Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each year and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.
The primary cause of skin cancer is ultraviolet radiation -most often
from the sun, but also from artificial sources like sunlamps and tanning booths.
You are at a higher risks of developing skin cancer if the following conditions are present:
-Fair skin and light-colored hair
-Freckle easily
-Large number of moles
-Moles of unusual size, shape or color
-Family history of skin cancer
-Excessive sun exposure
The most common type of skin cancer is basal cell carcinoma. It tends to grow very slowly and invade the neighboring skin, cartilage or bone. It very rarely spreads to lymph nodes or other organs in the body. Basal cell carcinoma is the least dangerous type of skin cancer.
A basal cell carcinoma usually presents as a firm raised nodule that may be white, pink or red. Often there is a history of partial healing with breakdown and subsequent bleeding.
Squamous cell carcinoma is the next most common type of skin cancer. It also tends to grow slowly. Most lesions appear on the lips, face or ears. In some cases, this cancer can spread to the surrounding lymph nodes.
Squamous cell carcinoma usually present as an irritated red lesion often with flaking of the skin. There may be ulceration or bleeding noted. A history of healing and subsequent breakdown is sometimes present.
Melanoma represents the third and most dangerous form of skin cancer. Fortunately, it is the least common type of cancer. If this cancer is detected early, when it is small, it may be cured. However, this cancer has a tendency to spread to lymph nodes and distant organs, often with fatal consequences.
Typical appearance of malignant melanoma
Melanoma is usually recognized by the "ABCD" rule.
"A" -Asymmetry of growth
"B" -Border irregularity, uneven edges
"C" -Color changes, brown, black, tan or red
"D" -Diameter more than 6mm across
There are a variety of skin lesions that must de distinguished from skin cancer. These are benign moles and keratoses. Moles or birthmarks are pigmented lesions, which are present on everyone's skin. They are often present since birth, although some develop as we grow. Keratoses usually grow in response to skin damage and aging. Some of these lesions are benign (seborrheic keratoses) while others are thought to be precancerous (solar keratoses).
It may be possible to distinguish these lesions based upon a careful physical examination, In many cases, a skin biopsy must be done to obtain a definitive diagnosis.
For any of the skin cancer types, the optimal treatment is complete eradication of the cancer. For most patients this involves surgical excision of the tumor with a margin of normal non-involved skin. It is important that a thorough a pathologic examination is done to assure complete removal of the skin cancer.
Depending upon the location and type of skin cancer, Dr. Bromley will determine the amount of skin that will be removed to insure a cure. Following the excision, reconstruction of the resulting defect is planned.
For some patients a simple closure of the incision will suffice. In other cases, rearrangement of the surrounding skin is performed to fill in and reconstruct the defect that was created. Still other cases necessitate closure of the defect with a distant skin graft. In all cases, the primary concern is complete removal of the skin cancer. However, it is also vitally important that post-operative disfigurement is minimized. For most patients, the skin cancer removal and reconstruction should leave a minimally noticeable scar.
For small lesions, an excision and simple closure can be done. This will result in a fine scar.
Once a skin cancer has been removed it is essential that the physician and patient monitor the excision site and the remainder of their skin to detect recurrence of the cancer or a new cancer.
If you have any questions regarding the treatment of skin cancer, or any other plastic surgical procedure, please contact our office. Photo galleries, in addition to 3D animation of this procedure can be found at the American Society of Plastic Surgeons website.
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