Skin cancer is becoming more and more common.  It is now listed by the World Health Organization (WHO) as the most common type of cancer in humans.  It can affect people of all races, but individuals with lighter skin tones have a higher likelihood of developing skin cancer.  Skin cancer is the abnormal mutation of skin cells that is triggered by the sun’s harmful rays.  This mostly affects those who get sunburnt easily.  There are three common types of skin cancers.

Many skin conditions can mimic possible skin cancers but actually be unrelated skin diseases.  Skin cancer may appear as dry, scaly patches or colored spots that appear on the skin surface.  These spots are called actinic keratosis.  Skin cancer usually starts out as a precancerous lesion that becomes cancerous after an extended period of time without treatment.  Actinic keratosis can develop into squamous cell carcinoma.  Precancerous nevus moles may develop into malignant melanoma.

Basal Cell Carcinoma (BCC)
BCC is the most common type of skin cancer and can affect people with all skin tones.  It typically appears as a pinkish bump on the skin.  The most common risk factors for BCC include years of excessive sun exposure and indoor tanning.  This condition affects sun-exposed areas such as the neck, head, and arms.  However, due to cell mutation, it can appear in other areas of the body, such as the chest and abdomen.  Early evaluation is recommended to prevent potential complications.  When BCC progresses, it can affect tissues, nerves, and bones close to the affected areas.

Squamous Cell Carcinoma (SCC)
SCC is the second most common skin cancer.  It typically affects individuals with lighter skin tones but can affect people with darker skin tones, although less frequently.  Typically, SCC appears as a firm reddish bump on the skin or may be described as a sore that heals but then reappears.  Like most skin cancer, it is related to prolonged sun exposure and is most likely to appear on areas of the skin that are exposed to sun.  It tends to invade deeper into the skin than BCC and can cause deformities.  Early detection is crucial to prevent spread to other parts of the body.

Melanoma is the least common skin cancer but has the worst prognosis and is most likely to be fatal.  According to the National Cancer Institute, an estimated 10,130 people will die of melanoma in 2016.  Melanoma is caused by exposure to the ultraviolet rays of the sun.  This condition always starts in the form of a mole.  Warning signs of possible cancer include:

  • Change in shape, color and size of the mole
  • Irregular borders of the mole
  • Uneven color of the mole, usually varying shades of black and brown

Merkel Cell Tumors
Merkel cells are very close to the nerve endings in the skin and are responsible for feeling skin sensations.  Merkel cell tumors are a rare form of skin cancer that starts with Merkel cells beginning to grow uncontrollably.  Because it grows very fast, it spreads to other parts of the body making it difficult to treat.

To determine if a skin condition is skin cancer, a medical provider’s evaluation is critical.  Your provider will typically perform a biopsy to determine if a lesion is cancerous.  There are four types of biopsy that are commonly used:

  • Shave biopsy – a sharp instrument is used to shave off the abnormal lesion.
  • Punch biopsy – a circular area of tissue is removed from the abnormal lesion.
  • Incision biopsy – a scalpel is used to remove a portion of the lesion.
  • Excision biopsy – a scalpel is used to remove the lesion and tissue around it.

Most skin cancers are caused by exposure to ultraviolet rays from the sun and indoor tanning systems.  To prevent skin cancer, it is recommend to avoid skin tanning and to use a sunscreen with SPF 50 if you are going to be out in the sun.

For more information, visit Careworks.

Author:  Jackie Borst, PA-C