’t fix it. So then you need to seek medical attention.”
Sometimes if it’s not that large, it may be able to be treated with oral antibiotics, but a lot of times, if it’s really big or not responding to the antibiotics, it will need to be cut open.
Sommer explained, “It’s kind of a similar procedure like removing a cyst, however we won’t close it. It’s usually packed with a gauze. It’s numbed with some lidocaine, an incision is made and the pus is usually expressed. If we can, we will send a culture out.”
The most common times of skin infections are what’s called Staphylococcus aureus — it’s a staph infection.
MRSA can be an issue in the Keys because of the temperature.
Sommer said, “We breed bacteria. So a lot of times we’ll send a culture out to make sure it’s not that and find the right antibiotic to give you to clear the infection.”
The area will be packed with medicated gauze and it’s changed out a couple times a day. Most people can change it on their own, but Nurse Nikki can change the gauze, too, if need be.
Sometimes biopsies of skin lesions can be performed.
Sommer said, “A lot of times you go to the dermatologist and you have skin lesions, dark spots, things that you’re concerned about for skin cancer. Sometimes they will take a biopsy and then refer to us it if is a basal cell or especially if it’s a squamous cell or melanoma. It would need to be excised more. However we do the same things kind of as the dermatologist. If you have a lesion, something on your skin that you’re concerned about, we can definitely take a biopsy.”
Cancer is always a concern, especially when you’re out in the sun a lot. However some people are more susceptible to skin cancer.
Sommer said, “So be aware, to make sure in those places that are hard to look at that somebody is looking at them for you. Even though the sun may not hit them doesn’t mean you can’t have a lesion somewhere that needs to be dealt with.”
In a punch biopsy, the lesion is round and the instrument looks like a tool with a round end that gets twisted into the skin and a biopsy is taken.
Sommer said, “Like we punch you in the skin with a little tool.”
An excisional biopsy will remove the lesion on the skin.
Sommer said, “What you see on the top, that’s why it has to be open is because you don’t see how deep it goes. So when they make the cut, if it’s especially like a skin cancer, sometimes it can seem like a little spot, but it actually is growing deeper into the skin, so they’ve got to go a little deeper. That’s why you excise it.”
Should you notice any changes in your skin, it really should be looked at.
Sommer suggested, “Make sure before you have any biopsy that if you’re on blood thinners or you have any type of clotting disorder, please let your doctor know. Through my career I’ve run into that where people will be like oh do you take anything to thin your blood? No and then they’ll be like oh wait a minute, I’m on Coumadin. Or I have a clotting disorder. You know ten years ago I had a blood clot after I had major surgery and they forget to tell you. Those are things you really need to tell the doctor. Just be aware that with any type of biopsy, make sure afterwards you keep it clean, dry. Sometimes an infection can occur. It’s not like it’s anybody’s fault. Down here, especially, any time you have sutures or an open wound, absolutely no ocean or pool until it is completely healed.”
For more information on Key West Surgical Group or for any concern about anything on your body, click here: https://www.keywestsurgicalgroup.com/