Skin cancers are the most common malignancies in fair skinned individuals. They are categorized in melanoma and non-melanoma cancers. Non melanoma embraces squamous cell carcinoma and basal cell carcinoma as well. It’s observed that UV radiations have direct connection with the skin cancers which is more common in countries having sun exposure such as Australia. It also occurs in individuals who migrate there at a very young age below 10years.
It is known as the malignant tumour of melanocytes it is usually asymptomatic but patient can present with itching as the initial symptom. It has more prevalence in men mostly on the upper back where as in women it can occur on both back and legs. It is due to mutation in chromosome 9 that encodes for p1INK4A.
Risk factor for malignant melanoma :
- Sunlight is the most important risk factor.
- Hereditary factors mostly in 1st degree relatives.
- Dysplastic syndromes
- Xerodermatic pigmentation
- Male predominance.
Patient can present with these signs:
- Borders irregularity
- Colour changes
- Diameter more than 10mm
There can be some other clinical warning that are mentioned through our Essay Writing Services that includes signs such as expansion of pre-existing mole, irritating or aching in pre-existing mole, growth of new pigmented abrasion in mature life, irregular borders or variation of colors within pigmented lesion.
The malignant melanomas can further be divided into sub types such as:
- Superficial spreading melanoma which is the most common type.
- Accrual lentiginous melanoma: most commonly present in hands and feet.
- Nodular melanoma: poor prognostic tumour.
- Lentigo maligna melanoma: most commonly present on sun damaged skin of the face.
Surgery is the only curative treatment.
Melanoma less than 1mm= surgical excision with 1cm margin.
Melanoma more than 1mm = surgical excision with 3mm margin.
Basal cell carcinoma:
It is the most common skin malignancy. The incidence has dramatically increased over last 30 years and accounts for more than 70 percent cases.
It is a slow growing tumour, locally aggressive but rarely metastasize known as Rodent ulcer. It presents as pearly papules containing sub epidermal blood vessels known as telangiectasia.
- Chronic sun exposure.
- Lightly pigmented individuals.
- Xerodermatic pigmentosum
- Surgical excision with a 3-5mm border.
- Medical treatments are appropriate for low-risk superficial tumors. Topical 5 fluorouracil, topical photodynamic therapy or imiquimod are effective.
Squamous cell carcinoma:
It is the second most common skin malignancy. It also has minimum risk of metastasizing with human papilloma virus as its precursor.
The clinical presentation of SCC is diverse ranging from development of a painful keratosis nodule in a pre-existing area or DE novo presentation of a nodule that may ulcerate. It is usually present on bald scalp, top of ears, back of hands and face. It can metastasize to lips, ears or draining lymph nodes in immunosuppressed patients.
- UV light
- Arsenic exposure.
- Actinic keratosis
- Old burn scars
- Surgical excision
There is a good evidence available that regular sunscreen use of SPF 100 at least can prevent from squamous cell carcinoma to a larger extent and it can also play a preventive role for melanomas and basal cell carcinoma to a lesser extent. It is often difficult to distinguish benign lesions from skin cancers on clinical grounds. Benign melanocytic naevi and basal cell papilloma present same as melanoma. Histological studies play an important role in its diagnosis. There is no excision requirement for the benign lesions until they are inflamed or traumatized repeatedly. Photoprotection advice is necessary for fair skinned people.