Scar - Fibrous tissue, composed of collagen, formed by fibroblasts or other cells. Scars are usually the result of damage to the body and are readily visible on the skin. Collagen and scarring are the glue by which the human body heals wounds. Without the formation of deep scars, almost all skin wounds would split apart. Gland or surface tissue has little or no binding capability; therefore, scar tissue is important to all skin-surgery results. When sewing or closing wounds, the author prefers to create a deep, hidden, strong scar for permanent binding because the deep scar takes the pressure off the surface tissues. The surface scar can then be minimized by proper tension and stitch techniques. Any surgery or wounding of the skin results in some scar formation. The key to good surgical results is how easily the final scar can be seen or how well it is hidden in pre-existing wrinkle lines or natural anatomy lines.

SCC - An abbreviation for squamous-cell carcinoma. See Squamous-cell carcinoma.

Scraping & Burning - Also known as curettage and electrodesiccation or C&D. See Curettage.

Screening - Looking at large numbers of people in the hope of detecting some disorder. In dermatology, screening is usually used to detect skin cancer.

Sebaceous hyperplasia ­ Benign hair oil-gland overgrowth. These growths are genetically preprogrammed and usually range in size from that of a pinhead to that of a pencil eraser. "Seb hypes," as they are sometimes called, usually look like a tiny, yellow donut just above the skin surface of the face. A tiny blood vessel may be present on the seb hype. They rarely go away and usually continue to grow and multiply throughout time. Sometimes they may cause significant cosmetic deformity. They can be treated best with electrosurgery, but some lasers have shown promise.

Seborrheic keratosis - A greasy, oily wart. They are benign but occasionally a squamous cancer has been reported to develop within a seborrheic keratosis. Therefore, careful, close examination is necessary to be sure that all is well. Seborrheic keratosis may arise from lentigos (age freckles) or may start on their own, growing usually as a greasy, stuck-on brown, tan or black wart-like growth. If examined very closely under a magnifying glass, miniature white or light horn pearls (tiny, white beads of keratin that can fit on the tip of a pen) may be noticed within the seborrheic keratosis. Very rarely will seborrheic keratoses develop a malignancy within. Because seborrheic keratoses are so common, there is also a possibility that one or more may collide merely by chance with a skin cancer growing nearby. Many times patients confuse seborrheic keratosis with melanoma and go to a doctor for examination. A thorough examination by an experienced doctor is usually a reliable way to tell the difference. Unfortunately, there is a type of melanoma known as verrucous melanoma that can mimic seborrheic keratosis. Fortunately, however, this is an extremely rare event.

Secondary procedure - Doing something a second time, usually surgery, e.g., for touching up, to make more nearly perfect or to repair a treatment failure.

Skin - The largest organ of the body. Skin is composed of living and dead layers. The dead layers include the surface scale, outside hair and nail plate. The living layers include the epidermis, dermis, subcutaneous and all of the structures found within those layers, including blood vessels, sweat glands, etc.

Squamous-cell carcinoma (SCC) - A skin tumor or cancer likely derived from the keratinocytes (skin- surface cells) closer to the surface of the skin. There are several grades of squamous-cell carcinoma, depending on how unusual the tumor's cells are. The less normal (and less natural) the cells are, the more aggressively (badly) they usually behave. For example, poorly differentiated (not looking much like any normal tissue found in the skin) squamous-cell carcinoma has a much greater tendency to spread unchecked and kill a patient than well-differentiated SCC.

Standard surgical excision ­ Also known as routine excision, it has the same net effect as an excisional biopsy. The doctor guesses how wide the lesion is, then cuts a wider specimen than it appears to him/her that the lesion occupies. The apparent excess is taken in order, he/she hopes, to clear away all of the abnormal cells of the skin cancer or skin process. This form of therapy (treatment) has an inherent failure rate that varies with the amount of normal tissue the doctor cuts around the edge. Excisional biopsy usually implies the process of vertical sectioning, which carries with it an inherent failure rate. See Vertical sections.

