Skin Cancer

WHAT ARE THE TYPES OF SKIN CANCER?

Basal cell cancer (BCC)

• BCC is the most common type of skin cancer. It is usually found on the face and limbs (sun exposed areas), 26% occur on the nose.
• 95% of cases occur between 40-79 years of age.
• They usually present as a flesh-coloured, pearly nodule, in time these nodules may ulcerate.
  They may also present as a lesion which may be mistaken for eczema or fungal infection, or an ‘enlarging scar’.
• Treatment includes a number of modalities, however excision is the mainstay of treatment.

Squamous cell carcinoma (SCC)

• SCC is the second most common skin cancer after BCC. They occur mainly in sun-exposed areas in the face and the body. However, they may arise in other areas of the body from predisposed lesions in the genital area or oral mucosa.
• Lesions usually present as non-healing ulcers or as a scaly irregular lesion.
• Treatment includes surgery, radiation and other non-surgical modalities.
• SCC is more dangerous than BCCs as they have a tendency of spreading to lymphatic system and lymph nodes.

Melanoma

• Melanoma is a cancer of the melanocytes in the skin (the cells responsible for pigmentation in the skin).
• Melanoma is a significant clinical problem with increasing morbidity and mortality.
• Risk factors:
  • UV exposure
  • Increasing age (> 50)
  • Family history
    • Risk may be 8 times higher in a positive family history
  • Phenotype I-II
    • Light skin colour
    • Light hair colour
  • Predisposing conditions:
    • Atypical mole syndrome:
      • More than 100 naevi (moles) 6-15 mm
      • 1 or more larger than 8mm
      • 1 or more with atypical features
      • Nevi present at birth and increase in number around puberty
    • Dysplastic naevus
• Presentation:
  • Melanomas usually arise from existing nevi undergoing malignant transformation or arising de novo.
  • Lesions appear as pigmented, atypical or ‘funny ‘ looking moles. ABCD
    • Asymmetry
    • Border irregularity
    • Color variegation
    • Diameter more than 6mm
  • NB lesions may be NON- pigmented and therefore careful screening is mandatory especially with the above listed risk factors.
• Treatment:
  • This involves a multi-disciplinary team, which includes surgeons, oncologists and radiation oncologists.
  • The type of surgery depends on the thickness of the melanoma but typically includes a wide resection of the lesion and possibly a sentinel lymph node biopsy.
  • Depending on the extent of the melanoma, treatment may also include chemotherapy.
  • Preventing skin cancer:
    • Always wear sunscreen (SPF 50)
    • Know your family history
    • Regular medical screening