Skin cancer represents an abnormal growth of skin cells and usually develops on skin exposed to the sun. Solar radiation is not the only provoking factor. Skin cancer can also appear on parts of the body covered with clothing as well as on the mucous membranes.
Karcinomima mogu prethoditi promene strukture ćelija kao i izgleda čak i nekoliko godina pre pojave malignih ćelija. Cancers can be preceded by changes in cell structure and appearance even a few years before the malignant cells appear. These are the so-called precancerous lesions and in cases of moles they are called dysplastic moles. As many as 40-50% of white adults develop at least one precancerous skin lesion by the age of 65. Dermoscopic examination can easily detect such changes, sometimes two years before they can be seen with the naked eye.
If detected on time, skin cancer can be completely cured.
Solar UV radiation is the primary risk factor for skin cancer, but important factors contributing to its development are also radiation, genetics, decreased immunity, immunosuppressive therapies, pollution and other malignant diseases.
Skin cancer most often develops in:
- • people with large number of moles
- • light skinned people with light eyes
- • people exposed to radiation
- • people overexposed to artificial UVA sources or sunlight
- • people who live at high geographical heights
- • people with a genetic predisposition
Precancerous lesions
Solar keratosis (actinic keratosis)
Actinic keratosis manifests as brown or reddish lesions that resemble confetti and whose surface is rough like a scab. Predilection sites are head, shoulders, arms, earlobes. They are a sign of a chronic sun damage to the skin and are made up of atypical skin surface cells.
Actinic keratosis occurs, on average, in people in their 40s or older. Since the index of solar radiation is higher every year and the use of tanning beds is more frequent, actinic keratosis can also be observed in younger people. Light skinned people with blonde or red hair, and light eyes belong to a more risky group.
When the scab on the solar keratosis surface becomes thicker, it needs to be removed and have pathohistological analysis performed on it, because of their tendency to turn into squamous cell carcinoma.
Actinic cheilitis (farmer’s lip)
Actinic cheilitis lip is a precancerous condition. It usually appears on the lower lip as red spots with scaliness. Persistent dryness and cracking of the lips are also present. The border between the lips and the surrounding skin can sometimes disappear, and the lips can be swollen. It is very important to treat actinic cheilitis on time. Otherwise, it can turn into invasive cancer.
Cutaneous horn (cornu cutaneum)
These are epidermal hyperkeratotic lesions that can have different shapes and sizes. They are characterized by sudden growth, usually on the basis of a wart or scale that has been present on the skin for years. The skin horn should always be sent for pathohistological analysis because we cannot know if a rapid lesion growth was triggered by cancer or atypical cells.
Mole check up
Moles on the skin are benign growths. It is believed that genetic predisposition in combination with UV radiation is the main trigger for their development. They can become atypical, and turn into melanoma or cancer.
It is extremely important to observe carefully your moles. They can get suspicious lesions. If you think that they are changing and look different than usual, you should definitely have a physician check your moles. Self-examination of moles can be done with the help of a recognition technique also known as:
ABCD rule
ABCD rule
Symmetry and Asymmetry look at your mole and draw a line in the middle of it. If both halves are equal, then your mole is symmetrical. If they are not, then the mole is asymmetrical, and you should pay more attention to its changes or have a dermoscopy performed.
The edges of the mole
Check the edges of your mole. They should not be jagged. If they are, you must see a physician.
The colour of the mole is also very important
If your mole is normal, its colour will be uniform. But if the mole has pink, black, brown colour, if it turned darker or lighter, it is time to visit a dermatologist.
Mole diameter
It is very important that we observe the changes on our body. This can be done after showering while the skin is still wet. In men, atypical moles most often develop on the back and in women on the lower leg. They can also appear between the toes, on the soles of the feet, behind the knees, on the neck, behind the ears and on the crotch. If you perform self-examination once a month, you will know when a change appears. You can take a photo of a mole and check whether it has changed. It is important for pregnant women, young people, and women in menopause to have their moles examined more often.
Timely removal of the changed mole can prevent melanoma, and if melanoma has already appeared and it is in the initial phase, it can be completely cured.
Of course, not every atypical mole is cancer. Atypical moles can be elevated, flat, brown, pink or of mixed colours. The physician will evaluate the mole based on the dermoscopic criteria. Sometimes the mole can be removed preventively or have a biopsy performed on it. This means that the pathologist will check the mole cells under a microscope. If it is confirmed that the mole has turned into melanoma, surgery will be usually performed and the surrounding tissue will be removed. If necessary, a treatment will be continued.