Stratum corneum - Usually the outermost layer of the epidermis on most exposed tissue, also known as the horny layer. It is composed of tightly packed, scale-like dead keratinocyte cells, which are constantly being replaced by new cells from the lower epidermis below. It is dead tissue (cells) that contributes to the physical outer barrier of the skin. The keratinocytes consist mostly of keratin, a protein. The outermost stratum corneum is relatively acidic and is therefore also called the acid mantle.

Subcutaneous - Lying below or under the cutaneous (dermis, leather) tissue. This tissue is usually composed of fat cells and the structures that run through it, i.e., blood vessels, nerves, etc. Fat is a soft, shock-absorbing barrier that acts as a conduit for the nerves and blood vessels. As well, subcutaneous tissue is an energy-storage device. See Fat in the glossary. The sebaceous glands of the hair follicle arise in the subcutaneous layer and are in high concentration on the face and scalp. There are no sebaceous glands on the palms or soles.

Surgery - A procedure that permanently manipulates or changes the body, usually by tool or instrument, with the expectation of some beneficial effect. Most skin surgery results in scarring (fiber tissue formation). However, if an incision is minor enough or well placed, the resulting scar may be difficult for the casual observer to detect. Signs of scarring include thickened skin, the loss of surface lines, redness and permanent whiteness.

Surgical biopsy ­ A fancy term that means the same thing as just plain old "biopsy." See Biopsy.

Syndrome - A group of signs or symptoms that, occuring together, characterize a particular abnormality (Webster's Dictionary). A collection of things that happen together in a patient that spell-out a special disease or problem that is usually given a particular name. Some, but not all, syndromes can hereditary in families.

Therapy ­ Treatment. Medical treatment does not involve cutting or phsically damaging the skin with electricity, acids, lasers or knives like surgical treatment does. Medical treatment may involve topicals, pills, injections, elixirs or the like.

Topical - Applicable to the surface, or on top of the skin. Ointments (greasy), creams (water and grease mixed), lotions (some water and oil mixed), solutions (water or alcohol based) or gels (usually alcohol based) are topically applied to the skin. Topical agents usually carry something of purpose if used to treat skin cancers or precancers. For example, topical fluorouracil (5-FU) is a chemotherapy drug used to treat precancers on the skin's surface. Topical 5-FU may be applied as either a cream or lotion.

Tumor - A growth that may be malignant or nonmalignant, good or bad, fast- or slow-growing. The term indicates the unusual presence of a type of tissue (group of cells) in an area in which it is not commonly found in most individuals. The word tumor is another term the author considers a "wastebasket" term (no talent for a doctor to use it and it provides little information to a trained specialist or an informed patient). For example, melanoma, a tumor, may kill a person. As well, a benign mole on the tip of the nose or the on the front of the knee can be considered a tumor, although it will not harm anyone. It is important to know that the word tumor does not necessarily mean something is deadly or even harmful to life.

Vein - Blood vessel that takes blood back to the heart from the capillaries, where oxygen has been released from the red blood cells for use by the body.

Verruca - The technical term for wart. Verrucous refers mainly to the visibly roughened ridge-like surface of a wart or other skin growth. See Wart.

Vertical sections ­ Usually made by the "breadloafing" method of testing a specimen to see if a tumor or another process still involves the edges of the sample taken from the body. If a process involves the edges of the tested specimen, then it is highly likely that the process (benign or malignant) involves the edges of the tissue that remain behind in the body from where the specimen was taken. Unfortunately, vertical sections test only a small segment (portion) of the edge of a specimen and, therefore, have an inherent failure or uncertainty rate. Most (yes, over 50%) surgeons do not know this important fact, as you will see if they are questioned. Vertical sections were the cause of the plastic surgeons' failing to cure the basal-cell skin cancer on President Reagan's nose the first time. Horizontal section testing does not have this inherent failure rate.

Wart ­ Otherwise known as a verruca. A wart is almost always a benign growth found on humans caused by the human papilloma (wart) virus (HPV). Warts are contagious (spreadable) but many people just have a weak immunity to wart and fungus infection to which they are, therefore, more susceptible than other people. Some wart virus infections have been shown to develop into cancer, although this is fairly rare event.