ABSTRACT
Doctors are frequently asked if anything needs to be done about a skin lesion or blemish. Often they are harmless and natural and many patients, especially if they are slightly guarded about intervention, willingly take the advice to ‘do nothing’. The natural history of skin lesions varies enormously. Some benign lesions may reach large proportions while some malignant lesions may be remarkably slow-growing and non-aggressive. Patients often worry that if they leave a benign lesion to enlarge it will be much more difficult to treat and will leave a much more obvious scar – this is rarely the case, although some lesions do continue to grow. Squamous cell carcinomas are generally more aggressive tumours than basal cell carcinomas. They tend to grow more quickly and invade other tissues, and they can spread to other organs via the lymphatics or blood vessels. Malignant melanoma is a worrying tumour because its behaviour is so unpredictable.
