Benign Skin Conditions
|Benign skin conditions|
|Moles and naevi||Long standing lesions, where appearance is the prime motivation for seeking removal of cystic, non-pigmented naevi.||Where there is a suspicion of neoplastic change or doubt about the diagnosis.
Symptomatic lesion (regularly infected, traumatised by rubbing on clothes or being regularly cut whilst shaving).
Large congenital hairy naevi.
Disproportionately large and obviously extremely unsightly pigmented naevi.
|Sebaceous cysts||To be debated||To be debated|
|Acne scarring||Generalised poor skin texture following burnt-out acne of the type amenable to treatment by resurfacing techniques (chemical peels, dermabrasion or laser).||Deep ‘pits’ or specific ‘ice pick’ scars may be treated by excision if associated with ingrowing hairs or repeated local infection.|
(Fibroepithelial polyps, pedunculated naevi)
|Small, non-pigmented typically axillary and fibroepithelial polyps around the neck and flexures.||Large, symptomatic or traumatised lesions
Pyogenic granuloma – in reality many of these in adults are often malignant melanomas or squamous cell carcinomas.
|Xanthelasmata||Where improvement in appearance is the factor prompting referral and serum cholesterol is normal.
Xanthelasmata do not cause functional problems.
|In the presence of a previously raised but controlled serum cholesterol, non smoker and thus when the lesions are a possible manifestation of demonstrable disease.|
|Spider naevi and small cutaneous vascular anomalies||Spider naevi. The treatment is by laser but they are excluded under local dermatological protocols||Congenital vascular anomalies including haemangiomas which can occasionally present as an emergency
Repeated bleeding from a vascular lesion
Repeated ulceration of a vascular lesion
Rapid growth and functional impairment