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Besides Melanoma skin cancer, the two other most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma.
ACTINIC KERATOSES are pre-malignances (pre-cancers) recognized as rough-surfaced patches on sun-exposed skin often better felt than seen. They are sometimes tender or sensitive and have a gritty feel, like fine sandpaper. They are usually treated with liquid nitrogen, applied by sprayer or cotton tipped applicator, which produces a blister or scab, destroying the pre-malignant cells. They can also be treated with various prescription topical creams, or photodynamic therapy (with Levulon and BLU-U Blue light). A percentage of actinic keratoses develop into skin cancers (mostly squamous cell carcinomas), so it is important to have them treated.
SQUAMOUS CELL CARCINOMAS usually are rough-surfaced bumps that extend down into the skin so if you squeeze the skin, it feels like a lump. One variety, called a KERATOACANTHOMA , looks like a volcano with a central crater and may be tender as a boil. They usually are only locally destructive, but can have some tendency to spread to local lymph glands (metastasize) especially if they are large (over an inch in diameter), left untreated, or on the lip, ear or central face. BOWENS DISEASE is also called SQUAMOUS CELL CARCINOMA IN SITU, and refers to squamous cell carcinoma confined to the top layer of the skin.
BASAL CELL CARCINOMAS are the most common cancers of humankind, making up the majority of the 1.5 million skin cancers diagnosed annually. Fortunately, they are also the most curable! They virtually never spread to other parts of the body but can invade deeply and destroy or disfigure the eyes, nose, lips, ear or other body parts. They can be recognized as pearly bumps with fine blood vessels on the surface or as sores that do not heal for more than two weeks. Less common forms of basal cell carcinoma can resemble a scar that appears for no apparent reason or even a rash resembling eczema, psoriasis or ringworm but which does not respond to appropriate therapy for these conditions. Basal cell carcinoma has also been mistaken for a pimple that doesn’t resolve.
Treatment Information
We recommend that your doctor or practitioner biopsy suspicious lesions rather than aiming to fully remove them at the initial evaluation. As with melanomas, even the most skilled dermatologists are unable to absolutely diagnose skin cancers 100% of the time and over- and under-treatment can be avoided if a biopsy gives your doctor the exact diagnoses and an idea of how deep the tumor is growing.
Treatment options for skin cancers include excision (easily performed in our office under local anesthesia), curettement and dessication, or Mohs micrographic surgery. The latter is a specialized type of excision performed by dermatologists in which the tumor is excised, analyzed microscopically, and mapped, while the patient remains in the office. Mohs micrographic surgery is often used for skin cancers on the face, because it is a tissue sparing surgery with a high cure rate. For a detailed description, please visit www.mohssurgery.org. There are some topical treatments for certain superficial types of skin cancer. Some patients are referred for radiation therapy. The appropriate treatment depends on skin cancer type, anatomic location of the cancer, and patient and doctor preferences.
Prevention
Prevention of skin cancer consists of daily use of sunscreens, protective clothing, and excess sun avoidance. Tanning beds can contribute to skin cancer, and should be absolutely avoided. Regular full body skin examinations help to detect pre-cancers and skin cancers in their earliest stages. Patients are advised to perform a monthly self skin examination in front of a full length mirror and using a hand held mirror. Any new or non-healing growths should prompt a visit to the dermatologist office. In the future, there may be therapies that can reverse some of the past sun damage done to the skin.
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