Skin Cancer Awareness
Skin cancer is the most common type of cancer in the United States. Our board-certified dermatologists at Dermatology Associates, PA are well-trained in the diagnosis and treatment of skin cancers. All surgical treatments are performed on-site in our well-equipped surgical suites. Below are examples of the most common types of skin cancer.
Types of Skin Cancer
Basal Cell Carcinoma (BCC)
Basal Cell Carcinoma (BCC) is the most common malignancy in humans. It usually occurs on sun-exposed skin in patients with a history of chronic sun exposure. These skin cancers are typically slow-growing and rarely spread to other areas of the body. If neglected, BCC can be locally invasive and disfiguring. BCC usually presents as a non-healing waxy sore with a pearly appearance. Bleeding and erosion are fairly common, as are fine blood vessels (telangiectasia) on the surface of the lesion.
Treatment usually consists of surgical removal in our office. Most lesions are treated with simple surgical excision. Mohs surgery is an advanced technique used at Dermatology Associates, PA for the microscopically controlled removal of aggressive or difficult lesions. Topical immunotherapy with Imiquimod (Aldara) can be used for superficial lesions.
Squamous Cell Carcinoma (SCC)
Squamous Cell Carcinoma (SCC) of the skin is the second most common form of skin cancer. SCC is much more common in areas with a high level of lifetime sun exposure. Aggressive forms of SCC can metastasize (spread) to other areas of the body. Most SCC arise from pre-cancerous lesions called actinic keratoses. These lesions are common on sun-exposed skin in fair-skinned individuals. Treatment of actinic keratoses with liquid nitrogen can prevent progression to SCC. SCC usually presents as a non-healing crusty patch or nodule that is painful.
Treatment consists of surgical removal in most cases. Nearly all cases can be treated on-site.
Malignant Melanoma is the least common of skin cancers, but the most feared because of its potential to spread to other areas of the body. Melanoma accounts for only 4% of all skin cancers; however, it causes the greatest number of deaths from skin cancer.
Melanoma can arise from a pre-existing mole, or can arise on normal appearing skin. Intense, intermittent sun exposure has been linked to the development of melanoma. Fair complexion, a history of blistering sunburns, a family history of melanoma and a large number of moles are other risk factors for melanoma. The current lifetime risk for developing melanoma is a startling one case per 65 Americans and this number continues to rise. It is important to recognize the early warning signs of melanoma. One successful method is the use of the ABCDE criteria:
A = Asymmetrical Shape
B = Border Irregularity
C = Color Variation / Uneven Color Distribution
D = Diameter
E = Evolution / Changes
The most common early symptom of melanoma is itching. Melanoma is easily cured by surgical excision if it is detected early. Prognosis is closely related to the microscopic thickness of the melanoma at the time that it is removed. Melanomas that have spread to other body areas remain very difficult to treat.
Surgical Treatment of
Excision: For severely abnormal moles, larger skin cancers, or invasive skin cancers, your dermatologist will most often recommend an excision. This procedure will take about 30 minutes and is performed in the office using local anesthetic. After cleaning and numbing the skin, your dermatologist will remove (excise) the abnormal skin with margins of normal skin around the lesion. Usually, sutures will be placed that need to be removed in 5-14 days depending on the location. You will need to limit your activity while sutures are in place. Most patients will only need Tylenol after the procedure. In some cases, your physician will prescribe you an antibiotic to take before or after the surgery.
Electrodessication and Curretage (ED&C): ED&C is an appropriate treatment for some superficial (shallow) skin cancers. The procedure typically takes about 10 minutes. After cleaning and numbing the skin, your dermatologist will remove (curette) abnormal appearing skin around the biopsy site and cauterize the affected area. You will not require any sutures and most people heal in 2-4 weeks depending on the location of the skin cancer.
The precise removal of skin cancer while preserving the greatest amount of healthy skin.
Mohs Micrographic Surgery is an outpatient form of skin cancer removal that is used for more aggressive skin cancers, skin cancers in locations that require tissue sparing techniques, or recurrent skin cancers. This form of surgery provides a very high cure rate. The greatest advantage of Mohs Surgery is that the entire margin or area around the skin cancer is evaluated microscopically at the time of removal. This method allows for precise removal of the skin cancer while preserving the greatest amount of normal skin. When arriving for Mohs Survery, the patient will be taken to our Mohs Operating Suite. After local anesthetic is administered, a layer of tissue around the cancer is removed and specially prepared for microscopic evaluation. The patient is then bandaged while the specimen is processed. This part of the procedure usually takes 30-90 minutes, depending on the size of the lesion. The Mohs surgeon will then evaluate all of the margins of the skin cancer. If the tumor is still present at a tissue edge, that area is mapped out and only that area is reexcised. When the Mohs surgeon determines that all of the skin cancer has been removed, reconstruction options will be discussed.
The dermatologists at Dermatology Associates, PA will be glad to discuss the various treatment options for skin cancer removal. Mohs Surgery is not indicated for all skin cancers, but it is an important and valuable service that we are pleased to provide when needed.
The visible lesion and a small segment of surrounding skin are removed
The removed tissue is examined under a microscope for cancer cells
If cancer cells are found, thin layers of skin continue to be removed and examined
The removal process continues until no more cancer cells are found
Our providers are expertly trained in the diagnosis and treatment of skin conditions, including the following