Surgical Evaluation of Common Benign Skin Lesions in Primary Care

Year 2020, Volume: 14 Issue: 1, 48 - 55, 16.03.2020

Sebahattin Destek Vahit Gül

https://doi.org/10.21763/tjfmpc.693073

Abstract

Objective: Skin tumours are common tumors and they are mostly benign. Benign skin lesions (BSLs) may be a sign of a syndrome or of a systemic malignant state. Sometimes they can transform into malignant types. The aim of the present study is to evaluate the prevalence and the clinico-pathological characteristics of a large series of BSLs which were excised in our clinic. Methods:The patients with skin lesions who underwent a total excisional biopsy in the general surgery clinic between the years 2012 and 2016 were reviewed. Malignant skin lesions were excluded from the study. The BSLs were classified according to the Pathology and Genetics of Skin Tumours of the World Health Organization Classification of Tumours. Results: A total of 551 patients with BCL were included in the study. Of the patients, 241 (43.7%) were female and 310 (56.7%) were male. The age range was between 2 and 98 years and the mean age was 39.7. The most common benign skin lesions (n = 184, 33.3%) were appendageal tumors and this finding was statistically significant (p = 0.001). The most common appendageal tumor type (n = 75, 13.6%) was verruca vulgaris. Conclusion: Benign skin lesions are usually seen by family physicians. Some of the BCLs may be confused with malignant skin lesions and may even be associated with systemic malignancies. It is very important that family physicians can recognize benign skin lesions and plan for diagnosis and treatment such as biopsy.



Amaç: Deri tümörleri çok yaygın olup çoğunlukla iyi huyludurlar. Benign cilt lezyonları (BCL), bir sendromun veya sistemik malign bir durumun belirtisi olabilirler. Bazen de malign lezyonlara dönüşebilirler. Çalışmamızın amacı, kliniğimizde eksize edilen geniş bir BCL serisinin prevalansını ve klinikopatolojik özelliklerini ortaya koymaktır. Gereç ve Yöntem: Genel cerrahi kliniğimizde 2012-2016 yılları arasında total eksizyonel biyopsi yapılan cilt lezyonları olan hastalar retrospektif olarak çalışmaya dahil edildi. Malign cilt lezyonları çalışma dışı bırakıldı. Benign cilt lezyonları Dünya Sağlık Örgütü Tümör Sınıflandırmasının Deri Tümörlerinin Patolojisi ve Genetiği'ne göre sınıflandırıldı. Bulgular: Çalışmaya BCL olan toplam 551 hasta dahil edildi. Bu hastaların 241’i (%43,7) kadın, 310’u (%56,7) erkekti. Yaş aralığı 2 ile 98 yaş aralığında olup, ortalama 39.7 idi. Benign cilt lezyonlarından en sık olarak (n=184, %33,3) appendageal tümörler yer almaktaydı ve bu bulgu istatistiksel olarak anlamlıydı (p=0.001). En sık görülen appendageal tümör tipi (n=75, %13,6)verruca vulgaris idi. Sonuç: Benign cilt lezyonları çoğunlukla aile hekimleri tarafından görülürler. Bunların bazıları malign cilt lezyonları ile karışabilir ve hatta sistemik maligniteler ile ilişkili olabilir. Benign cilt lezyonlarının aile hekimleri tarafından tanınması, biyopsi gibi tanı ve tedavi için planlama yapabilmesi çok önemlidir.