Skin cancer
Melanoma
Melanoma is the most dangerous skin cancer and the most difficult to treat. This type of skin cancer is completely different from others. You should know that any change in the mole can actually be melanoma, and you should visit a physician to have it timely removed, if necessary. If melanoma is not treated, it becomes one of the most aggressive cancers.
Nonmelanoma skin cancer
Squamous cell skin carcinoma manifests as a hard red nodule that bleeds, can develop a scab, has scales and if it is a wound then it cannot heal. It occurs on the forehead, nose, eyes, hands or those parts of the body that are most exposed to the sun. This cancer can be treated, but it is necessary to treat it on time.
Bowen’s disease
Bowen’s disease, also called ‘squamous cell carcinoma in situ’, is a surface form of skin cancer. Unlike “in situ”, the “invasive” cancer grows inward and may spread to deeper layers of the skin. Timely treatment prevents the development of the invasive form.
Basal cell carcinoma
Basal cell carcinoma is the most common form of skin cancer and the easiest to treat. It most often occurs in adults. This type of cancer spreads into deeper layers and encompasses wider areas and can cause damage to surrounding tissue. It spreads slowly and occurs in many forms. It can look like a waxy growth on the nose, neck and face and blood vessels can be observed on it. Those that appear on the back and chest are flesh-coloured, sometimes in the form of brown spots. Sometimes, but not so often, it can look like a light and concave scar.
Misconceptions about skin cancer
1. Only white people can have melanoma.
Even people with completely black skin can get melanoma in those parts that have not been sun exposed. They appear on the nails, feet, genital mucosa, in the mouth. As we have already said, white people get melanoma in 90% of cases on parts of the body that have been sun exposed. In the case of dark-skinned people, it happens in only 30% of cases.
2. Hairy moles cannot be cancerous.
Incorrectly. If melanoma has hair on it, it is the stage when cancer can be cured surgically. On the contrary, the hair disappears because the root of the hair is destroyed.
3. Each melanoma meets the ABCD rule (asymmetry, irregular edge, discoloration, size greater than 6mm)
This misconception only applies to a certain type of moles. For melanoma that is round – nodular, this rule does not apply. As they often do not meet any of the criteria, patients tend to ignore them.
4. It doesn’t hurt, so it’s not cancer.
If a mole is not painful, it does not mean that it is benign and that constitutes a big problem. When it starts to hurt or bleed, it is too late, because melanoma is already in an advanced stage.
5. Laser removal of moles is the safest.
People usually think that laser is the most suitable method for mole removal. They believe that the intervention does not hurt, does not damage the skin and does not leave a scar. A special problem is that the laser burns the entire mole, so it cannot be sent for pathohistological analysis, and only this analysis can give us true information about the mole’s condition. So, the misconception is that the laser removal does not hurt and is good for removing moles.
6. Mole scratches cause cancer.
People often think that if moles are scratched, they can turn into skin cancer, which is, of course, a misconception. Moles can heal without any consequences when injured.
7. The acid successfully removes all mole cells.
This is truly an incredible misconception and practice. Unprofessional people “melt” moles with acid. Not only that this practice does not help remove a mole, but it puts people’s lives in danger. When moles are treated with acid, metastases appear on the internal organs after some time. That is why it is important to constantly warn people that moles should be treated only by experts.
8. Tanning beds are no more harmful than solar radiation.
Those who think that tanning beds aren’t more harmful than solar radiation are seriously mistaken. Solar radiation has UVA and UVB radiation and tanning beds have up to 97% of UVA radiation, which has been proven to cause cancers. In a tanning bed, a person does not feel the burning. Because the rays in a tanning bed enter deep into the skin, the skin ages prematurely and the cellular structure of the skin changes. Tanning beds pose a huge risk of developing a skin cancer and its accelerated aging, and the cumulative effect has a negative impact.
9. You should not touch the mole in order to avoid skin cancer
A very dangerous misconception, because risky moles have to be removed. When the changed mole is not touched, the carcinogenic cells enter deep into the skin towards the internal organs. This is how melanoma metastases occur, and for them there isn’t currently any cure. The only way to cure an early melanoma is to have it surgically removed, which effectively prevents metastases.
References:
- Advances in Melanoma and Other Skin Cancers Research
- A retrospective study of changes in skin cancer characteristics over 11 years
- AADA – SKIN CANCER
- Mayo Clicin, Clinical Trials Skin Cancer
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