Skin and Soft Tissue Lesions

Dr. Castillo surgically diagnoses and treats a number of common skin and soft tissue problems such as sebaceous cysts, epidermoid cysts, lipomas, angiolipomas, and skin tags. He also performs more complicated surgical procedures to treat skin cancers.

Lipomas are benign fatty tissue tumors. They are soft, mobile and usually painless. They are frequently found on the arms and legs, but can also be on the back, neck, or trunk. Angiolipomas are similar to lipomas, but can be more firm and tender. These benign skin lesions are frequently removed in the office with local anesthetic. If they are large or firmly attached to the underlying muscle layer, Dr. Castillo may recommend removing them in an outpatient setting where the patient can be asleep.

Epidermoid and Sebaceous Cysts are benign collections of keratin, fat and/or oil. When they are located on the scalp, they are called Trichopilar Cysts. These cysts are usually painless, unless they rupture, which can cause a significant inflammatory response. If this happens, you do not need antibiotics. The inflammation will usually resolve with warm compresses, ibuprofen and time. These cysts can be removed when they are not ruptured and inflamed. Like lipomas, these are usually removed in the office with local anesthetic. Sometimes, depending on their size and location, Dr. Castillo will recommend excision in an outpatient setting where the patient can be asleep.

Skin tags are benign lesions that can easily be removed in the office with local anesthetic.

Skin Cancer

There are two types of skin cancer: Melanoma and Non-Melanoma.

Surgical excision is usually required for the treatment of melanoma. Depending on the size and location of the excision, this procedure will either be done in the office with local anesthetic or at an outpatient surgery center under general anesthesia.

In certain cases, it is important to also perform a Sentinel Lymph Node Biopsy. Dr. Castillo was a pioneer in the use of sentinel node biopsy in Arizona. This procedure is a method of diagnosing whether melanoma has spread to the lymph nodes. Stopping the spread of cancer through the lymphatic system is critical to stopping the spread of cancer throughout the body. Dr. Castillo has a near 100% success rate in locating sentinel lymph nodes in melanoma patients.

When melanoma has spread to the patient's lymphatic system, a sentinel lymph node is the first node into which the cancer is most likely to spread. To find the sentinel lymph node, Dr. Castillo injects a radioactive substance and blue dye close to where the skin cancer originated. He uses the blue dye and a device that detects radioactivity to identify the sentinel node. Once the sentinel lymph node is located, he removes it and sends it to the pathologist for further tests.

The most common types of non-melanomas are squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Frequently, these types of cancers are referred to plastic surgeons for removal.