Keywords

Benign skin lesions, primary care, surgical evaluation

References

• 1. Nguyen T, Zuniga R.Skin conditions: benign nodular skin lesions.FP Essent2013;407:24-30.
• 2. Ingraffea A. Benign skin lesions. Facial Plast Surg Clin North Am2013;21:21-32.
• 3. Higgins JC, Maher MH, Douglas MS. Diagnosing Common Benign Skin Tumors. Am Fam Physician2015;92:601-7.
• 4. Freak J. Identification of skin cancers 1: benign and premalignant lesions. Br J Community Nurs2005;10:8-12.
• 5. Edlich RF, Becker DG, Long WB, Masterson TM. Excisional biopsy of skin tumors. J Long Term Eff Med Implants 2004; 14: 201-14.
• 6. Murray CJ, Lopez AD, Black R,Mathers CD, Shibuya K, Ezzati M et al. Global burden of disease 2005: call for collaborators. Lancet 2007; 370109-110.
• 7. LeBoit, P E (Philip E); International Agency for Research on Cancer; World Health Organization; International Academy of Pathology; European Organization for Research on Treatment of Cancer; UniversitätsSpital Zürich DepartementPathologie. Pathology and genetics of skin tumours. Lyon: IARC Press; 2006:9-291.
• 8. Bertanha F, Nelumba EJP, Freiberg AK, Samorano LP, FestaNeto C. Profile of patients admitted to a triage dermatology clinic at a tertiary hospital in São Paulo, Brazil. An Bras Dermatol 2016; 91: 318–325.
• 9. Furue M, Yamazaki S, Jimbow K, Tsuchida T, Amagai M, Tanaka T et al. Prevalence of dermatological disorders in Japan: a nationwide, cross-sectional, seasonal, multicenter, hospital-based study. J Dermatol 2011; 38: 310-20.
• 10. Mohammedamin RS, van der Wouden JC, Koning S, van der Linden MW, Schellevis FG, vanSuijlekom-Smit LW et al. Increasing incidence of skin disorders in children? A comparison between 1987 and 2001. BMC Dermatol 2006; 6: 4.
• 11. Kartal D, Cinar SL, Akin S, Ferahbas A, Borlu M. Skin findings of geriatric patients in Turkey: A 5-year survey. Dermatol Sinica 2015; 33: 196-200.
• 12. Kim HS, Cho EA, Bae JM, Yu DS, Oh ST, Kang H et al. Recent trend in the incidence of premalignant and malignant skin lesions in Korea between 1991 and 2006. J Korean Med Sci 2010; 25: 924–9.
• 13. Choi SH, Kim KH, Song KH. Clinical Features of Cutaneous Premalignant Lesions in Busan City and the Eastern Gyeongnam Province, Korea: A Retrospective Review of 1,292 Cases over 19 Years (1995~2013). Ann Dermatol2016;28:172–8.
• 14. Bas Y, Kalkan G, Seckin HY, Takcı Z, Sahin S, Demir AK. Analysis of Dermatologic Problems in Geriatric Patients. Turk J Dermatol 2014; 2: 95-100.
• 15. Kyriakis KP, Alexoudi I, Askoxylaki K, Vrani F, Kosma E. Epidemiologic aspects of seborrheic keratoses. Int J Dermatol 2012; 51: 233–234.
• 16. Sinikumpu S-P, Huilaja L, Jokelainen J, Koiranen M, Auvinen J, Hägg PM et al. High Prevalence of Skin Diseases and Need for Treatment in a Middle-Aged Population. A Northern Finland Birth Cohort 1966 Study. PLoSOne 2014; 9: e99533.
• 17. Kanitakis J. Adnexal tumours of the skin as markers of cancer-prone syndromes. J Eur Acad Dermatol Venereol 2010;24:379-87.
• 18. Luba MC, Bangs SA, Mohler AM, Stulberg DL. Common benign skin tumors. Am Fam Physician 2003; 67: 729-38.
• 19. Gogi AM, Ramanujam R. Clinicopathological Study and Management of Peripheral Soft Tissue Tumours. J Clin Diagn Res2013;7:2524-2526.
• 20. Lee EH, Nehal KS, Disa JJ. Benign and premalignant skin lesions. PlastReconstr Surg2010;125:188e-198e.
• 21. Ferrándiz C, Malvehy J, Guillén C, Ferrándiz-Pulido C, Fernández-Figueras M. Precancerous Skin Lesions. ActasDermosifiliogr 2017; 108: 31-41.
• 22. Hwang S-M, Pan H-C, Hwang M-K, Kim M-W, Lee J-S. Malignant Skin Tumor Misdiagnosed as a Benign Skin Lesion. Arch Craniofac Surg 2016; 17: 86–89.
• 23. Woon DTS, Serpell JW. Preoperativecorebiopsy of soft‐tissuetumoursfacilitatestheirsurgicalmanagement: a 10‐year update. ANZ J Surg 2008;78:977–81.
• 24. Kasraeian S, Allison DC, Ahlmann ER, Fedenko AN, Menendez LR. A Comparison of Fine-needleAspiration, CoreBiopsy, andSurgicalBiopsy in theDiagnosis of ExtremitySoftTissueMasses. ClinOrthopRelatRes. 2010;468(11):2992-3002.
• 25. Layfield LJ, Schmidt RL, Sangle N, Crim JR. Diagnosticaccuracyandclinicalutility of biopsy in musculoskeletallesions: a comparison of fine-needleaspiration, core, andopenbiopsytechniques. DiagnCytopathol. 2014;42(6):476-86.