Skin cancer is the most common type of cancer in general. A new or changing lesion, especially if symptomatic, warrants being evaluated by a professional.
Patients with fair skin, especially those who have had any blistering sunburns during the first 2 decades of life and patients who have received immunosuppressive therapy or transplantations are predominantly susceptible to develop skin cancers.
Basal Cell Carcinoma
Basal Cell Carcinoma is the most common type of skin cancer, occurring typically in exposed areas. Basal cell carcinomas have different shapes and colors that range from pink patches to pink pearly papules or brown papules with rolled borders.
Basal cell carcinomas can be locally destructive and invasive but rarely metastasize to lymph nodes or other organs.
Based on the size and microscopic features these tumors, Basal cell carcinomas can be treated with electrodessication and curettage (scrapping and burning) of the skin, excision with 4mm-5mm margins or micrographic (Mohs) surgery.
Actinic Keratosis and Squamous Cell Carcinoma
Actinic keratosis are gritty scaly pink skin lesions that occur on chronically sun-exposed areas. These lesions have pre-malignant potential and should be evaluated by an experienced dermatologist given its ability to turn into squamous cell carcinomas. Actinic keratosis can be treated with multiple modalities including cryotherapy with liquid nitrogen, topical agents like imiquimod, 5-fluorouracil, ingenol mebutate or photodynamic therapy.
Squamous cell carcinoma is a common type of skin cancer that predominantly occurs in sun-exposed areas. These skin cancers have the capacity of invading tissue and in some situations, they can metastasize to local lymph nodes or distant organs. A pink papule with scale or a non-healing ulcer show be promptly evaluated by a dermatologist as treating these lesions prematurely is much easier than treating advanced disease.
Treatment of squamous cell carcinoma depends on the depth of invasion and microscopic features. Superficial disease can be treated depending on the area with electrodessication and curettage, topical 5-fluorouracil, surgical excision with 4mm-5mm clinical margins or micrographic (Mohs) surgery.
Mole Checks, Dysplastic Nevi and Melanoma
Nevi (moles) are proliferations of melanocytes, or cells that give pigment to our skin/hair. Nevi can occur since birth (congenital nevi) or more commonly, can be acquired throughout the first 40 years of life.
Melanocytes are vulnerable to environmental factors including ultraviolet light, which induces mutations that lead to abnormal proliferations of these cells. Moles with acquired mutations can change color, size and appearance, prompting a dermatologic evaluation.
At Houston Dermatology and Plastic Surgery, we are committed to provide you with the most comprehensive skin exam. A complete skin exam includes the scalp, oral mucosa, breasts, ears, genital and anal area, palms, soles, fingers toes and lymph node palpation. Our doctors will always be accompanied by a chaperone, and will always make you feel comfortable.
We use dermoscopy (magnified examination with polarized light) to evaluate all suspicious lesions.
These are some guidelines to screen for abnormal moles:
- Asymmetry (one side of the mole does not match the other side)
- Borders (regular and well-defined borders are preferred)
- Color (single is better than multiple colors)
- Diameter (lesions >6 mm should always be screened)
- Evolving (lesions that have changed in size, texture, symptoms, that are itchy or bleeding should always be examined)
It is important that men and women with fair skin, history of multiple blistering/non-blistering sunburns, current or prior use of tanning beds, personal or family history of atypical moles or melanoma or those who have been treated with radiation or have had a transplant, should have a full body skin exam at least ONCE a year.