What is Skin cancer?

Overview

Skin cancer arises within the skin. It may occur anywhere on the body but more commonly occurs in sun exposed areas such as the head and neck and limbs. There are three common forms of skin cancer namely basal cell carcinoma, also known as BCC or rodent ulcers, squamous cell carcinoma (SCC) and malignant melanoma which is the most aggressive. Skin cancers are associated with sun exposure, the use of sun beds, advancing age and in some cases, a familial predisposition. The diagnosis of skin cancers can usually be made clinically and is usually confirmed by a skin biopsy. 

Further information can be downloaded here in this Skin Cancer guide

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Types of skin cancer

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Basal cell carcinoma is the commonest type of skin cancer. It begins its growth from the most superficial layer of the skin called the epidermis and is very slow growing. It is associated with sunlight and ultraviolet radiation exposure and so most commonly occurs in the areas of the body which are most exposed such as the head and neck areas. BCCs almost never spreads however if left untreated, it can continue to grow locally and eventually involve nearby tissues.

BCCs often appear initially like a bump on the skin and can be mistaken as an insect bite or puncture injury from a thorn. It is often light pink or reddish in colour however it can also be flesh coloured or brown. Over time, it grows slowly and may appear to have a pearly or waxy appearance. It may also present as a sore that does not heal, ooze and crust over, have tiny bloody vessels adjacent to it and can occasionally bleed.

Further information can be downloaded here in the

Guidelines for the management of patients with basal cell carcinoma can be found here :

http://www.uhb.nhs.uk/Downloads/pdf/CancerPbBasalCellCarcinoma.pdf

Malignant melanoma is an aggressive form of skin cancer which develops from cells called melanocytes found within the skin. Moles are groups of melanocytes that lie adjacent to one another. Malignant melanoma therefore can arise within a pre-existing mole on the body although they can also occur where there was no obvious mole previously. Factors such as ultraviolet light exposure, prolonged sunlight exposure, use of sun beds and getting burnt as a child may all contribute to the development of melanoma. Very occasionally, melanoma can also run in families or arise in people who have a lot of abnormal moles, known as dysplastic naevus syndrome.

The majority of melanomas begin with a change in the appearance of your skin. This may be the development of a new mole or a change in a pre-existing mole. The ABCD checklist is useful in determining this :

Asymmetry : Melanomas are usually irregularly shaped whereas normal moles tend to be symmetrically shaped

Border : Melanomas have an irregularly shaped border whereas normal moles have a well defined border

Colour : Melanomas tend to have more than one colour with varying shades of brown, black or blue, whereas normal moles tend to be uniformly brown in colour

Diameter : Melanomas are usually 7mm or more in diameter

In addition, melanomas can also be crusty, itchy and occasionally bleed.

If you are concerned you may have melanoma, get in touch with your doctor immediately.

Some useful information and guidelines for the management of melanoma can be found here :

Melanoma : Some useful facts

Guidelines for the management of melanoma

Squamous cell carcinoma or SCC is a type of skin cancer that arises in the outer layer of the skin called the epidermis. Like other skin cancers, it is associated with ultraviolet radiation and sunlight exposure. Other factors which increase the risk of developing SCC include a suppressed immune system and having lesions such as chronic unhealing wounds or actinic keratosis.

SCC is the second commonest form of skin cancer and its incidence is increasing. It is possible for SCCs to spread to lymph nodes via the lymphatic system and if this occurs then a lymphadenectomy or lymph node clearance may be required.

Some useful information and guidelines for the management of squamous cell skin cancer can be found here :

Guidelines for the management of patients with squamous cell carcinoma of the skin

http://www.uhb.nhs.uk/Downloads/pdf/CancerPbSquamousCellCarcinomaSkin.pdf

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