Evaluating and Treating Skin Lesions: A Case Study in Cosmetic Shave Removal
By Dr. Ashley Baldree, Village Dermatology
Skin lesions can appear for various reasons and may vary greatly in appearance and texture. When a lesion's nature is uncertain, dermatologists often recommend biopsy or removal to ensure an accurate diagnosis and appropriate care. Today, I’ll share a case of a 50-year-old female patient who came to our office with a lesion on her thigh, leading to a careful evaluation and cosmetic shave removal procedure.
Case Overview
Our patient, a 50-year-old woman, presented with a moderately severe, asymptomatic lesion on her left anterior proximal thigh. The lesion had been present for several months but had not received any prior treatment. Given the uncertain nature of this growth, our differential diagnosis (DDx) included several possibilities: Neoplasm of Uncertain Behavior, skin tag, wart, and seborrheic keratosis (SK).
After thorough evaluation, we determined that a cosmetic shave removal would be the best approach. This allowed for both the removal of the lesion and histologic evaluation to confirm its nature.
Diagnosis: Neoplasm of Uncertain Behavior
"Neoplasm of Uncertain Behavior" is a term used when a lesion’s exact diagnosis is unclear, and it requires further examination to rule out potential concerns. While many lesions in this category are benign, the uncertainty warrants removal and biopsy to ensure there are no underlying risks.
Procedure Details: Cosmetic Shave Removal
Once the patient consented to the procedure, we reviewed the risks and benefits, which include:
Infection
Scarring
Bleeding
Prolonged Wound Healing
Incomplete Removal
Allergic Reactions to Anesthesia
Nerve Injury
Recurrence of the Lesion
Procedure Steps:
Preparation: The area was prepped with alcohol to maintain sterility, and 1% lidocaine with epinephrine was used as a local anesthetic to numb the area.
Removal: Using a scissors technique, a cosmetic shave removal was performed to remove the lesion. This method minimizes scarring and is ideal for benign or low-risk lesions.
Hemostasis: Drysol was applied to control bleeding.
Post-Procedure Care: After the shave removal, we applied petrolatum and a bandage to the wound and provided wound care instructions.
Post-Procedure Care and Follow-Up
After the procedure, we reviewed the following wound care instructions with the patient:
Keep the area clean and apply a fresh bandage daily.
Apply petrolatum to keep the wound moist, which aids in healing and reduces scarring.
Avoid sun exposure on the treated area until fully healed, as sun exposure can cause pigment changes.
We informed the patient that she would be contacted with biopsy results, typically within two weeks. If she hasn’t heard from our office by then, we encouraged her to call us for an update.
Importance of Skin Lesion Evaluation
This case highlights the importance of evaluating new or changing skin lesions, especially when there is uncertainty about the lesion’s nature. Even when a lesion appears harmless, a biopsy can provide peace of mind and help rule out any underlying concerns. Patients should perform regular self-exams and schedule yearly skin checks with their dermatologist to monitor for new or changing lesions.
If you have concerns about a skin lesion or would like to discuss treatment options, visit us at Village Dermatology in Katy, TX. Our team is here to help you understand your skin health and provide the best care options for your needs.