Skin and soft tissues

Abstract

Given the extremely common presentation of skin lesions by patients to surgeons and general practitioners alike, it is vital that all physicians be comfortable differentiating those lesions that are thoroughly benign, those that are somewhat questionable, and those that are most likely malignant. Given the rise in incidence of all forms of skin cancer and given the dismal outcomes associated with late diagnosis of squamous cell carcinoma and melanoma, recognizing the "red flags" of malignant skin lesions and knowing when to refer to a specialist for biopsy are essential skills. The general approach to the management of skin lesions is summarized in Algorithms 30.1 and 30.2. A similar statement can be made regarding soft tissue masses. Certainly, benign soft tissue lesions of the extremities in the form of lipomas or hematomas are extremely common, but it is the essential role of the physician or surgeon to recognize the symptoms and presentation of sarcoma, a disease that, while it may be relatively uncommon, is associated with extremely high rates of morbidity and mortality despite early recognition. Algorithm 30.3 outlines an approach to the initial evaluation of an extremity mass and to soft tissue sarcoma. © Springer Science+Business Media, Inc. 2005.