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Pictures of Skin Cancer

Some cancers are more common in aging skin. The underlying cause of skin cancer in older people is often the accumulated damage of many years of excessive exposure to the sun. In some cases there may be a genetic predisposition to skin cancer - either "cancer in the family" or the inheritance of a type of skin that increases risk for skin cancer. All skin cancers can be successfully treated if they are discovered and treated early. All are potentially disfiguring, and potentially fatal if they metastasize (spread) to other parts of the body.

The three most common forms of skin cancer are:

• Basal cell carcinoma
• Squamous cell carcinoma
• Melanoma

Basal Cell Carcinoma

Basal cell carcinoma arises in a layer of skin (basal layer) beneath the skin’s surface. It seldom metastasizes, although it may do so if the cancer invades lymph or blood vessels that can carry cancer cells to distant organs. The major spreading mechanism of basal cell carcinoma is by local invasion of surrounding skin tissue. If left untreated, it may become large and disfiguring.

The major risk factors for developing basal cell carcinoma are:

• excessive and chronic sun exposure over many years

• a fair (white) skin complexion, especially when hair is blond or red

While basal cell carcinoma has traditionally been a cancer associated with older people, it is now seen in more young adults than in the past.

Early detection of basal cell carcinoma can lead to early treatment and prevention of disfigurement. The most likely places for basal cell carcinoma to develop are areas exposed to sun—face, scalp, ears, neck, shoulders and back. Criteria to look for in self-examination:

• a small, pearly nodule, which may or may not have telangiectasia (small enlarged blood vessels) on the surface; the nodule increases in size slowly and may form an ulceration in its center; there may be some pigmentation

• a solitary, flat or slightly depressed lesion that is hard to the touch; it may be yellowish or whitish and have indistinct borders

• one or more reddish, scaling plaques that slowly enlarge; these lesions may resemble dermatitis or psoriasis

Any suspicious lesion should be examined immediately by a dermatologist and biopsied if the dermatologist deems it necessary to determine proper treatment.

Early, effective treatment of basal cell carcinoma by a dermatologic surgeon has a cure rate of more than 95%. However, new basal cell carcinomas can develop after treatment, so continued self-examination and regular examination by a dermatologist are important.

When basal cell carcinoma is discovered early and the diagnosis confirmed by biopsy, treatment may be carried out in the dermatologist’s office or an outpatient setting. Treatment procedures include:

• Curettage: A scalpel is used to scrape away malignant tissue. Electrocautery may be used after curettage to "mop up" any remaining cancer cells. Curettage is used chiefly for superficial carcinoma not previously treated.

• Cryosurgery: Liquid nitrogen is applied to the lesion to destroy malignant tissue by ultra-cold freezing.

• Topical chemotherapy: Cancer cells are destroyed by pharmacologic agents applied to the surface of the skin.

• Surgical excision: The cancer is surgically removed and the skin closed with stitches. This technique is used when the carcinoma is in deeper tissues.

• Mohs microscopic surgery: Surgical removal is performed under a microscope. In this technique, the surgeon can perform surgery layer by layer into the skin, under direct microscopic observation.

• Laser surgery: Cancerous tissue is destroyed by laser beam.

The dermatologist or dermatologic surgeon will discuss with the patient the type of treatment that will be most effective.

Squamous Cell Carcinoma

Squamous cell carcinoma develops in the outer layers of the skin. It is capable of metastasizing to other areas of the body if not treated early. It also spreads locally and may cause significant disfigurement.

The major risk factors for developing squamous cell carcinoma are:

• excessive, chronic exposure to sun, over many years

• overexposure or chronic exposure to x-rays

• long-term treatment with immunosuppressive drugs

• white skin, especially with blond or red hair

Criteria for self-examination:

• commonly appears as an ulcerated nodule or superficial erosion with poorly defined margins on the skin or lower lip; the lesion persists and does not heal

• a wart-like growth or plaque

• premalignant forms of squamous cell carcinoma include actinic keratosis, cutaneous horns (hard, fibrous growths), and Bowen’s disease (scaling, inflamed-looking plaques)

A suspicious lesion should be examined immediately by a dermatologist, and biopsied if deemed necessary by the dermatologist to determine proper treatment.

Squamous cell carcinoma can be significantly disfiguring if not treated early.

When a diagnosis of squamous cell carcinoma is confirmed by biopsy, treatment options are similar to those for basal cell carcinoma.

Melanoma

As with basal cell carcinoma and squamous cell carcinoma, excessive and chronic sun exposure is a major risk factor for melanoma. There also is a tendency for melanoma to "run in the family", and to be associated with a familial trait of having many moles on the body. Melanoma often arises in a pre-existing mole or pigmented lesion. Early diagnosis and treatment of melanoma is essential. Any person with many moles or a family history of melanoma should be examined regularly by a dermatologist. Every adult should self-examine at regular intervals to detect any early indications of melanoma. Self-examination is done using the A-B-C-D criteria:

A=Asymmetry (the left side of the lesion is unlike the right side)

B=Border Irregularity (the lesion has a scalloped or poorly defined border)

C=Color Variation (not all parts of the lesion are the same color; 
within the lesion may be patches of tan, brown, black, pink, white or blue)

D=Diameter (while melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller.  If you notice a mole different from others, or which changes, itches or bleeds even if it is smaller than 6mm, you should see a dermatologist)

It is worth noting that some melanomas do not conform to the A-B-C-D criteria, so any suspicious mole should be examined by a dermatologist.

Handmade Herbal Soap

The association of sunbed use with malignant melanoma and other skin cancers

Internation Journal of Cancer. 2006 Nov 27

Exposure to solar ultraviolet (UV) radiation is a known cause of skin cancer. Sunbed use represents an increasingly frequent source of artificial UV exposure in light-skinned populations. To assess the available evidence of the association between sunbed use and cutaneous malignant melanoma (melanoma) and other skin cancers, a systematic review of the literature till March 2006 on epidemiological and biological studies on sunbed use was performed in Pubmed, ISI Web of Science, Embase, Pascal, Cochrane library, Lilacs and Medcarib. Based on 19 informative studies, ever-use of sunbeds was positively associated with melanoma, although there was no consistent evidence of a dose-response relationship. First exposure to sunbeds before 35 years of age significantly increased the risk of melanoma, based on 7 informative studies. The summary relative risk of 3 studies of squamous cell carcinoma showed an increased risk. For basal cell carcinoma, the studies did not support an association. The evidence does not support a protective effect of the use of sunbeds against damage to the skin from subsequent sun exposure. Young adults should be discouraged from using indoor tanning equipment and restricted access to sunbeds by minors should be strongly considered.

"Indoor tanning is an unnecessary activity. While it produces a temporary cosmetic effect, it can cause long-term health problems," says Dr. Arielle N.B. Kauvar, associate professor of dermatology at New York University School of Medicine.

The tanning industry continues to promote the health benefits of despite the absence of evidence. "Because vitamin D can be produced through exposure to UV light, some people may think that they have to have exposure to the sun or a tanning lamp to produce optimal amounts of the nutrient. But, there are safe ways to get vitamin D each day -- drinking a couple of glasses of vitamin-D fortified milk or orange juice, eating salmon or mackerel and other foods rich in vitamin D, or taking a supplement - that do not pose a health risk like tanning does," Kauvar said.

American Academy of Dermatology - in-depth articles, medical information and helpful hints on a variety of skin, hair, and nail conditions.