Central PA Medicine - Summer 2017 - 24

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Community, Health & Wellness

FIGURE 1

FIGURE 2

FIGURE 3

Figure 1: Example of a basal cell carcinoma. It is a pink pearly papule. Note skin cancers can have a variable appearance. If there is any question
about a lesion, please have primary care doctor or dermatologist evaluate. Figure 2: Example of an actinic keratosis. It is an ill-defined scaly thin patch.
Figure 3: Example of a squamous cell carcinoma. It is a hyperkeratotic papule with scale. Note skin cancers can have a variable appearance. If there is any
question about a lesion, please have primary care doctor or dermatologist evaluate.
tissue. Generally, skin cancers like BCC and
SCC are localized and do not spread to other
parts of the body (metastasize). Skin cancer
is typically diagnosed by a skin biopsy. Skin
cancers are sometimes treated with medicines,
but most often with a surgical modality.

most skin cancers

are preventable.
exposure to radiation, chemical carcinogens (coal
tar, soot and arsenic), certain viruses (HPV),
and immunosuppression (organ transplant,
hematologic malignancies). SCCs present as
pink, scaly plaques, papules, or nodules that can
bleed, become crusty, or blood-tinged (Figure
3). They can be painful. SCCs can be locally
invasive like BCCs. Aggressive SCCs that are
left untreated, though rare, can spread to lymph
nodes and other organs.

commonly used and confer the highest cure
rate. Mohs micrographic surgery (MMS) is a
specialized surgical method to remove qualifying
skin cancers such as BCCs and SCCs, usually
from the head and neck regions.

Basal cell carcinoma (BCC) is the most
common type of skin cancer. There are at least
4 million new cases of BCC diagnosed in the
US every year. They arise from the bottom
layer of the skin (epidermis). They tend to be
Follow up
slow growing and usually not life-threatening.
It is important after the diagnosis and treatHowever, significant destruction of the skin
ment of a nonmelanoma skin cancer to continue
and underlying tissue can occur if the BCC
to have routine skin examinations every 6-12
is not recognized and treated. Vital structures
months. The risk of developing another skin
such as eyes, ears, noses, may be lost. The most Diagnosis
cancer is much higher after the diagnosis of
common causative factor is UV light. BCCs
If you have a concerning new growth with the first one.
usually occur on chronically sun exposed skin. the above characteristics, have your primary care
It can appear as a new shiny, pink bump, pink physician or dermatologist evaluate the lesion. Prevention
patch with little blood vessels on the surface The diagnosis of skin cancer is confirmed with
It is never too late to start protecting yourself
or an ulcer that readily bleeds and does not a skin biopsy. It is typically an office procedure from the sun (the number one modifiable cause
heal (Figure 1).
done with local anesthesia. For BCCs and SCCs, of skin cancers). The most well known way to
your physician will usually remove a small protect yourself from the sun is sunscreen. It
Actinic keratoses (AKs) are atypical cells in portion of the questionable lesion and send it is recommended to apply a broad spectrum
the uppermost part of skin and are considered to the laboratory. The laboratory will process sunscreen with a sun protective factor (SPF) of
premalignant. Approximately 1 to 2% will the tissue and a pathologist will determine if 30 or higher. Other actions that can help protect
develop into SCCs but they can also resolve it is skin cancer.
the skin involve sun protective clothing (wide
on their own. They appear as ill defined, pink,
brim hats, long sleeves, sunglasses), avoidance
scaly ("sandpaper") thin papules or plaques Treatment
of midday sun (10 am to 2 pm), seeking shade
mostly in chronically, sun exposed areas (Figure
There are several ways to treat nonmelanoma (umbrella), and avoidance of tanning beds.
2). Lesions can be treated to prevent squamous skin cancers and these treatments are highly
cell carcinomas.
successful. Different treatment options are
Finally, most skin cancers are preventable.
tailored based on patient's preference and health With early detection and treatment, they are
Squamous cell carcinoma (SCC) is the the status, the lesion's location, the histology, and curable. Take the time to check your and your
second most common skin cancer. SCCs tend size of the lesion. Individualized treatment will love ones' skin for new skin growths and when
to arise in areas of chronic sun exposure or injury be selected based on the factors above to cure in doubt, seek evaluation from your primary
(burn scars). There are other risks factors such as the cancer. Surgical modalities are the most care physician or dermatologist.
24 Summer 2017 Central PA Medicine


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