Skin Cancer

Actinic Keratoses - While not a true skin cancer, these are scaly, red bumps that appear in sun exposed areas. About 10% of these will progress to Squamous Cell Cancer and therefore they should be treated with either liquid nitrogen or a topical chemotherapy.

Basal Cell Cancer (BCC) - This is the most common type of skin cancer, with over 700,000 cases a year. While this skin cancer rarely metastasizes (travels throughout the body), this tumor can be destructive and result in loss of eyes, ears, and large amounts of skin in cosmetically significant areas, if not treated adequately. Treatment of this tumor should be based on the subtype and the location. The following are the 5 basic subtypes:

1. Superficial BCC
2. Nodular BCC
3. Micronodular BCC
4. Basosquamous cell cancer
5. Morpheaform BCC ( also called infiltrative or sclerosing)

Squamous Cell Cancer (SCC) - This is the second most common type of skin cancer. This tumor has a higher chance of metastasizing, especially if the cancer is on the lips or the ears. The 4 basic types of SCC are:

• Well Differentiated SCC
• Moderately well differentiated SCC
• Poorly differentiated SCC
• Spindle cell SCC

Once again, treatment should be based on the tumor type (histology) and the location.

Melanoma - All melanomas are malignant! The prognosis depends on the depth of the tumor (Breslow's level). The average age of a patient with melanoma is only 38! The risk factors for developing a melanoma are:

1. Family history of melanoma
2. Personal history of melanoma
3. History of sunburns
4. Many moles and freckles

If you have a mole that has some of the following characteristics (ABCD'S), then it needs to be examined by a dermatologist.

A. Asymmetry
B. Border that is irregular
C. Color - Black, blue, gray, red, white., etc
D. Diameter that is greater that the size of a pencil eraser

Treatment for melanoma is primarily surgical and requires that a margin of normal tissue be taken to give an adequate cure rate.