– ACADEMIC, SCIENTIFIC, CREATIVE –
WHAT ARE THE RISK FACTORS FOR SKIN CANCER?
- Prolonged sun exposure
- Sun burn at an early age
- Multiple sun burns
- Skin type (the fairer the skin type the higher the risk)
- Genetic factors
- Other environmental factors
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 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
- Atypical mole syndrome:
- Melanomas usually arise from existing nevi undergoing malignant transformation or arising de novo.
- Lesions appear as pigmented, atypical or ‘funny ‘ looking moles. ABCD
- 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.
- 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
Dr Dimitri Liakos is a member of the College of Plastic and Reconstructive Surgeons of South Africa and a member of the Association of Plastic, Reconstructive and Aesthetic Surgeons of South Africa (APRASSA).
He is a member of the World Society of Reconstructive Microsurgeons (WSRM) and the International Society of Aesthetic Plastic Surgeons (ISAPS).