Skin cancers are malignant tumors of any one of the many skin cell types. These growths stem from an uncontrolled cellular proliferation which eventually gives rise to the tumor (growth). Skin cancer can be superficial or deep (infiltrative) depending on the depth of invasion of the abnormal cells.
The most common forms of skin cancer are:
Bacal cell carcinoma (BCC):
These are very common, locally invasive tumors deriving from keratinocytes. Risk factors include sun damage, repeated sunburns, fair skin. There are also several rare genetic familial syndromes (Gorlin, Bazex-Dupre-Christol syndromes).
Although BCCs rarely, if ever, metastasize they tend to grow and cause local tissue destruction. Therefore early diagnosis and proper treatment are essential.
Treatment generally depends on location, size, type of tumor and patient’s preference.
Options include:
Surgical excision, cryotherapy, PDT and topical creams (for superficial tumors).
Squamous cell carcinoma (SCC):
An SCC is a common type of keratinising tumor and it is an invasive type of cancer. That means the abnormal cancerous cells have invaded the deeper layers of the skin and have now the ability to metastasize and prove fatal.
Risk factors include sun damage, immunosuppression (e.g. organ transplant recipients), previous skin injuries (non-healing ulcers), smoking and fair skin type.
Treatment will depend on staging of the tumor but generally involves surgical excision, radiotherapy and/or immunotherapy (Cemiplimab).
Melanoma:
Melanoma is the most serious and potentially fatal type of skin cancer. It stems from uncontrolled proliferation of pigment cells (melanocytes). It can develop anywhere on the skin (including nails) as well as, more rarely, the eyes (uveal melanoma). Melanoma can be superficial, invasive or metastatic. Treatment and management of melanomas is rapidly evolving. It depends on staging and the type of melanoma and generally involves surgical excision and chemo/immunotherapy.
Risk factors include ageing, UV exposure, fair skin type (phototype I-II), number of sunburns (especially in childhood). Number of moles has also been recognised as a risk factor with those with a large number of moles being at higher risk.
Although melanomas do derive from previous “normal” moles, it is very important to emphasize that the majority of melanomas develop de novo, i.e on previously healthy skin. Therefore although monitoring of changing moles is essential, spotting “new” lesions on the skin is equally important for early diagnosis and thus a more favorable prognosis.