There are many types of skin cancer and pre-cancers that we check for during your annual skin exam. For many reasons, including continued unprotected exposure to the sun as well as the proliferation of tanning salons, skin cancer rates are on the rise. If you are at risk, either by a personal history of sun exposure and sunburns (especially as a child), a personal history of previous skin cancer, or a positive family history of skin cancer, especially melanoma, call us to schedule your full-body skin cancer screening today!
Some of the more common forms of skin cancer are described below. If you suspect a lesion may be growing or changing, or may fit one of the descriptions below, please call our office to have Dr. Dubow perform your full-body skin cancer screening.
Basal Cell Carcinoma (BCC) is the most common type of skin cancer. Luckily, BCC is almost always localized to the affected skin and rarely spreads to lymph nodes or other parts of the body. Most often, basal skin cancer appears on the areas of your skin that are frequently exposed to the sun. Although usually slow-growing, there are more aggressive forms of BCC that can spread locally and cause ulceration and local disfigurement. Mohs micrographic surgery is a specialized method of skin cancer removal that we use in our practice to give higher cure rates while preserving surrounding unaffected tissue.
- Bump or growth that is pearly or waxy
- Flesh-colored or light pink bump
Your specific treatment is dependent upon the size, depth, and location of the lesion.
- Mohs micrographic surgery
- Surgical excision
- Curettage and electrodesiccation
- Topical therapy with Aldara (Imiquimod) or 5- Fluorouracil cream
Actinic Keratosis & Squamous Cell Carcinoma:
Squamous Cell Carcinoma (SCC) is the second most common type of skin cancer. As with BCC, if detected early, SCC can be cured. While SCC most often develops on skin that is frequently exposed to the sun, it can develop in non-sun-exposed areas like your mouth or genitals. Most commonly, SCC begins as a pre-cancer called actinic keratosis. These little sandpaper rough spots occur on sun-exposed areas of the scalp, face, forearms, and hands. Another early form of Squamous Cell Carcinoma is called Bowen's disease and often looks like a dull pink flat patch. Lastly, pre-cancerous changes called dysplasia as well as overt Squamous Cell Carcinoma can arise from genital or oral skin exposed to human papillomavirus (HPV), the virus that causes viral and sexually transmitted warts (condyloma).
- Crusty or rough bump on your skin
- Red or rough flat patch on your skin
- Dome-shaped bump that grows and bleeds
- Sore that does not heal or continues to return for more than two weeks
SCC is treatable if caught early. However, if aggressive or neglected, it can spread to local nerves and lymph nodes and then to other parts of your body. To diagnose SCC, Dr. Dubow can biopsy the growth and recommend the best treatment, as well as appropriate, follow up to screen for additional lesions.
Atypical Moles & Melanoma:
Melanoma is the most dangerous form of skin cancer; it can metastasize to your internal organs and be life-threatening. If caught early however melanoma can be completely cured with local removal.
Melanoma may present in many ways. Sometimes, people who have very “moley” skin will observe a mole that changes as described below. Other times, the melanoma appears “de novo,” which means it starts as a melanoma from Day 1 and is not associated with a pre-existing mole. Finally, not all melanoma begins on the skin because pigment cells (melanocytes) are also present in non-skin areas such as behind the eye and in the spinal cord and can become cancerous in these areas as well.
It is important to know that not all melanoma occurs on skin exposed to the sun. Although rare, melanoma can occur on the scalp of someone who has a full head of hair, on the bottom of the feet, or on the genital (labia, scrotal, or peri-anal) area. For this reason, a full-body skin exam should always include an examination or at least a question about lesions in these areas.
We see many patients in our practice who have “atypical” or “dysplastic” nevi or moles. This can be a confusing topic for both patients and dermatologists alike.
Sometimes, a growth is biopsied and it shows features that are neither completely benign nor frankly malignant enough to call the lesion melanoma. Such lesions are often called atypical. Such phrases as “atypical melanocytic neoplasm” “dysplastic nevus with severe atypia” or “atypical melanocytic hyperplasia” likely represent steps in transition from a completely benign mole to a melanoma. Unfortunately, there are varying criteria among pathologists who interpret biopsies and sometimes the findings are not clear cut of something completely benign nor malignant. In these cases, we will often recommend complete removal with more frequent screening exams. Nowadays, advanced laboratory techniques such as markers and genetic testing may offer additional hope to better classify such intermediate or unequivocal lesions.
Atypical Moles & Melanoma:
- Border Irregular
- Color variation
- Diameter greater than 6 millimeters (pencil eraser or larger)
- Evolving” or changing mole
The most effective way to treat early melanoma is surgical removal. For more advanced (thicker) melanomas, referral to a surgical oncologist to have local lymph nodes examined may be recommended. If a melanoma is caught at the earliest stage (“melanoma in situ”) surgical removal is almost always curative.