Types of Skin Cancer

Board-certified dermatologists are trained to identify subtle skin lesions that may indicate skin cancer. Devices such as dermatoscopes allow dermatologists to evaluate features of skin lesions that are not easily seen by the naked eye. A dermatoscope is a hand-held visual aid device a provider can use to examine and diagnose skin lesions and diseases, such as melanoma. If there is suspicion of skin cancer, a biopsy may be warranted; in such cases, a board-certified dermatopathologist will microscopically evaluate the lesion with greater scrutiny.

Two main groups account for many cancers that originate in the skin: non-melanoma skin cancers (NMSC) and Melanoma. The two most common NMSCs are basal cell carcinoma and squamous cell carcinoma. Basal cell carcinomas comprise nearly 80% of skin cancers, followed by 16% for squamous cell carcinoma and 4% for melanomas (3). Most skin cancers have a good prognosis if caught early.

BCC is the most common type of skin cancer. The average lifetime risk to develop BCC for those with light or fair complexions is about 30% (4). It is slow-growing and rarely spreads to other areas of the body. But if undiagnosed and untreated, it can grow deep and destroy local tissues, like cartilage and bone. Although BCC is common in fair skinned individuals, it can occur in people of any skin type.

BCC develops on skin exposed to the sun for years and from tanning bed use caused by ultraviolet radiation. It is usually found on the face, chest, neck, and back of the hands but can occur on any part of the body exposed to the sun. A BCC resembles a flesh-colored, pearly bump or pinkish skin patch frequently found on the nose, eyelids, cheeks, and lips.

SCC is the second most common type of skin cancer. It develops on unprotected skin exposed to intense, long-term sun and tanning bed ultraviolet radiation. SCC can spread to other parts of the body and disfigure the affected area. SCC is associated with your immune system putting you at risk for deadly complications. When caught early, it can be treated with favorable outcomes.

SCC commonly develops on the face, ears, neck, chest, lips, back of the hands, and legs. It can also develop on the genitals, in burns, scars, ulcers, and in areas exposed to x-rays and chemicals. Women often get SCC on their legs, but it can develop anywhere on skin that is exposed to long-term ultraviolet radiation. Indoor tanning increases the risk of most all forms of skin cancer.

SCC lesions may appear as firm, red bumps, scaly patches, or sores that won’t heal. It can also appear as raised growths with a depressed center, wart-like growths, or flat with minor skin changes.

Other than long-term intense UV radiation, risk factors include:

• A prior BCC or SCC
• A family history of SCC
• A family history of Melanoma
• Age

SCC is commonly found in areas of aesthetic importance like the face and ears. Minimally invasive surgical procedures such as Mohs surgery, spares healthy tissues, reduces the risk of recurrence, and produces good aesthetic outcomes.

Melanoma is the deadliest form of skin cancer. It can appear as a newly formed pigmented lesion or from a pre-existing mole or birthmark. Melanomas can form virtually anywhere on the skin, including the palms and soles, underneath nails, the mouth, genitals, and eye.

Everyone is at risk for developing Melanoma, but people with a family history of melanoma are at a 10% increased risk. When a first-degree relative, such as a mother, father, sister or brother, has melanoma, the risk increases to a 50% chance of developing this disease. (5)

Other risk factors include:

• Experiencing even a single blistering sunburn in childhood
• Residing in warm, sunny climates year-round
• Using tanning beds
• Being fair skinned with light eye color, and having blond or red hair
• Having a large number of moles

One in 27 men and one in 40 women will develop melanoma during their lives. (6) When treated early before spreading, the five-year survival rate of melanoma is nearly 99% Awareness of risk factors and good sun protection are important first steps. Routine skin examinations by a board-certified dermatologist are essential for closely evaluating and monitoring suspicious lesions.

When melanoma has spread to the lymph nodes, the five-year survival rate falls to 64%. When melanoma has spread to a distant site, the five-year survival rate drops to 23%. A delay in treating melanoma significantly increases the risk of death.